In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.
Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version. Learn more.

We use cookies to optimise the design of this website and make continuous improvement. By continuing your visit, you consent to the use of cookies. Learn more

Nebivolol prevents anthracycline-induced cardiotoxicity

Non-Invasive Imaging
Cardiovascular Pharmacology and Pharmacotherapy
Heart Failure (HF)


Rome, Italy – 28 Aug 2016: Nebivolol prevents anthracycline-induced cardiotoxicity, according to research presented at ESC Congress 2016 today by Professor Mirela Cleopatra Tomescu, a cardiologist at Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.1

“Breast cancer is a major public health problem worldwide, with a death rate of about 1 in 33 patients,” said Professor Tomescu. “Anthracyclines are a class of powerful pharmacological agents widely used in the treatment of breast cancer but they have a toxic effect on the heart, inducing heart failure.”

The goal of the current study was to find a method that detects cardiotoxicity accurately and early, and to see if a cardioprotective drug could prevent heart failure in these patients.

Depressed myocardial contractility is traditionally diagnosed using echocardiography, based on the estimation of left ventricular ejection fraction (LVEF) and fraction shortening (FS). However, these parameters are affected in the advanced stages of cardiotoxicity. New echocardiographic techniques, such as tissue Doppler, speckle tracking and strain rate imaging, allow the recognition of myocardial dysfunction before heart failure symptoms occur, and before the classical echocardiographic parameters are impaired.

For the cardioprotective drug, the researchers chose nebivolol, a cardioselective beta blocker with anti-oxidant, anti-apoptotic and vasodilator properties which is used to treat hypertension and heart failure.

The study group included 60 women with HER-2 negative breast cancer, with a mean age of 52 ± 13 years, scheduled to start chemotherapy with doxorubicin. They were randomly divided into two groups, the control group (n=30) and the nebivolol-treatment group (n=30). Nebivolol was administered at a dose of 5 mg once daily, for the duration of chemotherapy. Cytostatic treatment was performed with doxorubicin 70 mg/m2, administered intravenously alone, every 21 days. There were six cycles of cytotoxic therapy. The average cumulative dose of doxorubicin was 520 ± 8 mg/m2.

Echocardiography was performed at baseline and after six months of chemotherapy and included conventional two-dimensional echocardiography, tissue Doppler imaging, and speckle tracking imaging. There were no significant differences between groups in baseline clinical and echocardiographic characteristics. The cumulative dose of doxorubicin was similar in the two groups. No patient stopped chemotherapy, and no patient died during the study.

After six cycles of chemotherapy with doxorubicin, LVEF, FS, and left ventricular (LV) diameters did not change significantly in either group. In the control group, tissue Doppler imaging revealed significant alterations of LV diastolic function, assessed by a decrease of myocardial velocities. Speckle-tracking imaging assessed in the control group showed a statistically significant alteration of the LV systolic function, of longitudinal and radial strains, as well as of the strain rates. In the nebivolol treatment group, no significant changes in heart function were noted.

Professor Tomescu said: “Conventional echocardiography showed no change in heart function in either group following chemotherapy. But the newer, more sensitive echocardiographic techniques showed heart damage after chemotherapy. Patients who received nebivolol were protected and had normal heart function. Our study demonstrates the utility of new echocardiographic methods such as tissue Doppler and speckle tracking imaging in the early detection of ventricular dysfunction induced by cytostatic treatment.”

She concluded: “Our finding that nebivolol treatment prevented anthracycline-induced cardiotoxicity is encouraging, but larger studies with a longer follow-up period are needed to confirm the results.”

Ends

 

References

(1) Professor Mirela Cleopatra Tomescu will present the abstract “Protective effect of nebivolol on anthracycline-induced cardiotoxicity, assessed by tissue doppler velocities and by speckle tracking echocardiography” during:

Notes to editor

Sources of funding: None 

Disclosures: None

ESC Press Office
For background information, please contact the ESC Press Office.

For press enquiries, please contact, the Media & Press Coordinator, Jacques Olivier Costa: +393427028575 

For independent comment on site, please contact the ESC Spokesperson coordinator, Celine Colas: +393402405148 

The press conference timetable is available here. 

To access all the scientific resources from the sessions during the congress, visit ESC Congress 365.  

About the European Society of Cardiology

The European Society of Cardiology brings together health care professionals from more than 120 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.

About ESC Congress 2016

ESC Congress is the world’s largest gathering of cardiovascular professionals contributing to global awareness of the latest clinical trials and breakthrough discoveries. ESC Congress 2016 takes place 27 to 31 August at the Fiera di Roma in Rome, Italy. The scientific programme is here. More information is available from the ESC Press Office at press@escardio.org

This press release accompanies both a presentation and an ESC press conference at the ESC Congress 2016. Edited by the ESC from material supplied by the investigators themselves, this press release does not necessarily reflect the opinion of the European Society of Cardiology. The content of the press release has been approved by the presenter.