What is the clinical evidence from this study?

Study design: RCT. Population: chronic heart failure (n=52). Intervention: oral metoprolol vs. continued the same therapy (diuretics, digitalis, ACEI). Primary outcome: Echocardiographic parameters and atrial and brain natriuretic peptides (ANP, BNP).

January 1, 2000Open Access

Effect of Beta-Blocker on Left Ventricular Function and Natrituretic Peptides in Patients With Chronic Heart Failure Treated With Angiotensin-Converting Enzyme Inhibitor

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.

Study Design

Type

RCT (n=52)

Structured PICO

Does oral metoprolol improve left ventricular function and natriuretic peptide levels in patients with chronic heart failure treated with ACEI?

Population

n=52 patients with chronic heart failure who have been treated with a combination of diuretics, digitalis and angiotensin-converting enzyme inhibitor (ACEI) for more than 6 months.

Intervention

Oral metoprolol for 6 months or more, in addition to baseline therapy (ACEI, diuretics, digitalis).

Comparator

Continued baseline therapy (ACEI, diuretics, digitalis) for another 6 months or more.

Outcome

Echocardiographic parameters (left ventricular dimensions at end-diastole and end-systole, fractional shortening) and plasma levels of atrial and brain natriuretic peptides (ANP, BNP) at 6 months.surrogate

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.

Abstract

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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