PMID- 14607208
OWN - NLM
STAT- MEDLINE
DCOM- 20040312
LR  - 20190513
IS  - 1388-9842 (Print)
IS  - 1388-9842 (Linking)
VI  - 5
IP  - 5
DP  - 2003 Oct
TI  - Increased exercise ejection fraction and reversed remodeling after long-term 
      treatment with metoprolol in congestive heart failure: a randomized, stratified, 
      double-blind, placebo-controlled trial in mild to moderate heart failure due to 
      ischemic or idiopathic dilated cardiomyopathy.
PG  - 679-91
AB  - BACKGROUND: the effects of long-term administration of beta-blockers on left 
      ventricular (LV) function during exercise in patients with ischemic heart disease 
      (IHD) and idiopathic dilated cardiomyopathy (DCM) are controversial. PATIENTS AND 
      METHODS: patients with stable congestive heart failure (CHF) (New York heart 
      association [NYHA] class II and III) and ejection fraction (EF) < or =0.40 were 
      randomized to metoprolol, 50 mg t.i.d. or placebo for 6 months. Patients were 
      divided into two groups: ischemic heart disease (IHD) and idiopathic dilated 
      cardiomyopathy (DCM). The mean EF was 0.29 in both groups and 92% were taking 
      angiotensin-converting enzyme (ACE) inhibitors. In the IHD group, 84% had 
      suffered a myocardial infarction (MI) and 64% had undergone revascularization at 
      least 6 months before the study. LV volumes were measured by equilibrium 
      radionuclide angiography. Mitral regurgitation was assessed by Doppler 
      echocardiography. All values are changes for metoprolol subtracted by changes for 
      placebo. RESULTS: metoprolol improved LV function markedly both at rest and 
      during sub-maximal exercise in both groups. The mean increase in EF was 0.069 at 
      rest (P<0.001) and 0.078 during submaximal exercise (P<0.001). LV end-diastolic 
      volume decreased by 22 ml at rest (P=0.006) and by 15 ml during exercise 
      (P=0.006). LV end-systolic volume decreased by 23 ml both at rest (P=0.001) and 
      during exercise (P=0.004). Exercise time increased by 39 s (P=0.08). In the 
      metoprolol group, mitral regurgitation decreased (P=0.0026) and only one patient 
      developed atrial fibrillation vs. eight in the placebo group (P=0.01). 
      CONCLUSION: metoprolol improves EF both at rest and during submaximal exercise 
      and prevents LV dilatation in mild to moderate CHF due to IHD or DCM.
FAU - Waagstein, F
AU  - Waagstein F
AD  - Wallenberg Laboratory and Department of Cardiology, Sahlgrenska University 
      Hospital, SE-413 45 Goteborg, Sweden. Waagstein@wlab.gu.se
FAU - Stromblad, O
AU  - Stromblad O
FAU - Andersson, B
AU  - Andersson B
FAU - Bohm, M
AU  - Bohm M
FAU - Darius, M
AU  - Darius M
FAU - Delius, W
AU  - Delius W
FAU - Goss, F
AU  - Goss F
FAU - Osterziel, K J
AU  - Osterziel KJ
FAU - Sigmund, M
AU  - Sigmund M
FAU - Trenkwalder, S-P
AU  - Trenkwalder SP
FAU - Wahlqvist, I
AU  - Wahlqvist I
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
RN  - 0 (Adrenergic beta-Antagonists)
RN  - GEB06NHM23 (Metoprolol)
SB  - IM
MH  - Adrenergic beta-Antagonists/*therapeutic use
MH  - Cardiomyopathy, Dilated/diagnostic imaging/*drug therapy/physiopathology
MH  - Double-Blind Method
MH  - Exercise/physiology
MH  - Exercise Test
MH  - Female
MH  - Gated Blood-Pool Imaging
MH  - Heart/diagnostic imaging
MH  - Humans
MH  - Male
MH  - Metoprolol/*therapeutic use
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/prevention & control
MH  - Myocardial Ischemia/*drug therapy/physiopathology
MH  - Stroke Volume/*physiology
MH  - Time Factors
MH  - Ventricular Remodeling/*drug effects
EDAT- 2003/11/11 05:00
MHDA- 2004/03/16 05:00
CRDT- 2003/11/11 05:00
PHST- 2003/11/11 05:00 [pubmed]
PHST- 2004/03/16 05:00 [medline]
PHST- 2003/11/11 05:00 [entrez]
AID - S1388984203001053 [pii]
AID - 10.1016/s1388-9842(03)00105-3 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2003 Oct;5(5):679-91. doi: 10.1016/s1388-9842(03)00105-3.