The standard treatment for dilated cardiomyopathies seen in chronic heart failure (CHF) is a combination of angiotensin-converting enzyme inhibitor (ACEi) and β1-adrenergic receptor (β1-AR) blocker. Despite great success in the treatment of CHF, there continues to be high levels of morbidity and mortality. Recent results have suggested that a combination of β2-adrenergic receptor (β2-AR) stimulation with a β1-AR blocker might be an effective therapeutic option; however, there has been considerable debate on the long-term effectiveness of β2-AR agonists. In this issue, Ahmet et al., describe a study that compared combined β1-AR blocker + β2AR agonist with the standard treatment in a coronary arterial ligation rat model. Two weeks after coronary ligation, the rats were split into groups that were treated for 12 months with 1) β1-AR blocker + β2-AR agonist, 2) ACEi + β1-AR blocker, 3) β1-AR blocker + β2-AR agonist + ACEi, or 4) no treatment. Echocardiography studies revealed significant reduction of left ventricle chamber remodeling, functional deterioration, and infarct expansion in all treatment groups. However, the reduction was more pronounced in the β1-AR blocker + β2-AR agonist treatment group, and reduction of mortality in this group was as good or better than the other two forms of treatment. These results suggest that β1-AR blocker + β2-AR agonist treatment warrants further investigation as a treatment regimen.
See article at J Pharmacol Exp Ther 2009, 331:178–185.
- © 2009 by the American Society for Pharmacology and Experimental Therapeutics