Curative effect of β‑blocker on various ejection fractions of patients with atrial fibrillation

The aim of this study was to retrospectively determine the effects of metoprolol on patients presenting with persistent atrial fibrillation (AF), but either with or without a reduced ejection fraction (EF). All patients meeting the inclusion criteria were treated for 2 years with metoprolol. Blood pressure, heart rate and echocardiography parameters were measured and analysed in patients before and after treatment. The patients were divided into 2 cohorts as follows: Those presenting with a low EF (<50%) and those with normal EF values (≥50%). In total, 151 patients enrolled were 136; however, of these 15 were lost to mortality during the follow-up period, thus leaving a total of 136 patients. In total, 42 patients presented EF values <50%, while the remaining 94 presented with normal EF values. Treatment with metoprolol controlled blood pressure (both diastolic and systolic) and heart rate in patients with both low and normal EF values. EF values in the low EF group significantly increased following treatment. In addition, the echocardiography data revealed a statistically significant decrease in left atrial and ventricular diameters in the low EF group. On the whole, the findings of this study demonstrate that patients with AF and low EF values who were treated with metoprolol presented with improved cardiac function parameters. However, metoprolol should be contraindicated for patients with high EF values (i.e., absence of heart failure) as it seemed to increase their risk of heart failure based on the N-terminal pro b-type natriuretic peptide (NT-pro BNP) results.