| Metoprolol reverses left ventricular remodeling in patients with asymptomatic systolic dysfunction: the REversal of VEntricular Remodeling with Toprol-XL (REVERT) trial. | |
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MedLine Citation:
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PMID: 17576868 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: There are no randomized, controlled trial data to support the benefit of beta-blockers in patients with asymptomatic left ventricular systolic dysfunction. We investigated whether beta-blocker therapy ameliorates left ventricular remodeling in asymptomatic patients with left ventricular systolic dysfunction. METHOD AND RESULTS: Patients with left ventricular ejection fraction <40%, mild left ventricular dilation, and no symptoms of heart failure (New York Heart Association class I) were randomly assigned to receive extended-release metoprolol succinate (Toprol-XL, AstraZeneca) 200 mg or 50 mg or placebo for 12 months. Echocardiographic assessments of left ventricular end-systolic volume, end-diastolic volume, mass, and ejection fraction were performed at baseline and at 6 and 12 months. The 149 patients randomized to the 3 treatment groups (200 mg, n=48; 50 mg, n=48; and placebo, n=53) were similar with regard to all baseline characteristics including age (mean, 66 years), gender (74% male), plasma brain natriuretic peptide (79 pg/mL), left ventricular end-diastolic volume index (110 mL/m2), and left ventricular ejection fraction (27%). At 12 months in the 200-mg group, there was a 14+/-3 mL/m2 decrease (least square mean+/-SE) in end-systolic volume index and a 6+/-1% increase in left ventricular ejection fraction (P<0.05 versus baseline and placebo for both). The decrease in end-diastolic volume index (14+/-3) was different from that seen at baseline (P<0.05) but not with placebo. In the 50-mg group, end-systolic and end-diastolic volume indexes decreased relative to baseline but were not different from what was seen with placebo, whereas ejection fraction increased by 4+/-1% (P<0.05 versus baseline and placebo). CONCLUSION: Beta-blocker therapy can ameliorate left ventricular remodeling in asymptomatic patients with left ventricular systolic dysfunction. |
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Authors:
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Wilson S Colucci; Theodore J Kolias; Kirkwood F Adams; William F Armstrong; Jalal K Ghali; Stephen S Gottlieb; Barry Greenberg; Michael I Klibaner; Marrick L Kukin; Jennifer E Sugg; |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2007-06-18 |
Journal Detail:
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Title: Circulation Volume: 116 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2007 Jul |
Date Detail:
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Created Date: 2007-07-03 Completed Date: 2007-07-20 Revised Date: - |
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: 49-56 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Medicine, Boston University Medical Center, 88 E Newton St, Boston, MA 02118, USA. wilson.colucci@bmc.org |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00038077 |
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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administration & dosage,
pharmacology,
therapeutic use* Aged Angiotensin II Type 1 Receptor Blockers / administration & dosage, therapeutic use Angiotensin-Converting Enzyme Inhibitors / administration & dosage, therapeutic use Blood Pressure / drug effects Cardiovascular Agents / administration & dosage, therapeutic use Dose-Response Relationship, Drug Drug Therapy, Combination Female Heart Rate / drug effects Humans Male Metoprolol / administration & dosage, pharmacology, therapeutic use* Middle Aged Natriuretic Peptide, Brain / blood Stroke Volume Treatment Outcome Ventricular Dysfunction, Left / blood, drug therapy*, physiopathology, ultrasonography Ventricular Remodeling / drug effects* |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Cardiovascular Agents; 114471-18-0/Natriuretic Peptide, Brain; 37350-58-6/Metoprolol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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