Nav: Home

Research suggests alternative treatment for beta blocker intolerant heart attack patients

April 10, 2018

Beta blockers have become a prescription drug staple for recovering heart attack patients. However, these blood pressure-reducing medications cannot be tolerated by many patients who are at higher risk for developing cardiovascular disease, including those with chronic obstructive pulmonary disease (COPD) and asthma, the elderly, and diabetics. As seen in the March 26 issue of Thyroid, researchers at New York Institute of Technology College of Osteopathic Medicine (NYITCOM) now pose a new treatment for patients with beta blocker intolerance: thyroid hormone therapy.

Formally known as "beta-adrenergic blocking agents," beta blockers came to prominence in the 1960s, when deaths from myocardial infarction (MI), the clinical term for heart attack, were very common. The drugs work by blocking the neurotransmitters norepinephrine and epinephrine, also known as adrenaline, from binding to receptors in the heart. Consequently, when the effects of the neurotransmitters are impeded, heart rate and blood pressure are lowered, allowing the heart to beat with less force and more easily deliver circulation to the body.

During MI, increased adrenaline raises pressure in the arteries and increases heart rate to compensate for the sudden loss of contractile tissue. Unfortunately, this places added stress on surviving myocardium, the heart's muscular tissue. Muscular damage to the heart sustained during infarction may cause the organ to be less effective in pumping blood to the rest of the body, a condition that can eventually lead to heart failure and death.

Since beta blockers are known to improve chance of survival, patients unable to tolerate beta blockers may then be at greater risk for heart failure than those able to withstand the drugs. However, the NYITCOM researchers suggest that the thyroid hormone triiodothyronine (T3), which controls many aspects of cardiovascular function and is also a powerful regulator of beta receptor function, may offer an alternative therapy.

"While beta blockers have been viewed as the gold standard in MI treatment for years, a significant population at risk for heart failure is unable to tolerate these drugs. If given beta blockers, these patients' conditions can, in fact, worsen -- heart rate may fall too low and heart function could deteriorate," said Martin Gerdes, Ph.D., chair, Biomedical Sciences, NYITCOM, and senior investigator in the study. "Preclinical studies have shown thyroid hormone treatment to be a safe and effective method for managing cardiovascular disorders, and may offer a better option for these patients."

To investigate this option, Gerdes' team, which included experts from China's top cardiovascular center, FuWai Heart Hospital, compared the effectiveness of T3 and metoprolol, a commonly prescribed beta blocker, in female laboratory rats. Immediately following MI, the rats were provided either a low dose of T3 or the beta blocker in their drinking water for a total of eight weeks. At the end of that period, thyroid hormone proved to be as good, if not better, than metoprolol at improving heart function and reversing expression of detrimental genes linked to heart failure, providing all the benefits of the beta blocker plus some additional benefits unique to thyroid hormones, such as improved expression of genes related to better contraction and relaxation of the heart.

"Both treatments provide comparable results and similar long-term benefits, including improved function in the left ventricle, an area often damaged during heart attack, as well as reduced infarction size and improved vessel function," said Gerdes, who has studied the cardiovascular benefits and effects of thyroid hormone treatment for more than a decade. "Overall, these results suggest that T3 is capable of providing a safe alternative for beta blocker intolerant patients following MI."

The researchers will continue studying the effectiveness of thyroid hormone after MI and encourage clinical researchers to consider examining low dose T3 treatment of MI patients who cannot tolerate beta blockers.
-end-
For more information about NYITCOM, visit nyit.edu/medicine.

About NYIT

NYIT (New York Institute of Technology) offers 90 degree programs, including undergraduate, graduate, and professional degrees, in more than 50 fields of study, including architecture and design; arts and sciences; education; engineering and computing sciences; health professions; management; and osteopathic medicine. A non-profit independent, private institution of higher education, NYIT has 10,000 students in programs and campuses in New York (Manhattan and Old Westbury, Long Island) and Arkansas as well as China, Canada, and the United Arab Emirates. NYIT sponsors 13 NCAA Division II programs.

NYIT is guided by its mission to provide career-oriented professional education, offer access to opportunity to all qualified students, and support applications-oriented research that benefits the larger world. More than 100,000 graduates have received degrees from NYIT. For more information, visit nyit.edu.

New York Institute of Technology

Related Heart Failure Articles:

Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.
Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.
How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.
Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.
NSAID impairs immune response in heart failure, worsens heart and kidney damage
Non-steroidal anti-inflammatory drugs, or NSAIDs, are widely known as pain-killers and can relieve pain and inflammation.
Heart cell defect identified as possible cause of heart failure in pregnancy
A new Tel Aviv University study reveals that one of the possible primary causes of heart failure in pregnant women is a functional heart cell defect.
In heart failure, a stronger heart could spell worse symptoms
Patients with stronger-pumping hearts have as many physical and cognitive impairments as those with weaker hearts, suggesting the need for better treatment.
Patients with common heart failure more likely to have lethal heart rhythms
New Smidt Heart Institute Research shows that patients with Heart Failure with Preserved Ejection Fraction (HFpEF) are more likely to have lethal heart rhythms.
Why does diabetes cause heart failure?
A Loyola University Chicago Stritch School of Medicine study reveals how, on a cellular level, diabetes can cause heart failure.
Oxygen therapy for patients suffering from a heart attack does not prevent heart failure
Oxygen therapy does not prevent the development of heart failure.
More Heart Failure News and Heart Failure Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Risk
Why do we revere risk-takers, even when their actions terrify us? Why are some better at taking risks than others? This hour, TED speakers explore the alluring, dangerous, and calculated sides of risk. Guests include professional rock climber Alex Honnold, economist Mariana Mazzucato, psychology researcher Kashfia Rahman, structural engineer and bridge designer Ian Firth, and risk intelligence expert Dylan Evans.
Now Playing: Science for the People

#540 Specialize? Or Generalize?
Ever been called a "jack of all trades, master of none"? The world loves to elevate specialists, people who drill deep into a single topic. Those people are great. But there's a place for generalists too, argues David Epstein. Jacks of all trades are often more successful than specialists. And he's got science to back it up. We talk with Epstein about his latest book, "Range: Why Generalists Triumph in a Specialized World".
Now Playing: Radiolab

Dolly Parton's America: Neon Moss
Today on Radiolab, we're bringing you the fourth episode of Jad's special series, Dolly Parton's America. In this episode, Jad goes back up the mountain to visit Dolly's actual Tennessee mountain home, where she tells stories about her first trips out of the holler. Back on the mountaintop, standing under the rain by the Little Pigeon River, the trip triggers memories of Jad's first visit to his father's childhood home, and opens the gateway to dizzying stories of music and migration. Support Radiolab today at Radiolab.org/donate.