Determination of the impact of bisoprolol and сarvedilol on regulatory-adaptive status of patients with chronic heart failure and preserved left ventricular fraction

Objective. To determine the effect of bisoprolol or carvedilol therapy on the regulatory-adaptive status (RAS) of patients with chronic heart failure (CHF) and preserved ejection fraction (pEF) of the left ventricle (LV) the background of hypertensive disease (HD).Material and methods. The study involved 68 patients with CHF and pEF of the LV, who were randomized into two groups for treatment with bisoprolol (7,3±2,4 mg/day, n=34) and carvedilol (28,4±12,3 mg/day, n=34). As part of the combination therapy, quinapril was prescribed (13,5±2,5 mg/ day, n=34 and 12,6±2,9 mg/day, n=34), and if indicated - atorvastatin (16,3±5,0 mg/day, n=11 and 15,5±5,2 mg/day, n=11) and acetylsalicylic acid in the intestinal soluble shell (93,8±17,7 mg/day, n=8 and 94,4±15,8 mg/day, n=8), respectively. Initially and after 6 months of therapy were carried out: quantitative assessment of RAS (by means of a sample of cardiac-respiratory synchronism), treadmill test, six-minute walking test, subjective assessment of quality of life, determination of the level of N-terminal fragment of brain natriuretic peptide, echocardioscopy, daily monitoring of blood pressure.Results. Both regimens of combined drug therapy had comparable cardioprotective, hypotensive and neuromodulating effects, equally increased exercise tolerance. In comparison with bisoprolol, carvedilol differed positive impact on RAS, improved quality of life more.Conclusion. In patients with CHF and pEF LV in combination therapy, the use of carvedilol, in comparison with bisoprolol, may be preferable due to the positive effect on the RAS.