Nebivolol Therapy in Patients with Decompensated Chronic Cor Pulmonale
Study Objective: To investigate the effects of Nebivolol on central· hemodynamics, Mood rheoLogicaL properties, and disturbances in cardiac rhythm and its variability in patients with chronic cor pulmonale (CCP). Study Design: This was a cohort, prospective, parallel-group, observational study. Materials and Methods: We examined 68 patients with Stage III-IV chronic obstructive pulmonary disease (COPD) associated with compensated (n = 22) and decompensated (n = 46) chronic cor pulmonale. Some 26 patients with decompensated CCP received a selective beta-blocker Nebivolol 2.5-5 mg/day for 6 months as part of their combination regimens. Patient examination incLuded Doppler echocardiography, 24-hour ECG monitoring, testing of pulmonary function, and assessment of blood rheological properties. Results: Patients with decompensated CCP had significant central hemodynamic changes, disturbances in cardiac rhythm and its variabiLity, increased blood and plasma viscosity, increased platelet aggregability, and marked obstructive and restrictive ventilatory defects. Added to a compLex treatment protocol, Nebivolol, a-selective ß-blocker, helped treat patients' arrhythmias and improve the tone of the autonomic nervous system with no statistically significant changes in puLmonary function parameters. Conclusion: As part of combination regimens used in patients with CCP, Nebivolol helps to reduce central and peripheral adverse hemodynamic changes, disturbances in cardiac rhythm and its variability without aggravation of ventilatory defects.