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Pronounced improvement in systolic and diastolic ventricular long axis function after treatment with metoprolol
Author(s) -
Sveälv Bente Grüner,
Täng Margareta Scharin,
Waagstein Finn,
Andersson Bert
Publication year - 2007
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2007.02.007
Subject(s) - metoprolol , medicine , cardiology , ejection fraction , heart failure , dobutamine , placebo , hemodynamics , alternative medicine , pathology
Background: Although it is well known that left ventricular (LV) function improves after treatment with beta‐blockers in heart failure, little attention has been paid to the effects on LV long axis (LAX) function. Aims: To evaluate LV LAX function after treatment with metoprolol, and to assess whether LV LAX contractile reserve could predict future long‐term improvement. Methods: Twenty‐four heart failure patients were randomised to metoprolol or placebo for 6 months, followed by 6 months of open treatment with metoprolol. Rest and dobutamine stress echocardiography (DSE) was performed before and after each treatment period. Results: After treatment with metoprolol, LV LAX function improved significantly, systolic velocity from 29±8 to 32±15 mm/s, p <0.01 (metoprolol) vs. 28±7 to 28±11 mm/s, ns (placebo); atrioventricular plane fractional shortening (AVP‐FS) from 5.4±2.1 to 7.4±2.7%, p < 0.001 (metoprolol) vs. 5.9±2.1 to 5.8±2.9%, ns (placebo). The improvement in function was maintained during DSE. LV LAX contractile reserve could not predict treatment response; the treatment effect on LV LAX function was significantly greater than the contractile reserve at baseline. The relative improvement in LV LAX function after metoprolol was 38%, compared with a 20% improvement in LV ejection fraction (EF). Conclusion A significant improvement in LV LAX function was observed after treatment with metoprolol. AVP‐FS and systolic velocities increased significantly, and to a greater extent than LVEF.