Evaluation of the effect of bisoprolol and carvedilol on the functional status of patients with chronic heart failure and preserved left ventricular ejection fraction

Background. Chronic heart failure (CHF) is the most common outcome of cardiovascular diseases, primarily arterial hypertension and coronary artery disease. Beta-blockers provide correction of arterial hypertension, reduce myocardium remodeling, exhibit antianginal and antiarrhythmic effects, and slow down the progression of CHF. At the same time, bisoprolol and carvedilol, differing in their phar-macochemical properties, can influence the functional status in different directions. Objective. Determination of the effect of combination therapy with bisoprolol or carvedilol on the functional status of patients with CHF and preserved left ventricular ejection fraction (pLVEF). Methods. The study involved 80 patients with CHF and pLVEF, who were randomized into two groups for treatment with bisoprolol or carvedilol. As part of the combination therapy, quinapril was prescribed, if indicated - atorvastatin, enteric-coated acetylsalicylic acid. At baseline and 24 weeks after therapy, quantitative assessment of the regulatory adaptive status (RAS), echocardioscopy, treadmill test, 6-minute walking test, subjective assessment of quality of life, and determination of the N-terminal pro brain natriuretic peptide level were performed. Results. Both schemes of combination therapy improved the structural and functional parameters of the heart, increased exercise tolerance, and controlled arterial hypertension. Compared to bisoprolol, carvedilol had a positive effect on RAS and improved the quality of life to a greater extent. Conclusion. In patients with CHF and pLVEF, carvedilol as part of combination therapy may be preferable to bisoprolol due to its positive effect on functional state.

functional status, bisoprolol, carvedilol, regulatory and adaptive status, chronic heart failure