S. Witchitz et al., Treatment of heart failure with Celiprolol, a cardioselective beta blockerwith beta-2 agonist vasodilatory properties, AM J CARD, 85(12), 2000, pp. 1467-1471
Citations number
28
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Treatment with beta blockers results in improvement in functional status, a
nd reduces mortality in patients with heart failure, A number of difference
s in the results noted could be due to additional properties of the specifi
c beta blockers studied: absence of cardioselectivity, and existence of a v
asodilator effect and of an associated antioxidant effect, We studied the e
ffects of celiprolol, a cardioselective beta blocker with a stimulant effec
t on beta 2 receptors. One hundred thirty-two patients presenting with chro
nic heart failure of various etiologies, with an ejection fraction of <40%
and New York Heart Association cardiac functional status grades II acid III
were included in a randomized, double-blind, placebo-controlled study. The
maximum dose of celiprolol (100 mg) was attained after 1 month. The study
lasted 1 year. The primary evaluation criterion was functional class as eva
luated using the Goldman questionnaire. There was no difference in efficacy
between the 2 treatment groups in terms of functional class (p = 0.56). Wi
th regard to the secondary evaluation criteria, an improvement in DiBianco
functional score was seen with celiprolol (p = 0.03), as well as a signific
ant reduction in heart rate (p = 0.01). Ejection fraction increased in both
groups (p = 0.15). There was no difference regarding improvement in left v
entricular volume as determined at echocardiography or in exercise capacity
. The safety profile of celiprolol was excellent. There was no difference i
n terms of cardiovascular mortality (2 receiving celiprolol vs 4 placebo),
onset of arrhythmias (2 receiving celiprolol vs 3 placebo), worsening of he
art failure (26 receiving celiprolol vs 23 placebo), or noncardiovascular a
dverse events (9 receiving celiprolol vs 14 placebo). The absence of a sign
ificant efficacy of celiprolol, a beta blocker with vasodilator properties,
but exerting stimulation of beta 2 receptors, suggests an unfavorable role
of this latter property in heart failure. However, the safety profile of c
eliprolol was excellent. This beta blocker may consequently be used for its
other indications, hypertension and angina, in patients presenting with al
tered cardiac function. (C) 2000 by Excerpta Medico, Inc.