PMID- 11704477
OWN - NLM
STAT- MEDLINE
DCOM- 20020129
LR  - 20190921
IS  - 1053-2498 (Print)
IS  - 1053-2498 (Linking)
VI  - 20
IP  - 11
DP  - 2001 Nov
TI  - Long-term effect of atenolol on ejection fraction, symptoms, and exercise 
      variables in patients with advanced left ventricular dysfunction.
PG  - 1174-80
AB  - AIMS: We recently reported a beneficial clinical effect of atenolol, a beta(1) 
      selective adrenergic antagonist, in 100 ambulatory heart failure patients with 
      low left ventricular ejection fraction (LVEF, <or=25%) who were receiving 
      background therapy with 40 mg/day enalapril. In this sub-study, we investigated 
      the effects of atenolol vs placebo on LVEF, New York Heart Association (NYHA) 
      class, workload, and peak oxygen consumption (Vo(2)). METHODS AND RESULTS: We 
      included 43 patients (23 receiving atenolol, 20 receiving placebo) who had 
      similar entry characteristics. We evaluated LVEF once a year and evaluated 
      workload, pVO(2), and NYHA class before and after 6, 12, and 24 months. Repeated 
      measures of analysis of variance were used for comparison of serial measurements. 
      After 2 years, both atenolol (18% +/- 5% vs 36% +/- 18%, p < 0.05) and placebo 
      (18% +/- 5% vs 23% +/- 5%, p < 0.05) increased LVEF, with a more pronounced 
      effect of atenolol (p = 0.02), which also changed NYHA class distribution more 
      favorably over time (p < 0.05). Workload and peak Vo(2) increased after atenolol 
      (110 +/- 47 vs 140 +/- 48 watts, p < 0.05, and 18 +/- 5 vs 21 +/- 5 ml/kg/min, p 
      < 0.05) but not after placebo (100 +/- 35 vs 110 +/- 38 watts, p < 0.05, between 
      groups and 17 +/- 4 vs 19 +/- 7 ml/kg/min, not significant, between groups). 
      CONCLUSIONS: In patients with advanced heart failure who tolerate long-term 
      atenolol vs placebo treatment added to high-dose enalapril for 2 years without 
      cardiac events, systolic left ventricular function is markedly improved. These 
      patients experience greater relief of symptoms and increased exercise tolerance.
FAU - Hulsmann, M
AU  - Hulsmann M
AD  - Department of Cardiology, Ludwig Boltzmann Institute for Cardiovascular Research, 
      University of Vienna, Vienna, Austria. martin.huelsmann@univie.ac.at
FAU - Sturm, B
AU  - Sturm B
FAU - Pacher, R
AU  - Pacher R
FAU - Berger, R
AU  - Berger R
FAU - Bojic, A
AU  - Bojic A
FAU - Frey, B
AU  - Frey B
FAU - Stanek, B
AU  - Stanek B
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 50VV3VW0TI (Atenolol)
RN  - 69PN84IO1A (Enalapril)
SB  - IM
MH  - Adrenergic beta-Antagonists/administration & dosage/*pharmacology
MH  - Atenolol/administration & dosage/*pharmacology
MH  - Double-Blind Method
MH  - Enalapril/administration & dosage
MH  - Exercise Test
MH  - Exercise Tolerance/*drug effects
MH  - Humans
MH  - Oxygen Consumption/drug effects
MH  - Prospective Studies
MH  - Stroke Volume/*drug effects
MH  - Ventricular Dysfunction, Left/drug therapy/*physiopathology
EDAT- 2001/11/13 10:00
MHDA- 2002/01/30 10:01
CRDT- 2001/11/13 10:00
PHST- 2001/11/13 10:00 [pubmed]
PHST- 2002/01/30 10:01 [medline]
PHST- 2001/11/13 10:00 [entrez]
AID - S1053-2498(01)00341-2 [pii]
AID - 10.1016/s1053-2498(01)00341-2 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2001 Nov;20(11):1174-80. doi: 
      10.1016/s1053-2498(01)00341-2.