{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T05:16:08Z","timestamp":1765170968280,"version":"3.46.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Beta-agonists like Levalbuterol and Albuterol are used in the treatment of Hyperkalemia. However, few studies in the medical literature have directly compared the cardiac effects and potassium-lowering efficacy of levalbuterol and albuterol, yielding inconclusive results. Understanding the cardiovascular effects and potassium-lowering abilities of these medications in hyperkalemic patients is crucial for optimizing treatment strategies and minimizing adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This randomized controlled trial conducted at Aleppo University Hospital in Syria aimed to compare the cardiovascular and potassium-lowering effects of Levalbuterol vs. Albuterol in hyperkalemic patients. The study, carried out between October 2021 and February 2022, utilized a single-center single-blinded two-armed design with patients randomized using a computer-generated sequence and block randomization method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results showed no significant difference in mean HR change between Levalbuterol and Albuterol groups at 30\u2005min, nor in the change in potassium serum levels at 90\u2005min. Both drugs exhibited similar patterns in HR changes over time and blood pressure variations at different points. Despite limitations in data collection for side effects, the reported symptoms in both groups were consistent with known side effects of beta-agonists, with tremors and nervousness being the most commonly reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study provides the first direct insights into the effects of Levalbuterol and Albuterol on heart rate, potassium levels, and blood pressure which would be very important in specific cases such as in patients with heart failure. Both medications showed similar patterns in heart rate changes, potassium levels, and blood pressure variations at different time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>Clinicaltrials.gov<\/jats:ext-link>\n                      , identifier NCT05173584.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2025.1463999","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T05:12:40Z","timestamp":1765170760000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing the cardiovascular and potassium lowering effects of levalbuterol compared to albuterol: a randomized control trial"],"prefix":"10.3389","volume":"12","author":[{"given":"Baraa","family":"Shebli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike","family":"Ghabally","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Besher","family":"Shabouk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad Yamen","family":"Arnaout","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Besher","family":"Zeina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Malhis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1016\/j.ekir.2020.05.001","article-title":"2018 kidney disease: improving global outcomes (KDIGO) hepatitis C in chronic kidney disease guideline implementation: Asia summit conference report","volume":"5","author":"Li","year":"2020","journal-title":"Kidney Int Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"Cd003235","DOI":"10.1002\/14651858.CD003235.pub2","article-title":"Emergency interventions for hyperkalaemia","volume":"2005","author":"Mahoney","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"B3","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1136\/thx.51.1.54","article-title":"Evaluation of the beta 2 adrenoceptor agonist\/antagonist activity of formoterol and salmeterol","volume":"51","author":"Grove","year":"1996","journal-title":"Thorax"},{"key":"B4","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1111\/j.1365-2125.1997.tb00025.x","article-title":"Evaluation of partial beta-adrenoceptor agonist activity","volume":"43","author":"Lipworth","year":"1997","journal-title":"Br J Clin Pharmacol"},{"key":"B5","first-page":"503","article-title":"Treatment of hyperkalaemia by altering the transcellular gradient in patients with renal failure: effect of various therapeutic approaches","volume":"74","author":"Ngugi","year":"1997","journal-title":"East Afr Med J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1513\/pats.200504-027SR","article-title":"Molecular mechanisms of beta2-adrenergic receptor function and regulation","volume":"2","author":"McGraw","year":"2005","journal-title":"Proc Am Thorac Soc"},{"key":"B7","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1097\/MEJ.0000000000000691","article-title":"Acute hyperkalemia in the emergency department: a summary from a kidney disease: improving global outcomes conference","volume":"27","author":"Lindner","year":"2020","journal-title":"Eur J Emerg Med"},{"key":"B8","article-title":"Half life","volume-title":"StatPearls","author":"Hallare","year":"2024"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e0154963","DOI":"10.1371\/journal.pone.0154963","article-title":"Optimal dose and method of administration of intravenous insulin in the management of emergency hyperkalemia: a systematic review","volume":"11","author":"Harel","year":"2016","journal-title":"PLoS One"},{"key":"B10","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1111\/j.0894-0959.2004.17346.x","article-title":"Use of insulin and oral hypoglycemic medications in patients with diabetes mellitus and advanced kidney disease","volume":"17","author":"Snyder","year":"2004","journal-title":"Semin Dial"},{"key":"B11","doi-asserted-by":"publisher","first-page":"934","DOI":"10.3949\/ccjm.84a.17056","article-title":"Diagnosis and treatment of hyperkalemia","volume":"84","author":"Palmer","year":"2017","journal-title":"Cleve Clin J Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1345\/aph.1S003","article-title":"A comparison of heart rate changes associated with levalbuterol and racemic albuterol in pediatric cardiology patients","volume":"47","author":"Kelly","year":"2013","journal-title":"Ann Pharmacother"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1971","DOI":"10.1093\/ajhp\/60.19.1971","article-title":"Changes in heart rate associated with nebulized racemic albuterol and levalbuterol in intensive care patients","volume":"60","author":"Lam","year":"2003","journal-title":"Am J Health Syst Pharm"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.pupt.2009.10.001","article-title":"Pharmacological modulation of beta-adrenoceptor function in patients with coexisting chronic obstructive pulmonary disease and chronic heart failure","volume":"23","author":"Matera","year":"2010","journal-title":"Pulm Pharmacol Ther"},{"key":"B15","doi-asserted-by":"publisher","first-page":"101725","DOI":"10.1016\/j.ppedcard.2024.101725","article-title":"Cardiac effects of levalbuterol vs. Albuterol in pediatric asthma attack patients: a systematic review and meta-analysis","volume":"74","author":"Shebli","year":"2024","journal-title":"Prog Pediatr Cardiol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1136\/emj.2005.024414","article-title":"Best evidence topic report. Nebulised levalbuterol or albuterol for lowering serum potassium","volume":"22","author":"Ostovar","year":"2005","journal-title":"Emerg Med J"},{"key":"B17","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/S0736-4679(03)00133-1","article-title":"Levalbuterol is as effective as racemic albuterol in lowering serum potassium","volume":"25","author":"Pancu","year":"2003","journal-title":"J Emerg Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"2002","DOI":"10.1111\/jvim.16552","article-title":"Effect of inhaled albuterol on whole blood potassium concentrations in dogs","volume":"36","author":"Ogrodny","year":"2022","journal-title":"J Vet Intern Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/j.pupt.2012.11.003","article-title":"Levalbuterol versus albuterol for acute asthma: a systematic review and meta-analysis","volume":"26","author":"Jat","year":"2013","journal-title":"Pulm Pharmacol Ther"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1463999\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T05:12:41Z","timestamp":1765170761000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1463999\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,8]]},"references-count":19,"alternative-id":["10.3389\/fcvm.2025.1463999"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1463999","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,8]]},"article-number":"1463999"}}