Key result
Metoprolol therapy for 6 months significantly improved cardiac function, including an increase in resting ejection fraction from 27.3% to 35.2%, and exercise capacity in patients with heart failure.
Why the study?
Does metoprolol improve ventricular function and cardiopulmonary exercise capacity in patients with mild to moderate heart failure (LVEF <40%, NYHA II-III)?
RCT (n=52)
Does metoprolol improve ventricular function and cardiopulmonary exercise capacity in patients with mild to moderate heart failure (LVEF <40%, NYHA II-III)?
Metoprolol therapy for 6 months significantly improves cardiac function and exercise capacity in patients with mild to moderate heart failure, regardless of ischemic or non-ischemic etiology.
Supports metoprolol in mild-moderate HF; extends RCT evidence to objective EF and exercise gains.
UNLABELLED: Beta-blocker therapy results in a functional benefit in patients with heart failure (CHF) due to idiopathic dilated cardiomyopathy (DCM). This study assessed if similar effects were observed in patients with ischemic heart disease (CAD), NYHA II-III after 6 months of therapy with metoprolol. METHODS AND RESULTS: Fifty-two patients with CHF secondary to DCM (26 patients) and CAD (26 patients) and a left ventricular ejection fraction (EF)<40% were enrolled in the placebo-controlled study. The study medication was titrated over 6 weeks, the mean final dosage was 135 mg/day. Three patients died due to cardiogenic shock, two received placebo and one metoprolol. Eight patients did not complete the study due to non-compliance. Metoprolol significantly reduced heart rate at rest and after submaximal and maximal exercise. Vo(2)-max and Vo(2)-AT as well as the 6-min walk test improved significantly after metoprolol treatment. There was a significant increase in EF at rest (27.3-35. 2%), submaximal (28.5-37.7%) and maximal exercise (28.7-40.9%) in the metoprolol-treated patients. No differences were found between patients with CAD and DCM. We also observed reduced left ventricular volumes. CONCLUSION: The additional therapy with metoprolol improved cardiac function and the cardiopulmonary exercise capacity in patients with CHF.
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Genth‐Zotz et al. (2000) conducted an RCT in Mild to Moderate Heart Failure (n=52). Metoprolol vs. Placebo was evaluated on Ventricular function and cardiopulmonary exercise testing. Metoprolol therapy for 6 months significantly improved cardiac function, including an increase in resting ejection fraction from 27.3% to 35.2%, and exercise capacity in patients with heart failure.
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