Longitudinal myocardial contraction improves early during titration with metoprolol CR/XL in patients with heart failure.

• To investigate diastolic and systolic left ventricular recovery during titration with metoprolol CR/XL (controlled release/extended release).Placebo run in, followed by an open study.University hospital.14 patients with chronic heart failure.Metoprolol CR/XL titrated from 12.5 mg once daily to 200 mg once daily.M mode recordings of atrioventricular (AV) plane displacement, Doppler measurement of transmitral flow and pulmonary venous flow, two dimensional ejection fraction, and measurement of venous plasma concentration of noradrenaline. Patients were investigated after 2, 4, 6, and 24 weeks of treatment.A reduction of heart rate was observed on the first dose (12.5 mg once daily), from a mean (SD) of 74 (11) to 67 (11) beats/min, p < 0.05. This was accompanied by prominent effects on AV plane filling parameters, including an increase in early diastolic filling period from 87 (28) to 105 (33) ms (p < 0.05), and in the lateral AV plane fractional shortening from 8.7 (2.7)% to 10.2 (2.8)% (p < 0.05). An early trend towards improvement in global systolic left ventricular function was also seen, although this was not significant until six weeks. Ejection fraction increased from 33 (7.5)% to 38 (11)% (p < 0.05).First effects of left ventricular recovery during beta blocker treatment were seen in recordings of longitudinal performance, as expressed by AV plane displacement. Doppler flow dynamics as well as global systolic recovery appeared several weeks later, emphasising the importance of longitudinal performance in evaluating left ventricular function.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

Adrenergic beta-Antagonists

administration & dosage

Catecholamines

blood

Chronic Disease

Delayed-Action Preparations

Diastole

physiology

Dose-Response Relationship

Drug

Echocardiography

Female

Heart Failure

blood

drug therapy

physiopathology

Humans

Male

Metoprolol

administration & dosage

analogs & derivatives

Middle Aged

Myocardial Contraction

drug effects

Systole

physiology

Publication and Content Type

ref (subject category)

art (subject category)