| Effects of beta-adrenergic blocking therapy on left ventricular diastolic relaxation properties in patients with dilated cardiomyopathy. | |
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MedLine Citation:
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PMID: 10449695 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The hemodynamic mechanism for the improvement in left ventricle (LV) end-diastolic pressure in cardiomyopathy patients treated with beta-adrenergic blocking agents is controversial. We hypothesized that the salutary effect of this kind of therapy on LV end-diastolic pressure would be indicative of an improvement in late, passive diastolic relaxation properties. METHODS AND RESULTS: We studied 14 cardiomyopathy patients in normal sinus rhythm with no arteriographic evidence of coronary artery disease and an LV ejection fraction of </=40% by radionuclide angiography both before and after 6 months of metoprolol therapy with simultaneous micromanometry and biplane cineventriculography. Four comparable patients who were not treated with metoprolol were studied in a similar fashion and served as control subjects. In those receiving metoprolol, LV end-diastolic pressure decreased (P=0.001). The isovolumic relaxation index, tau(ln), shortened (P=0.03). In a similar fashion, the LV chamber stiffness constant, kappa, decreased (P=0.02), LV volume elastance improved (P=0.04), and the myocardial stiffness constant, kappa(e), decreased (P=0.02). A multiple regression analysis revealed that the decrease in LV end-diastolic pressure was indicative of significant improvements in tau(ln) and kappa(e) with the relationship: LV end-diastolic pressure=-4.73+0.27 tau(ln)+0.54 kappa(e) (r=0.81, P<0.0001). These LV diastolic relaxation properties did not change or worsened in the control cardiomyopathy patients. CONCLUSIONS: We conclude that the decrease in LV end-diastolic pressure in cardiomyopathy patients treated with metoprolol is an indicator of improvement in LV diastolic properties resulting from more complete myocardial relaxation. |
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Authors:
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M H Kim; W H Devlin; S K Das; J Petrusha; D Montgomery; M R Starling |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Circulation Volume: 100 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 1999 Aug |
Date Detail:
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Created Date: 1999-09-02 Completed Date: 1999-09-02 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 729-35 Citation Subset: AIM; IM |
Affiliation:
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University of Michigan and Veterans Affairs Medical Centers, Ann Arbor, MI 48105, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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pharmacology,
therapeutic use* Cardiomyopathy, Dilated / drug therapy*, physiopathology Diastole / drug effects* Female Heart Rate / drug effects Humans Male Metoprolol / pharmacology, therapeutic use* Middle Aged Muscle Relaxation / drug effects Myocardial Contraction / drug effects Stroke Volume / drug effects Ventricular Function, Left / drug effects* |
| Grant Support | |
ID/Acronym/Agency:
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R01-HL-36450/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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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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