Document Detail


An appropriate indication for the initiation of beta-blocker therapy in dilated cardiomyopathy.
MedLine Citation:
PMID:  16272814     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although long-term treatment with beta-blockers has been shown to improve morbidity and mortality in dilated cardiomyopathy (DCM), patient responses are heterogeneous. METHODS: To establish the appropriate indication for the initiation of beta-blocker therapy, we retrospectively analyzed 38 DCM patients treated with beta-blockers (metoprolol or carvedilol) and examined differences in baseline profiles between patients who could continue the therapy (responders) and those who could not (non-responders). RESULTS: In 13 non-responders, the duration from onset of symptoms to beta-blocker initiation was longer (p < 0.05), systolic blood pressure was lower (p < 0.001), serum sodium concentration was lower (p < 0.05), left ventricular posterior wall thickness was thinner (p < 0.05), left ventricular end-diastolic pressure was higher (p < 0.05) and left ventricular wall stress was lower (p < 0.05) than in 25 responders. In 19 patients receiving carvedilol, 5 non-responders showed higher levels of human atrial natriuretic peptide (p < 0.05) and brain natriuretic peptide (p < 0.01) than 13 responders. Discriminant analysis with a linear discriminant function showed the following equation predicted response to beta-blocker therapy: h = 0.004 x systolic blood pressure - 0.002 x brain natriuretic peptide + 0.667 (R2 = 0.67, p < 0.001). The probability of predicting the response was 94.1% with h > or = 0.5. CONCLUSION: We conclude that h > or = 0.5 is the appropriate indication for the initiation of beta-blocker therapy in DCM.
Authors:
Toshifumi Morooka; Teruo Inoue; Norihiko Kotooka; Daisuke Fujimatsu; Aiko Komatsu; Fumi Uchida; Kazuyo Yoshida; Shigemasa Hashimoto; Yutaka Hikichi; Toru Kato; Koichi Node
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2005-11-01
Journal Detail:
Title:  Cardiology     Volume:  105     ISSN:  0008-6312     ISO Abbreviation:  Cardiology     Publication Date:  2006  
Date Detail:
Created Date:  2005-11-25     Completed Date:  2006-03-02     Revised Date:  2010-03-29    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  61-6     Citation Subset:  IM    
Copyright Information:
Copyright 2006 S. Karger AG, Basel.
Affiliation:
Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, Saga, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Adult
Aged
Atrial Natriuretic Factor / blood
Biological Markers / blood
Blood Pressure / drug effects
Cardiomyopathy, Dilated / blood,  drug therapy*,  physiopathology
Discriminant Analysis
Female
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Predictive Value of Tests
Retrospective Studies
Stroke Volume / drug effects
Treatment Outcome
Ventricular Dysfunction, Left / drug therapy
Ventricular Pressure / drug effects
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain; 85637-73-6/Atrial Natriuretic Factor

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


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