Dataset Information

Cardiac and Vascular ?1-Adrenoceptors in Congestive Heart Failure: A Systematic Review.

ABSTRACT: As heart failure (HF) is a devastating health problem worldwide, a better understanding and the development of more effective therapeutic approaches are required. HF is characterized by sympathetic system activation which stimulates ?- and ?-adrenoceptors (ARs). The exposure of the cardiovascular system to the increased locally released and circulating levels of catecholamines leads to a well-described downregulation and desensitization of ?-ARs. However, information on the role of ?-AR is limited. We have performed a systematic literature review examining the role of both cardiac and vascular ?1-ARs in HF using 5 databases for our search. All three ?1-AR subtypes (?1A, ?1B and ?1D) are expressed in human and animal hearts and blood vessels in a tissue-dependent manner. We summarize the changes observed in HF regarding the density, signaling and responses of ?1-ARs. Conflicting findings arise from different studies concerning the influence that HF has on ?1-AR expression and function; in contrast to ?-ARs there is no consistent evidence for down-regulation or desensitization of cardiac or vascular ?1-ARs. Whether ?1-ARs are a therapeutic target in HF remains a matter of debate.

SUBMITTER: Kayk?-Mutlu G

PROVIDER: S-EPMC7694190 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Publications

Cardiac and Vascular α<sub>1</sub>-Adrenoceptors in Congestive Heart Failure: A Systematic Review.

Kaykı-Mutlu Gizem G Papazisi Olga O Palmen Meindert M Danser A H Jan AHJ Michel Martin C MC Arioglu-Inan Ebru E

Cells 20201104 11

As heart failure (HF) is a devastating health problem worldwide, a better understanding and the development of more effective therapeutic approaches are required. HF is characterized by sympathetic system activation which stimulates α- and β-adrenoceptors (ARs). The exposure of the cardiovascular system to the increased locally released and circulating levels of catecholamines leads to a well-described downregulation and desensitization of β-ARs. However, information on the role of α-AR is limit ...[more]

PMID: 33158106

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Project description:BackgroundBeta-blockers are an essential part of standard therapy in adult congestive heart failure and therefore, are expected to be beneficial in children. However, congestive heart failure in children differs from that in adults in terms of characteristics, aetiology, and drug clearance. Therefore, paediatric needs must be specifically investigated. This is an update of a Cochrane review previously published in 2009.ObjectivesTo assess the effect of beta-adrenoceptor-blockers (beta-blockers) in children with congestive heart failure.Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and LILACS up to November 2015. Bibliographies of identified studies were checked. No language restrictions were applied.Selection criteriaRandomised, controlled, clinical trials investigating the effect of beta-blocker therapy on paediatric congestive heart failure.Data collection and analysisTwo review authors independently extracted and assessed data from the included trials.Main resultsWe identified four new studies for the review update; the review now includes seven studies with 420 participants. Four small studies with 20 to 30 children each, and two larger studies of 80 children each, showed an improvement of congestive heart failure with beta-blocker therapy. A larger study with 161 participants showed no evidence of benefit over placebo in a composite measure of heart failure outcomes. The included studies showed no significant difference in mortality or heart transplantation rates between the beta-blocker and control groups. No significant adverse events were reported with beta-blockers, apart from one episode of complete heart block. A meta-analysis of left ventricular ejection fraction (LVEF) and fractional shortening (LVFS) data showed a very small improvement with beta-blockers. However, there were vast differences in the age, age range, and health of the participants (aetiology and severity of heart failure; heterogeneity of diagnoses and co-morbidities); there was a range of treatments across studies (choice of beta-blocker, dosing, duration of treatment); and a lack of standardised methods and outcome measures. Therefore, the primary outcomes could not be pooled in meta-analyses.Authors' conclusionsThere is not enough evidence to support or discourage the use of beta-blockers in children with congestive heart failure, or to propose a paediatric dosing scheme. However, the sparse data available suggested that children with congestive heart failure might benefit from beta-blocker treatment. Further investigations in clearly defined populations with standardised methodology are required to establish guidelines for therapy. Pharmacokinetic investigations of beta-blockers in children are also required to provide effective dosing in future trials.

Dataset Information

Cardiac and Vascular ?1-Adrenoceptors in Congestive Heart Failure: A Systematic Review.

Publications

Cardiac and Vascular α<sub>1</sub>-Adrenoceptors in Congestive Heart Failure: A Systematic Review.

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