Objective To determine the possible association of anti-β1-adrenergic receptors(anti-β1-AR), anti-β2-AR and anti-α1-AR with carvedilol treatment in patients with heart failure(HF). Methods A total of 267 HF patien...Objective To determine the possible association of anti-β1-adrenergic receptors(anti-β1-AR), anti-β2-AR and anti-α1-AR with carvedilol treatment in patients with heart failure(HF). Methods A total of 267 HF patients were prospectively enrolled. Blood samples were measured by an enzyme-linked immunosorbent assay. All of the patients received carvedilol for their HF. Each patient was followed up for six months and their cardiac function was measured. Results The final analysis encompassed 137 patients comprising 65 patients with three autoantibodies(positive group) and 72 patients without all three autoantibodies but with one or two autoantibodies(negative group). The frequency and geometric mean titer of anti-β1-AR, anti-β2-AR, and anti-α1-AR were significantly lower in the group without all three autoantibodies after six months of carvedilol treatment(all P < 0.01;from 100% to 57%, 50%, and 49%, respectively;and from 1: 118, 1: 138, and 1: 130 to 1: 72, 1: 61, and 1: 67, respectively). Furthermore, 28 patients in the positive group demonstrated complete ablation of autoantibodies. In addition, left ventricular remodelling and function was significantly improved by the use of carvedilol combined with the standard treatment regime for six months in the positive group(P < 0.01) when compared to the negative group(P < 0.05). Conclusions Carvedilol treatment significantly decreases frequency and geometric mean titer in patients with all three autoantibodies, even up to complete ablation, and significantly improved cardiac function and remodelling. The effect of carvedilol is probably correlated to the presence of all three autoantibodies.展开更多
β-blockers have been recommended as a standard treatment for patients with mild to moderate systolic chronic heart failure （CHF） because they not only relieve patients＇ symptoms but also decrease mortality. Howeve...β-blockers have been recommended as a standard treatment for patients with mild to moderate systolic chronic heart failure （CHF） because they not only relieve patients＇ symptoms but also decrease mortality. However, β-blockers have a variety of effects on different CHF patients. Among them, β1-adrenergic receptor （AR） gene polymorphism is probably a significant one. The purpose of this study was to investigate the effects of metoprolol on cardiac function, cardiac geometrical size and density of β1-AR of CHF patients as well as the association between two common single nucleotide polymorphisms （SNPs） of β1-AR（Gly389Arg and Ser49Gly） and the effects of metoprolol.展开更多
心脏病患者22例(男17、女5例),年龄21～64岁(平均46岁),均有心衰。试验方法为美托洛尔50mg 顿服后持续监测心电、血压、心率6个小时。结果发现服药后90～150min 血压和心率降至最低点,与药物血浆浓度峰值相吻合,3～4 h 可回复。5例(22....心脏病患者22例(男17、女5例),年龄21～64岁(平均46岁),均有心衰。试验方法为美托洛尔50mg 顿服后持续监测心电、血压、心率6个小时。结果发现服药后90～150min 血压和心率降至最低点,与药物血浆浓度峰值相吻合,3～4 h 可回复。5例(22.7%)服药后血压曾降至<12.0/8.0kPa,或心率<55次/分,或有明显症状而判为试验阳性;另17例(77.3%)为阴性。试验阴性者中10例以美托洛尔25mg 日2次服,平均12.6d,血压和心率改变未超过试验中所达到的幅度。提示本试验可反映机体对美托洛尔的耐受性,试验结果和临床应用效果具良好的相关性。试验中未见严重副作用,表明对心脏病伴心衰患者以及老年人也是安全的,可为临床应用提供依据。展开更多
基金the Beijing Natural Science Foundation (No. 7174306)。
文摘Objective To determine the possible association of anti-β1-adrenergic receptors(anti-β1-AR), anti-β2-AR and anti-α1-AR with carvedilol treatment in patients with heart failure(HF). Methods A total of 267 HF patients were prospectively enrolled. Blood samples were measured by an enzyme-linked immunosorbent assay. All of the patients received carvedilol for their HF. Each patient was followed up for six months and their cardiac function was measured. Results The final analysis encompassed 137 patients comprising 65 patients with three autoantibodies(positive group) and 72 patients without all three autoantibodies but with one or two autoantibodies(negative group). The frequency and geometric mean titer of anti-β1-AR, anti-β2-AR, and anti-α1-AR were significantly lower in the group without all three autoantibodies after six months of carvedilol treatment(all P < 0.01;from 100% to 57%, 50%, and 49%, respectively;and from 1: 118, 1: 138, and 1: 130 to 1: 72, 1: 61, and 1: 67, respectively). Furthermore, 28 patients in the positive group demonstrated complete ablation of autoantibodies. In addition, left ventricular remodelling and function was significantly improved by the use of carvedilol combined with the standard treatment regime for six months in the positive group(P < 0.01) when compared to the negative group(P < 0.05). Conclusions Carvedilol treatment significantly decreases frequency and geometric mean titer in patients with all three autoantibodies, even up to complete ablation, and significantly improved cardiac function and remodelling. The effect of carvedilol is probably correlated to the presence of all three autoantibodies.
文摘β-blockers have been recommended as a standard treatment for patients with mild to moderate systolic chronic heart failure （CHF） because they not only relieve patients＇ symptoms but also decrease mortality. However, β-blockers have a variety of effects on different CHF patients. Among them, β1-adrenergic receptor （AR） gene polymorphism is probably a significant one. The purpose of this study was to investigate the effects of metoprolol on cardiac function, cardiac geometrical size and density of β1-AR of CHF patients as well as the association between two common single nucleotide polymorphisms （SNPs） of β1-AR（Gly389Arg and Ser49Gly） and the effects of metoprolol.
