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Improved exercise h...
Improved exercise hemodynamic status in dilated cardiomyopathy after beta-adrenergic blockade treatment.
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- Andersson, Bert, 1952 (author)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Wallenberglaboratoriet,Cardiovascular Institute,Wallenberg Laboratory
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Hamm, C (author)
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Persson, S (author)
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Wikström, G (author)
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Sinagra, G (author)
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- Hjalmarson, Åke, 1937 (author)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Wallenberglaboratoriet,Cardiovascular Institute,Wallenberg Laboratory
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- Waagstein, Finn, 1938 (author)
- Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Hjärt-kärlinstitutionen,Wallenberg Laboratory,Cardiovascular Institute
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(creator_code:org_t)
- 1994
- 1994
- English.
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In: Journal of the American College of Cardiology. - 0735-1097. ; 23:6, s. 1397-404
- Related links:
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https://gup.ub.gu.se...
Abstract
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- This study was performed to investigate exercise hemodynamic status in a double-blind, placebo-controlled trial and was a substudy in the Metoprolol in Dilated Cardiomyopathy Trial.Previous open studies have shown beneficial effects on exercise hemodynamic status after beta-adrenergic blocking agent therapy in patients with congestive heart failure.The study included 41 patients with idiopathic dilated cardiomyopathy with ejection fraction < 0.40 (metoprolol, 20 patients; placebo, 21 patients) whose hemodynamic status was investigated at rest and during supine submaximal exercise, at baseline and after 6 and 12 months of treatment. Myocardial metabolism was evaluated in a subset of 19 patients.Metoprolol-treated patients responded favorably, as expressed by improved exercise cardiac index ([mean +/- SD] placebo 4.8 +/- 1.6 to 4.7 +/- 1.8 liters/min per m2, metoprolol 4.3 +/- 1.1 to 5.4 +/- 1.9 liters/min per m2, p = 0.0001) and stroke work index (placebo 44 +/- 20 to 41 +/- 27 g.m/m2, metoprolol 35 +/- 16 to 58 +/- 28 g.m/m2, p < 0.0001). Exercise systolic arterial pressure increased (placebo 161 +/- 25 to 151 +/- 23 mm Hg, metoprolol 155 +/- 29 to 165 +/- 37 mm Hg, p = 0.0003) as well as exercise oxygen consumption index (placebo 463 +/- 194 to 474 +/- 232 ml/min per m2, metoprolol 406 +/- 272 to 507 +/- 298 ml/min per m2, p = 0.045). There was a significant increase in exercise duration in the metoprolol group (63 +/- 38 s) compared with the placebo group (-24 +/- 42 s) (p = 0.01). Net myocardial lactate extraction increased in the metoprolol group, suggesting less myocardial ischemia (placebo 17 +/- 22 to 9.5 +/- 6.4 mmol/min, metoprolol -32 +/- 100 to 42 +/- 45 mmol/min, p = 0.03). Peripheral levels of norepinephrine tended to decrease at rest and during exercise, whereas myocardial net spillover was unchanged.Metoprolol improved hemodynamic status in patients with dilated cardiomyopathy at rest and had a more pronounced effect during exercise. These positive effects were achieved along with improved or stable myocardial metabolic data.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Analysis of Variance
- Cardiomyopathy
- Dilated
- drug therapy
- epidemiology
- physiopathology
- Double-Blind Method
- Europe
- Exercise
- physiology
- Female
- Hemodynamics
- drug effects
- Humans
- Male
- Metoprolol
- therapeutic use
- Middle Aged
- North America
- Time Factors
Publication and Content Type
- ref (subject category)
- art (subject category)
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Andersson, Bert, ...
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Hamm, C
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Persson, S
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Wikström, G
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Sinagra, G
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Hjalmarson, Åke, ...
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show more...
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Waagstein, Finn, ...
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show less...
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- MEDICAL AND HEALTH SCIENCES
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University of Gothenburg