Effects of β-Blocker Therapy on High Sensitivity C-Reactive Protein, Oxidative Stress, and Cardiac Function in Patients With Congestive Heart Failure

Nagatomo, Yuji; Yoshikawa, Tsutomu; Kohno, Takashi; Yoshizawa, Akihiro; Anzai, Toshihisa; Meguro, Tomomi; Satoh, Toru; Ogawa, Satoshi

doi:10.1016/j.cardfail.2007.02.004

« Previous Next »Journal of Cardiac Failure
Volume 13, Issue 5 , Pages 365-371, June 2007

Effects of β-Blocker Therapy on High Sensitivity C-Reactive Protein, Oxidative Stress, and Cardiac Function in Patients With Congestive Heart Failure

Yuji Nagatomo, MD
- From the Cardiology Division, Department of Medicine, Keio University School of Medicine, Tokyo
Tsutomu Yoshikawa, MD
- From the Cardiology Division, Department of Medicine, Keio University School of Medicine, Tokyo
- Reprint requests: Tsutomu Yoshikawa, MD, Cardiology Division, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan 160-8582.
Takashi Kohno, MD
- From the Cardiology Division, Department of Medicine, Keio University School of Medicine, Tokyo
Akihiro Yoshizawa, MD
- From the Cardiology Division, Department of Medicine, Keio University School of Medicine, Tokyo
Toshihisa Anzai, MD
- From the Cardiology Division, Department of Medicine, Keio University School of Medicine, Tokyo
Tomomi Meguro, MD
- Tokyo Electric Power Corporation Hospital, Tokyo, Japan
Toru Satoh, MD
- From the Cardiology Division, Department of Medicine, Keio University School of Medicine, Tokyo
Satoshi Ogawa, MD
- From the Cardiology Division, Department of Medicine, Keio University School of Medicine, Tokyo

Received 27 June 2006; received in revised form 14 February 2007; accepted 19 February 2007.

Tokyo, Japan

Abstract

Background

It is uncertain whether β-blocker therapy affects serum C-reactive protein (CRP) level in patients with congestive heart failure (CHF). We attempted to determine if β-blocker therapy decreases serum CRP production and to correlate the production with biomarkers and cardiac function in such patients.

Methods and Results

Fifty-two patients with mild to moderate CHF with a left ventricular ejection fraction (EF) <40% were enrolled. They were randomly assigned to metoprolol or carvedilol treatment groups. The CRP concentration decreased significantly in patients with higher baseline CRP concentration, but not in those with lower baseline CRP concentrations. There was an inverse correlation between ΔCRP and ΔEF 16 weeks after the start of β-blocker therapy for patients with higher baseline CRP concentrations. In patients with higher baseline concentrations, CRP decreased in patients who received carvedilol, but not in those who received metoprolol. Plasma lipid peroxide (LPO) concentration significantly decreased, and there was an inverse correlation between ΔCRP and ΔLPO 16 weeks after the start of therapy.

Conclusions

Administration of β-blockers is associated with attenuation of inflammatory marker in certain patients with CHF. The antioxidant effects of β-blockers, especially carvedilol, may play a role in mediating the phenomenon.

Key Words: Interleukin-6, oxidative stress, cardiac function, inflammation