Effects of metoprolol therapy on left ventricular remodeling and function in patients with chronic heart failure

Cai Yufu; Xie Xiaoxia; Li Ping

doi:10.3760/cma.j.issn.1673-4777.2015.03.009

Abstract：Objective To evaluate the effects of metoprolol on the heart function improvement,remodeling process and prognosis in chronic heart failure patients.Methods Totally 180 patients with chronic heart failure were divided into control group(90 patients)and observation group(90 patients).The control group was given basic treatment with digoxin,diuretics,angiotensin converting enzyme inhibitor (ACEI).The observation group was given metoprolol in addition to basic treatment [6.25 mg/1 time,2 times/d orally every 1-2 weeks adjustable dose 1 times,until it reached the target dose (50 mg,2 times/d) or the maximum tolerance dose].Heart function,left ventricular ejection fraction(LVEF),left ventricular diastolic dimension(LVEDD),left ventricular endsystolic dimension(LVESD),resting heart rate (RHR),plasma amino-terminal pro-brain natriuretic peptide (NT-proBNP) level and 6-minute walk test(6MWT) in chronic heart failure patients were observed before and after six months treatment.Results After treatment,the LVEF and 6MWT were obviously improved; RHR in observation group was decreased [80.0％ (72/90) vs 48.9％ (44/90),95.5％ (86/90) vs 80.0％ (72/90),(55 ± 6) ％ vs (50 ± 6) ％,(523 ± 18) m vs (421 ± 18) m,(66 ± 5) times a minute vs (79 ± 6) times a minute] (P ＜ 0.01).LVEDD,LVESD and NT-proBNP level were also decreased at 6 months compared with those in observation group [(45.1 ± 0.2) mm vs (50.1 ± 0.3) mm,(34.6 ± 2.2) mm vs (38.3 ± 2.1) mm,(888 ± 50) ng/L vs (899 ± 60) ng/L] (P ＜ 0.05).Conclusions In additional to the conventional therapy with angiotensin converting enzyme inhibitors,metoprolol can improve left ventricular performance and remodeling in patients with chronic heart failure.