Key result
Concomitant oral metoprolol therapy significantly improved left ventricular dimensions and fractional shortening, and decreased plasma ANP and BNP levels in patients with chronic heart failure.
Why the study?
Does oral metoprolol improve left ventricular function and natriuretic peptide levels in patients with chronic heart failure treated with ACEI?
RCT (n=52)
Does oral metoprolol improve left ventricular function and natriuretic peptide levels in patients with chronic heart failure treated with ACEI?
The addition of metoprolol to standard therapy including ACE inhibitors improves left ventricular function and reduces natriuretic peptide levels in patients with chronic heart failure.
Should not yet change practice in ACEI-treated chronic heart failure; supports hypothesis but leaves open need for randomized confirmation.
To evaluate whether or not beta-blockers can improve the condition of patients with heart failure treated with a combination of diuretics, digitalis and angiotensin-converting enzyme inhibitor (ACEI), 52 patients with chronic heart failure who have been treated with ACEI for more than 6 months were enrolled. They were divided into 2 groups: 26 patients continued the same therapy another 6 months or more (group A), and 26 patients were given oral metoprolol for 6 months or more, in addition to the ACEI (group B). Echocardiographic parameters and atrial and brain natriuretic peptides (ANP, BNP) were measured. The left ventricular dimensions at end-diastole and end-systole were significantly decreased and fractional shortening was significantly increased in group B after 6 months' treatment with the beta-blocker, but these parameters remained unchanged in group A. Plasma levels of both ANP and BNP were significantly decreased in group B, but remained unchanged in group A. These results indicate that concomitant beta-blocker therapy can improve left ventricular function and attenuate plasma ANP and BNP levels in patients with chronic heart failure treated with ACEI.
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Hara et al. (2000) conducted an RCT in chronic heart failure (n=52). oral metoprolol vs. continued the same therapy (diuretics, digitalis, ACEI) was evaluated on Echocardiographic parameters and atrial and brain natriuretic peptides (ANP, BNP). Concomitant oral metoprolol therapy significantly improved left ventricular dimensions and fractional shortening, and decreased plasma ANP and BNP levels in patients with chronic heart failure.
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