Endocrine Abstracts

Background and aims: The aim of this study was to study the effect of Nebivolol on clinical course and heart rate variability (HRV) parameters in type 2 diabetes (T2DM) patients (pts) with coronary heart disease (CHD) and Chronic heart failure (CHF) of III-IV FC.

Materials and methods: Participants were 35 T2DM pts with CHD and CHF/ III-IV FC. The pts were divided into 2 groups (Gr.) Gr.1 (n=15, 10m/5f, mean age 59±7 years) on basic therapy. Gr.2 (n=20, 13m/7f, mean age 61±4.5 years) – Nebivolol was added to the basic therapy. Treatment was initiated with 2.5 mg/daily, dose increased to 5 mg/daily. Nebivolol was administered for 3 months. Echocardiography, to study end-diastolic diameter of LV, EF and FS and Holter ECG to assess myocardial ischemia (MI) episodes, HRV and arrhythmia were performed.

Results: In both groups treatment resulted in improvements in CHF course, reflected by decrease in FC of CHF. EDV evidently dropped in both groups, though for Gr.2 it was more pronounced, than for Gr.1 (20.3% vs 17.3%) EF and FS increased by 21.3% and 23.8%, respectively (Gr.1) and 26.1 and 29.9% respectively (Gr.2). The use of Nebivolol resulted in improvement of HRV parameters – SDNN (P=0.000) and triangular index (P=0.000). HRV parameter improvement was significant in Gr.2 when compares to Gr.1. SMI episodes also became less frequent in Nebivolol group. Post-treatment complex ventricular arrhythmias were observed more frequently in Gr.1. than Gr.2 (33.3 vs 20%).

Conclusion: Nebivolol in T2DM pts with CHD and CHF positively effects the clinical course of CHF, LV systolic function and ventricular rhythm impairment, decreases MI, increases HRV parameters. Nebivolol does not deteriorate lipid and carbohydrate metabolism makes it possible to successfully use it in T2DM pts with CHD and CHF.