Effects of metoprolol CR in patients with ischemic and dilated cardiomyopathy -: The randomized evaluation of strategies for left ventricular dysfunction pilot study

被引：192

作者：

Cirillo, W ^{[1
]}

Decanini, R ^{[1
]}

Coelho, OR ^{[1
]}

Avezum, A ^{[1
]}

Peixoto, MSP ^{[1
]}

Piegas, LS ^{[1
]}

Neto, JMR ^{[1
]}

Paiva, M ^{[1
]}

Carvalho, AC ^{[1
]}

de Almeida, DR ^{[1
]}

Fernandes, IML ^{[1
]}

Malavasi, MC ^{[1
]}

Pavanello, R ^{[1
]}

Canesin, M ^{[1
]}

Ishii, S ^{[1
]}

Barretto, ACP ^{[1
]}

Imrie, J ^{[1
]}

Moore, R ^{[1
]}

Woo, K ^{[1
]}

Bernstein, V ^{[1
]}

Mizgala, HF ^{[1
]}

Mooney, S ^{[1
]}

Hilbich, D ^{[1
]}

Kuritzky, R ^{[1
]}

Rupka, DW ^{[1
]}

Blackwell, MM ^{[1
]}

Breakwell, L ^{[1
]}

Kornder, JM ^{[1
]}

Pearce, SA ^{[1
]}

Polasek, P ^{[1
]}

Richardson, PM ^{[1
]}

Grant, J ^{[1
]}

Isaac, D ^{[1
]}

Beresford, P ^{[1
]}

Giannoccaro, P ^{[1
]}

Roth, D ^{[1
]}

Greenwood, P ^{[1
]}

Muzyka, T ^{[1
]}

Prosser, A ^{[1
]}

Brass, N ^{[1
]}

Hui, W ^{[1
]}

Kvill, L ^{[1
]}

Goeres, M ^{[1
]}

MacDonald, K ^{[1
]}

Senaratne, M ^{[1
]}

Hill, L ^{[1
]}

Humen, D ^{[1
]}

Teo, KK ^{[1
]}

Habib, N ^{[1
]}

机构：

[1] McMaster Clin, Canadian Cardiovasc Collaborat, Project Off, Hamilton, ON L8L 2X2, Canada

来源：

CIRCULATION | 2000年 / 101卷 / 04期

关键词：

heart failure; receptors; adrenergic; beta; hormones; ventricles;

D O I：

10.1161/01.CIR.101.4.378

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background-Metoprolol provides clinical benefits in patients with congestive heart failure (CHF). in this study, we investigated the effects of controlled-release metoprolol (metoprolol CR) on clinical status, on left ventricular (LV) volumes and function, and on neurohumoral activation in a large number of patients with CHF of mixed causes. Methods and Results-Four hundred twenty-six patients with symptomatic CHF were randomized to receive metoprolol CR or placebo for 24 weeks. Metoprolol CR did not affect 6-minute walk distance, New York Heart Association functional class, or quality of life. However, there was a significant improvement in measures of LV function with an attenuation in the increase in LV end-diastolic (+23 +/- 65 mL [placebo] versus +6 +/- 61 mL, P = 0.01) and LV end-systolic (+19 +/- 55 mL [placebo] versus -2 +/- 51 mL, P < 0.001) volumes after 24 weeks of therapy. LV ejection fraction was unchanged (-0.05% or -0.005) in the placebo group but increased by 2.4% in the metoprolol CR-treated patients (P = 0.001). Patients receiving metoprolol CR had a greater decrease in angiotensin II (P = 0.036) and renin (P = 0.032) levels bur an increase in N-terminal atrial natriuretic peptide and brain natriuretic peptide levels (P < 0.01). There were fewer deaths in the group receiving beta-blockers (3.4% versus 8.1%), and there was a similar number of patients experiencing the composite outcomes of death or any hospitalization. Conclusions-When added to ACE inhibitors, angiotensin II receptor antagonists, or both, the use of metoprolol CR improves ventricular function, reduces activation of the renin-angiotensin systems, and results in fewer deaths.

引用

页码：378 / 384

页数：7

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