Dynamics of functional parameters in patients with chronic heart failure and preserved left ventricular ejection fraction treated with bisoprolol and nebivolol

Tregubov V.G., Kostyleva S.A., Khilkevich P.V., Veselenko M.I., Gerdel D.E.

1) Kuban State Medical University, Krasnodar, Russia; 2) Regional Clinical Hospital No. 2, Krasnodar, Russia

Background: As a rule, the effectiveness of β-blocker therapy is assessed based on its effect on individual structural and functional cardiac parameters. Due to their heterogeneity, a comprehensive assessment of the functional state, including regulatory-adaptive status (RAS), exercise tolerance, and quality of life (QOL), is necessary to monitor the effectiveness of beta-blocker therapy in chronic heart failure (CHF). 
Objective: Comparative assessment of the effects of bisoprolol and nebivolol on the functional status of patients with CHF and preserved left ventricular (LV) ejection fraction (EF) associated with stage III arterial hypertension.
Materials and methods: This study enrolled 80 patients with CHF and preserved LVEF ≥50%. Participants were randomly assigned to receive bisoprolol or nebivolol. Combination therapy included quinapril, as well as enteric-coated atorvastatin and aspirin (acetylsalicylic acid) if indicated. A comprehensive diagnostic program was administered throughout the 24-week study. A quantitative assessment of RAS was performed using a cardiorespiratory synchronization (CRS) test at baseline and at the end of therapy. Echocardiography, a treadmill test, and a 6-minute walk test were also performed. Patients’ QOL was assessed subjectively; N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were determined, and 24-hour blood pressure monitoring was performed. 
Results: A positive effect on structural and functional parameters of cardiac function was observed in both study groups. Nebivolol demonstrated a more pronounced increase in RAS compared to bisoprolol. Furthermore, it contributed to increased exercise tolerance and improved QOL in patients.
Conclusion: A comparative analysis of the effects of nebivolol and bisoprolol on the functional status of patients with CHF and preserved LVEF associated with stage III arterial hypertension demonstrates that nebivolol has a more pronounced positive effect. 

For citations: Tregubov V.G., Kostyleva S.A., Khilkevich P.V., Veselenko M.I., Gerdel D.E. Dynamics of functional parameters in patients with chronic heart failure and preserved left ventricular ejection fraction treated with bisoprolol and nebivolol. Pharmateca. 2026;33(1):8-15. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.1.8-15

Authors’ contribution: V.G. Tregubov, S.A. Kostyleva, P.V. Khilkevich, M.I. Veselenko, D.E. Gerdel – development of the concept, study design and data collection. V.G. Tregubov, S.A. Kostyleva, P.V. Khilkevich, M.I. Veselenko – analysis and interpretation of the results. S.A. Kostyleva, P.V. Khilkevich, D.E. Gerdel – drafting the manuscript and forming its final result. V.G. Tregubov, M.I. Veselenko – critical revision of the draft manuscript and introduction of valuable comments of intellectual content.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Ethical Approval: The study was approved by the Ethics Committee of the Kuban State Medical University (Protocol No. 5 dated January 20, 2017).
Patient Consent for Publication: The retrospective design of the study did not require informed consent from patients for statistical processing of anonymized data for subsequent publication.
Authors’ Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.

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About the Authors

Vitaliy G. Tregubov, Dr. Sci. (Med.), Professor, Department of Therapy No. 2, Faculty of Advanced Training and Professional Retraining of Specialists, Kuban State Medical University; Cardiologist, Regional Clinical Hospital No. 2, Krasnodar, Russia; ORCID: https://orcid.org/0000-0003-0635-3598
Sofia A. Kostyleva, Cardiologist, Cardiology Department No. 1, Regional Clinical Hospital No. 2, Krasnodar, Russia; kostyleva.sof@yandex.ru,
ORCID: https://orcid.org/0009-0004-0246-0892 (corresponding author)
Pavel V. Khilkevich, Regional Clinical Hospital No. 2, Krasnodar, Russia; ORCID: https://orcid.org/0000-0002-2641-5189
Marina I. Veselenko, Regional Clinical Hospital No. 2, Krasnodar, Russia; ORCID: https://orcid.org/0009-0004-7558-0588
Daria E. Gerdel, Kuban State Medical University, Krasnodar, Russia; ORCID: https://orcid.org/0009-0006-3643-630X

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