Projects / Programmes source: ARIS

Carvedilol or Bisoprolol in Patients with Chronic Heart Failure and Chronic Pulomonary Obstructive disease: An Investigator Initiated randomized double blind cross-over Trial

Research activity

Code Science Field Subfield
3.06.00  Medical sciences  Cardiovascular system   

Code Science Field
B540  Biomedical sciences  Respiratory system 
Chronic heart failure; chronic obstructive pulmonary disease; carvedilol, bisoprolol
Evaluation (rules)
source: COBISS
Researchers (10)
no. Code Name and surname Research area Role Period No. of publicationsNo. of publications
1.  22807  PhD Peter Korošec  Microbiology and immunology  Researcher  2008 - 2011  697 
2.  10921  PhD Mitja Košnik  Microbiology and immunology  Researcher  2008 - 2011  1,539 
3.  22680  PhD Mitja Lainščak  Cardiovascular system  Head  2008 - 2011  698 
4.  23464  PhD Mateja Marc Malovrh  Microbiology and immunology  Researcher  2008 - 2011  168 
5.  06630  PhD Pika Meško Brguljan  Biochemistry and molecular biology  Researcher  2008 - 2011  344 
6.  21806  PhD Matej Podbregar  Cardiovascular system  Researcher  2008 - 2011  330 
7.  04293  PhD Janez Rozman  Systems and cybernetics  Researcher  2008 - 2011  245 
8.  29763  MSc Irena Šarc  Cardiovascular system  Researcher  2008 - 2011  163 
9.  25178  PhD Sabina Škrgat  Microbiology and immunology  Researcher  2008 - 2011  319 
10.  25180  MSc Tjaša Šubic  Cardiovascular system  Researcher  2008 - 2011  35 
Organisations (3)
no. Code Research organisation City Registration number No. of publicationsNo. of publications
1.  0312  University Medical Centre Ljubljana  Ljubljana  5057272000  75,631 
2.  1326  ITIS, Implantable Technology and Sensors, producing, trading, servicing and researching enterprise, d.o.o. Ljubljana  Ljubljana  5824796000  245 
3.  1613  University Clinic of Respiratory and Allergic Diseases  Golnik  1190997  7,148 
Chronic heart failure (CHF) is a serious, prevalent, and deadly condition. Controlled clinical trials proved the benefit of beta blockers in patients with CHF. However, epidemiological studies across Europe report failure to implement beta blockers which remain under-used and under-dosed. Several issues may contribute to the current daily practice in CHF patients. Clinical trials population does not resemble the population from the community. Fear of adverse effects as hypotension, bradycardia, fatigue or worsening of concomitant disease, especially chronic pulmonary obstructive disease (COPD) is still root-bounded. Additionally, long titration period might be important, as well as satisfaction with benefit achieved with lower doses. Trials generaly have excluded patients with COPD and we do not have any data on beta blockers in patients with concomitant CHF and COPD. Therefore, COPD still is associated with lower prescription rate of β-blockers in the everyday clinical practice. In addition, both CHF and COPD are associated with body wasting and cachexia, which is independent predictor of mortality. During last few years it has been shown that CHF patients with higher body mass index, higher total cholesterol or higher body fat mass have better clinical outcomes. Additionally, it was shown that treatment with beta blockers is associated to weight gain, also in HF patients. Based on the results of the prospective observational pilot study it seems this is mostly attributed to the accumulation of body fat.
Significance for science
Our results demonstrated gap between guideline recommended titration scheme and feasibility in clinical practice. We were also able to show several differences in clinical parameters between compared cardioselective and non-selective beta blockers. Cardioselective beta blockers reduced heart rate whilst non-selective had more pronounced effect on pulmonary function. Our results are particularly applicable for patients with concomitant chronic obstructive pulmonary disease where bisoprolol should be preferred beta blocker. Bisoprolol was associated with less pulmonary side effects and caused no reduction in pulmonary function tests.
Significance for the country
Slovenia centers were part of multicenter study. Researchers are coauthors of main and secondary publications. Other studies within same study group are either ongoing or are planned.
Most important scientific results Annual report 2008, 2009, final report, complete report on dLib.si
Most important socioeconomically and culturally relevant results Annual report 2008, 2009, final report, complete report on dLib.si
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