SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Effects of nebivolol on biomarkers in elderly patients with heart failure.

Taneja, AK; Gaze, D; Coats, AJS; Dumitrascu, D; Spinarova, L; Collinson, P; Roughton, M; Flather, MD; SENIORS Investigators (2014) Effects of nebivolol on biomarkers in elderly patients with heart failure. Int J Cardiol, 175 (2). pp. 253-260. ISSN 1874-1754 https://doi.org/10.1016/j.ijcard.2014.05.018
SGUL Authors: Collinson, Paul

[img] Microsoft Word (.doc) Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (439kB)

Abstract

BACKGROUND: Heart failure activates neurohormones, and elevated levels of brain natriuretic peptide (BNP) are associated with adverse outcomes. The SENIORS trial showed that nebivolol, a highly selective beta-1 antagonist with vasodilating properties, reduced the composite outcome of all cause mortality or cardiovascular hospital admissions in older patients with heart failure. We explored the effects of nebivolol on a range of neurohormones, cytokines and markers of nitric oxide activity in heart failure. METHODS: In a subset of patients in SENIORS we measured N-terminal pro-brain natriuretic peptide (NT-BNP), pro atrial natriuretic peptide (Pro-ANP), endothelin-1 (ET-1), peripheral norepinephrine (PNE), soluble Fas (sFas), soluble Fas-ligand (sFas-L), tumour necrosis factor-alpha (TNF-α), serum uric acid (SUA), symmetrical dimethyl arginine (SDMA), arginine, citrulline and asymmetrical dimethyl arginine (ADMA) at baseline (before study drug), at 6 months and 12 months in a prespecified substudy. RESULTS: One hundred and six patients were enrolled and 75 had a baseline and at least one follow-up sample. There were no significant differences in neurohormone cytokines or nitric oxide markers measured between the two groups at six or twelve months. NT-ProBNP showed a numerical increase in the nebivolol group compared to placebo (P=0.08) and sFas showed a numerical increase in patients on placebo (P=0.08). Mean baseline LVEF was 35% in both groups and at 12 months was 43% on nebivolol group and 34% on placebo group (P=0.01). CONCLUSION: There were trends but no clear changes associated with nebivolol in neurohormones, cytokines or markers of nitric oxide activity in this study of elderly patients with heart failure. Further studies are needed to understand the mechanistic effects of beta blockers on biomarkers in heart failure.

Item Type: Article
Additional Information: © 2014. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Beta blockers in heart failure, NT-Pro BNP and beta blockers, Nebivolol, Neurohormones, SENIORS substudy, Adrenergic beta-1 Receptor Antagonists, Aged, Aged, 80 and over, Benzopyrans, Biomarkers, Cytokines, Double-Blind Method, Ethanolamines, Female, Heart Failure, Humans, Internationality, Male, Nebivolol, Neurotransmitter Agents, Treatment Outcome, SENIORS Investigators, Humans, Ethanolamines, Benzopyrans, Neurotransmitter Agents, Biological Markers, Cytokines, Treatment Outcome, Double-Blind Method, Internationality, Aged, Aged, 80 and over, Female, Male, Heart Failure, Adrenergic beta-1 Receptor Antagonists, Beta blockers in heart failure, Neurohormones, SENIORS substudy, Nebivolol, NT-Pro BNP and beta blockers, Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Cardiovascular System & Cardiology, Beta blockers in heart failure, Neurohormones, SENIORS substudy, Nebivolol, NT-Pro BNP and beta blockers, LEFT-VENTRICULAR DYSFUNCTION, BRAIN NATRIURETIC PEPTIDE, NITRIC-OXIDE RELEASE, BETA-BLOCKADE, CARVEDILOL THERAPY, ENDOTHELIAL-CELLS, NT-PROBNP, MECHANISM, BLOCKERS, PREDICTION, Cardiovascular System & Hematology, 1102 Cardiovascular Medicine And Haematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cardiac (INCCCA)
Journal or Publication Title: Int J Cardiol
ISSN: 1874-1754
Language: eng
Dates:
DateEvent
1 August 2014Published
17 May 2014Published Online
11 May 2014Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
PubMed ID: 24877590
Web of Science ID: WOS:000340249400013
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108950
Publisher's version: https://doi.org/10.1016/j.ijcard.2014.05.018

Actions (login required)

Edit Item Edit Item