Eff ect of nebivolol and carvedilol on the functional state of patients with chronic heart failure and preserved left ventricular ejection fraction

Objective. Compare the eff ect of combination therapy with nebivolol or carvedilol on the functional state of patients with chronic heart failure (CHF) and preserved ejection fraction (pEF) of the left ventricle (LV). 
Material and methods. The study involved 80 patients with diastolic CHF, who were randomized into two groups. In group I was appointed of nebivolol (7.7 ± 2.4 mg/day, n = 40), in group II — carvedilol (30.5 ± 8.7 mg/day, n = 40). As part of the combination therapy, quinapril was prescribed (13.7 ± 2.7 mg/day, n = 40 and 13.5 ± 2.6 mg/day, n = 40), and if indicated — atorvastatin (15.3 ± 4.6 mg/day, n = 17 and 16.2 ± 5.2 mg/day, n = 17) and acetylsalicylic acid in the intestinal soluble shell (96.4 ± 13.4 mg/day, n = 14 and 93.8 ± 13.3 mg/day, n = 13), respectively. Initially and after 6 months of therapy were carried out: quantitative assessment of regulatory-adaptive status (RAS) (by means of a sample of cardiac-respiratory synchronism), echocardioscopy, treadmill test, test with a six-minute walk, subjective assessment of quality of life, determination of the level of the N-terminal fragment of the brain natriuretic peptide in blood plasma, daily monitoring of blood pressure. 
Results. Both schemes of combined therapy comparably improved the structural and functional state of the heart, controlled arterial hypertension. In comparison with carvedilol, nebivolol diff ered positive eff ect on the RAS, more increased tolerance to physical activity and improved quality of life. 
Conclusion. In patients with CHF pEF LV in combination therapy, the use of nebivolol, in comparison with carvedilol, may be preferable due to the more pronounced positive eff ect on the functional state.

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