Protective effects of bisoprolol against myocardial injury and pulmonary dysfunction in patients with chronic heart failure

Abstract Objectives This study was designed to elucidate differences in effects of 2 beta blockers, bisoprolol and carvedilol, in patients with chronic heart failure. Background Although the beta blockers bisoprolol and carvedilol are commonly used in patients with chronic heart failure, differences in the efficacy and safety of these medications have not been established in this patient population. Methods Patients with chronic systolic heart failure, defined as ≤45% ejection fraction, who had received intensive medical therapy with the exception of beta blockers, were randomly assigned to receive either bisoprolol or carvedilol for 24weeks. Results A total of 67 patients were enrolled in the study (bisoprolol: 38 patients, carvedilol: 29 patients). No difference was observed in the improvement of NYHA class, ejection fraction, or N-terminal pro-brain-type natriuretic peptide level between groups. In contrast, the level of high sensitivity troponin T decreased in the bisoprolol group [−4.1±0.9 to −4.5±0.8 log (ng/ml), P=0.003], but did not change in the carvedilol group [−4.4±1.1 to −4.6±0.8 log (ng/ml), P=0.161]. Forced expiratory volume in the first second increased in the bisoprolol group [2.26±0.70 to 2.40±0.70 (L), P=0.014], but did not change in the carvedilol group [2.53±0.71 to 2.59±0.78 (L), P=0.127]. Conclusion Bisoprolol might be superior to carvedilol in providing protection from myocardial injury and preserving pulmonary function in patients with chronic systolic heart failure.