Document Detail


Effect of metoprolol on rest and exercise left ventricular systolic and diastolic function in idiopathic dilated cardiomyopathy.
MedLine Citation:
PMID:  11174349     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To further characterize the effects of heart rate on systolic and diastolic function in patients with idiopathic dilated cardiomyopathy (IDCM), it was hypothesized that the relationship between heart rate and left ventricular systolic and diastolic function would be unaltered by beta-blockade and exercise. METHODS: Eighteen patients with IDCM were randomized in a double-blind manner to receive either metoprolol or placebo for 3 months. Before and after 3 months of therapy, resting and exercise radionuclide left ventriculograms were obtained for assessment of left ventricular systolic and diastolic function. RESULTS: At rest, metoprolol treatment compared with placebo was associated with decreased heart rate (61 +/- 11 vs 99 +/- 10 beats/min, P <.0001) and an increased left ventricular ejection fraction (0.32% +/- 0.10% vs 0.17% +/- 0.08%, P =.01). With exercise, metoprolol compared with placebo caused a decreased heart rate (86 +/- 18 vs 126 +/- 43 beats/min, P =.056), an increase in left ventricular ejection fraction (0.32% +/- 0.14% vs 0.19% +/- 0.07%, P =.052), a longer time to peak filling rate (164 +/- 21 vs 127 +/- 17 ms, P =.005), and a decreased peak filling rate (5.41 +/- 1.71 vs 8.40 +/- 1.85 stroke volumes/s, P =.012). Before beta-blockade, heart rate at rest was negatively correlated to left ventricular ejection fraction and positively correlated to peak filling rate; with exercise, the relationships of heart rate to left ventricular ejection fraction and peak filling rate were similar. After metoprolol treatment, the heart rate continued to have a similar positive correlation with the peak filling rate at rest and with exercise. CONCLUSIONS: In patients with IDCM, systolic and diastolic cardiac function, at rest and with exercise, was related to heart rate. After beta-blockade, at rest and with exercise, diastolic function continued to be related to heart rate.
Authors:
I P Clements; W L Miller
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American heart journal     Volume:  141     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-03-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  259     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Disease and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minn.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Cardiomyopathy, Dilated / drug therapy*,  physiopathology,  radionuclide imaging
Diastole / drug effects
Double-Blind Method
Exercise*
Female
Heart Rate / drug effects
Humans
Male
Metoprolol / therapeutic use*
Middle Aged
Myocardial Contraction / drug effects*
Radionuclide Ventriculography
Rest*
Stroke Volume / drug effects
Systole / drug effects
Ventricular Function, Left / drug effects*
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 37350-58-6/Metoprolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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