Abstract
Aim of the study. – To analyze the effect of bisoprolol in patients with stable congestive heart failure and who tolerated beta-blockers. Material and methods. – Two hundred and one patients performed before and 3 months after maximal tolerated doses of bisoprolol have been reached, a clinical evaluation, an echocardiography, a radionuclide angiography, a cardiopulmonary exercise test and hormonal determinations. Results. – Mean dose of bisoprolol was 8.8 ± 2.4 mg/d. Patients had a significant improvement in NYHA classification. Heart rate at rest decreased from 87 ± 17 to 66 ± 12 beats/min ( P < 0.0001) without any effect on electrocardiographic parameters. Left ventricular ejection fraction improved from 31 ± 11 to 41 ± 13% ( P < 0.0001), with a significant decrease in end-diastolic and end-systolic left ventricle diameters and volumes. Mitral profil improved. Peak VO 2 increased from 16.1 ± 5 to 16.8 ± 5.5 ml/min/kg ( P = 0.001) with a significant increase in O 2 pulse (from 8.52 ± 2.7 to 11.2 ± 3.5 ml/min/beats, P < 0.0001). Plasma levels of A-type and of B-type natriuretic peptides and of norepinephrine significantly decreased after bisoprolol. Conclusions. – Bisoprolol significantly improved left ventricle ejection fraction with a reverse remodeling of the left ventricle, a decrease in hormonal activation and a modest improvement in exercise capacity.
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