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Effects of β2-receptor stimulation by indacaterol in chronic heart failure treated with selective or non-selective β-blockers: a randomized trial

Title: Effects of β2-receptor stimulation by indacaterol in chronic heart failure treated with selective or non-selective β-blockers: a randomized trial
Authors: Contini, Mauro; Spadafora, Emanuele; Barbieri, Simone; Gugliandolo, Paola; Salvioni, Elisabetta; Magini, Alessandra; Apostolo, Anna; Palermo, Pietro; Alimento, Marina; Agostoni, Piergiuseppe
Contributors: M. Contini; E. Spadafora; S. Barbieri; P. Gugliandolo; E. Salvioni; A. Magini; A. Apostolo; P. Palermo; M. Alimento; P. Agostoni
Publisher Information: Nature Publishing Group
Publication Year: 2020
Collection: The University of Milan: Archivio Istituzionale della Ricerca (AIR)
Subject Terms: Settore MED/11 - Malattie dell'Apparato Cardiovascolare
Description: Alveolar β2-receptor blockade worsens lung diffusion in heart failure (HF). This effect could be mitigated by stimulating alveolar β2-receptors. We investigated the safety and the effects of indacaterol on lung diffusion, lung mechanics, sleep respiratory behavior, cardiac rhythm, welfare, and exercise performance in HF patients treated with a selective (bisoprolol) or a non-selective (carvedilol) β-blocker. Study procedures were performed before and after indacaterol and placebo treatments according to a cross-over, randomized, double-blind protocol in forty-four patients (27 on bisoprolol and 17 on carvedilol). No differences between indacaterol and placebo were observed in the whole population except for a significantly higher VE/VCO2 slope and lower maximal PETCO2 during exercise with indacaterol, entirely due to the difference in the bisoprolol group (VE/VCO2 31.8 ± 5.9 vs. 28.5 ± 5.6, p < 0.0001 and maximal PETCO2 36.7 ± 5.5 vs. 37.7 ± 5.8 mmHg, p < 0.02 with indacaterol and placebo, respectively). In carvedilol, indacaterol was associated with a higher peak heart rate (119 ± 34 vs. 113 ± 30 bpm, with indacaterol and placebo) and a lower prevalence of hypopnea during sleep (3.8 [0.0;6.3] vs. 5.8 [2.9;10.5] events/hour, with indacaterol and placebo). Inhaled indacaterol is well tolerated in HF patients, it does not influence lung diffusion, and, in bisoprolol, it increases ventilation response to exercise.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/32345990; info:eu-repo/semantics/altIdentifier/wos/WOS:000560712400002; volume:10; issue:1; journal:SCIENTIFIC REPORTS; https://hdl.handle.net/2434/743298
DOI: 10.1038/s41598-020-62644-1
Availability: https://hdl.handle.net/2434/743298; https://doi.org/10.1038/s41598-020-62644-1
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.331F7BFF
Database: BASE