Lege Artis Medicinae

[Metoprolol treatment in dialated cardiomyopathy]

DÉKÁNY Miklós1, NYOLCAS Noémi1, FIÓK János1, VÁNDOR László2, SEREG Mátyás3, BALOGH Ildikó4

DECEMBER 25, 1991

Lege Artis Medicinae - 1991;1(18)

[Authors applied metoprolol for treating heart failure in with dilated cardiomyopathy. Patients were given digitalis, diuretics as well as ACE-inhibitor and vasodilator drugs. The grade of heart failure was according to NYHA classification in the mean 2.5 class. For assessing the effect of metoprolol clinical variables and results of non-invasive tests were evaluated and compared in 3 consecutive periods: 1) before starting metoprolol, 2) 2–4 weeks after reaching its definitive dose (short-term effect), 3) 3-6 months later (medium-term effect). Early intolerance appeared in 3 patients; signi ficant progression of heart failure in 2 and hypotension causing complaints in 1. Evaluating the actually treated 17 patients clinical signs of heart failure (NYHA class) decreased, left ventricular ejection fraction improved, though not significantly in case of every considered variables, left atrial filling pressure decreased, exercise capacity did not alter, rate-pressure product decreased at rest and at low level of exercise as well. The authors stress the significance of "up-regulation" of myocardial beta-1 receptors in the reduction of myocardial toxic catecholamin effect and myocardial oxygen demand as well as in the increase of myocardial blood supply. Referring to the data of the respective literature and to their own experiences the authors suggest metoprolol treatment in cases of dilated cardiomyopathy, where previus therapy did not prove to be efficient.]

AFFILIATIONS

  1. Orvostovábbképző Egyetem II. Belgyógyászati Klinika
  2. Országos Kardiológiai Intézet Belgyógyászati Osztály
  3. Szent György Kórház Belgyógyászati Osztály Székesfehérvár
  4. Orvostovábbképző Egyetem Radiológiai Klinika

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