Effects Of Bisoprolol In Patients Research Articles

A Comparative Study to Investigate the Effects of Bisoprolol in Patients with Chronic Heart Failure and Hypertension When Switched from Tablets to Transdermal Patches.

Oral beta-blockers are effective for heart failure and hypertension. Here, we conducted a prospective study to investigate the efficacy of the beta-blocker bisoprolol in patients switching from the oral tablet to the transdermal patch. We studied 50 outpatients receiving oral bisoprolol for chronic heart failure and hypertension. After patients switched treatments, we measured heart rate (HR) over 24 h by Holter echocardiography as the primary endpoint. Secondary endpoints were (1) HR at 00:00, 06:00, 12:00, and 18:00, (2) the total number of premature atrial contractions (PACs) over 24 h and the incidence rate per time segment, and the total number of premature ventricular contractions (PVCs) over 24 h and the incidence rate per time segment, (3) blood pressure, (4) atrial natriuretic peptide and B-type natriuretic peptide, and (5) echocardiography. Minimum, maximum, mean, and total HR over 24 h was not significantly different between the two groups. Mean and maximum HR at 06:00, total PACs, total PVCs, and PVCs at 00:00 to 05:59 and 06:00 to 11:59 were significantly lower in the patch group. Compared with oral bisoprolol, the bisoprolol transdermal patch lowers HR at 06:00 and inhibits the onset of PVCs during sleep and in the morning.

Effects of bisoprolol in patients with stable congestive heart failure

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. But de l'étude. – Analyser l'effet du bisoprolol chez des patients suivis pour une insuffisance cardiaque stable et tolérant les bêtabloquants. Matériel et méthodes. – Deux cent un patients ont bénéficié avant et trois mois après l'obtention de doses maximales tolérables de bisoprolol, d'une évaluation clinique et paraclinique comprenant une échographie cardiaque, une mesure isotopique des fractions d'éjection, une épreuve d'effort et des dosages hormonaux. Résultats. – La dose moyenne de bisoprolol est de 8,8 ± 2,4 mg/jour. La classification de la NYHA s'améliore. La fréquence cardiaque de repos passe de 87 ± 17 à 66 ± 12 batts/minute ( p < 0,0001) sans effet sur les paramètres électrocardiographiques. La fraction d'éjection du ventricule gauche passe de 31 ± 11 à 41 ± 13 % ( p < 0,0001), avec une diminution significative des diamètres et des volumes télédiastoliques et télésystoliques du ventricule gauche. Le profil mitral s'améliore. Le pic de VO 2 passe de 16,1 ± 5 à 16,8 ± 5,5 ml/minute par kilogramme ( p = 0,001) avec une augmentation significative du pouls d'O 2 (de 8,52 ± 2,7 à 11,2 ± 3,5 ml/minute par battement, p < 0,0001). Les taux plasmatiques de peptides natriurétiques A et B et de norépinéphrine diminuent significativement après bisoprolol. Conclusions. – Le bisoprolol améliore significativement la fraction d'éjection du ventricule gauche avec un remodelage favorable du ventricule gauche, une diminution de l'activation hormonale et une discrète amélioration des capacités d'effort.

Effects of bisoprolol in patients with stable congestive heart failure

To analyze the effect of bisoprolol in patients with stable congestive heart failure and who tolerated beta-blockers. 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. 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 profile improved. Peak VO2 increased from 16.1 +/- 5 to 16.8 +/- 5.5 ml/min/kg (P = 0.001) with a significant increase in O2 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. 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.

Effects of bisoprolol in patients with severe heart failure in combination with essential hypertension

Effects of bisoprolol in patients with severe heart failure in combination with essential hypertension

Multicenter Evaluation of the Hemodynamic Effects of Bisoprolol in Patients with Mild to Moderate Hypertension

Twenty-six patients with mild-to-moderate essential hypertension participated in a 6-week outpatient, multicenter, randomized, double-blind, placebo-controlled two-way crossover study to assess the hemodynamic effects of bisoprolol (20 mg QD) at steady state. Hemodynamic assessments included sitting blood pressure, heart rate, and left-ventricular ejection fraction by radionuclide ventriculography after 7 days of bisoprolol or placebo at trough (24 h post-dose) and peak (3 h post-dose) values. The group adjusted mean ejection fraction was not significantly different in patients receiving bisoprolol compared with the placebo group at either peak or trough measurements; in fact, means in patients taking bisoprolol were slightly higher than in the placebo group. No symptomatic hypotension was documented. Blood pressure, measured 24 hours after dosing, was significantly lower in those receiving bisoprolol when compared with the placebo group, by 7.7 mm Hg and 9 mm Hg for diastolic and systolic blood pressure, respectively. Similarly, mean values of heart rate were 10 beats/min lower in the bisoprolol patients than in the placebo group. Only headache and insomnia occurred as adverse events. Bisoprolol (20 mg QD) effectively lowered blood pressure over a 24-hour period without significantly reducing ejection fraction or causing adverse clinical or biochemical events.

Haemodynamic Effects of Bisoprolol in Patients with Coronary Heart Disease: Influence of Various Bisoprolol Plasma Concentrations

The aim of this study was to investigate the haemodynamics of the beta 1-selective beta-blocker bisoprolol at plasma concentrations that would be expected to block completely the cardiac beta-receptors. Seven patients with stable exercise-dependent angina pectoris received 40 mg bisoprolol, and six patients received 10 mg bisoprolol orally as a single dose. Before and 1.5 h after administration, the following parameters were measured at rest and during physical exercise within the framework of an invasive diagnostic investigation: cardiac output, blood pressure in the systemic and pulmonary circulation, heart rate, and ST-segment change. Further haemodynamic factors were derived from these parameters. Before beta-blockade, the change from rest to exercise resulted in an increase in heart rate, blood pressure, and cardiac index, and also in an increase in pulmonary capillary wedge pressure as an indication of ischaemically induced left-ventricular dysfunction. After 40 mg bisoprolol, under exercise conditions, the cardiac index decreased as a consequence of reduced heart rate, and the mean pulmonary capillary wedge pressure increased slightly, compared with baseline. This finding was attributable to clearer changes in three patients; however, as an overall result, an improvement of oxygen consumption also was achieved in these patients. Measured by reduction in cardiac index, no appreciable increase in effect was achieved at bisoprolol plasma concentrations greater than 60 ng/ml. In angina pectoris patients, bisoprolol possesses the typical haemodynamic profile of a beta-adrenoceptor antagonist. There was no indication of a beta-blockade-independent negative inotropic effect of bisoprolol. Forty mg bisoprolol was shown to be an unnecessarily high dose. It may be deduced that the therapeutic dose range of bisoprolol is between 5 and 20 mg.