Effects of Metoprolol CR in Patients With Ischemic and Dilated Cardiomyopathy Academic Article uri icon

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abstract

  • BACKGROUND: Metoprolol provides clinical benefits in patients with congestive heart failure (CHF). In this study, we investigated the effects of controlled-release metoprolol (metoprolol CR) on clinical status, on left ventricular (LV) volumes and function, and on neurohumoral activation in a large number of patients with CHF of mixed causes. METHODS AND RESULTS: Four hundred twenty-six patients with symptomatic CHF were randomized to receive metoprolol CR or placebo for 24 weeks. Metoprolol CR did not affect 6-minute walk distance, New York Heart Association functional class, or quality of life. However, there was a significant improvement in measures of LV function with an attenuation in the increase in LV end-diastolic (+23+/-65 mL [placebo] versus +6+/-61 mL, P=0.01) and LV end-systolic (+19+/-55 mL [placebo] versus -2+/-51 mL, P<0.001) volumes after 24 weeks of therapy. LV ejection fraction was unchanged (-0.05% or -0.005) in the placebo group but increased by 2. 4% in the metoprolol CR-treated patients (P=0.001). Patients receiving metoprolol CR had a greater decrease in angiotensin II (P=0.036) and renin (P=0.032) levels but an increase in N-terminal atrial natriuretic peptide and brain natriuretic peptide levels (P<0. 01). There were fewer deaths in the group receiving beta-blockers (3. 4% versus 8.1%), and there was a similar number of patients experiencing the composite outcomes of death or any hospitalization. CONCLUSIONS: When added to ACE inhibitors, angiotensin II receptor antagonists, or both, the use of metoprolol CR improves ventricular function, reduces activation of the renin-angiotensin systems, and results in fewer deaths.

authors

  • Cirillo, W
  • Decanini, R
  • Coelho, OR
  • Avezum, A
  • Peixoto, MSP
  • Piegas, LS
  • Neto, JMR
  • Paiva, M
  • Carvalho, AC
  • de Almeida, DR
  • Fernandes, IML
  • Malavasi, MC
  • Pavanello, R
  • Canesin, M
  • Ishii, S
  • Barretto, ACP
  • Imrie, J
  • Moore, R
  • Woo, K
  • Bernstein, V
  • Mizgala, HF
  • Mooney, S
  • Hilbich, D
  • Kuritzky, R
  • Rupka, DW
  • Blackwell, MM
  • Breakwell, L
  • Kornder, JM
  • Pearce, SA
  • Polasek, P
  • Richardson, PM
  • Grant, J
  • Isaac, D
  • Beresford, P
  • Giannoccaro, P
  • Roth, D
  • Greenwood, P
  • Muzyka, T
  • Prosser, A
  • Brass, N
  • Hui, W
  • Kvill, L
  • Goeres, M
  • MacDonald, K
  • Senaratne, M
  • Hill, L
  • Humen, D
  • Teo, KK
  • Habib, N
  • Habib, N
  • Teekasingh, S
  • MacKenzie, J
  • McEwen, B
  • Morris, A
  • Dhair, A
  • Lai, C
  • Kwiatkowski, K
  • Brugos, J
  • Nawaz, S
  • Andrews, J
  • Moe, G
  • Freskiw, K
  • Gilbert, B
  • Morgan, CD
  • Bozek, B
  • Halperin, F
  • Ricci, AJ
  • Singh, N
  • Cappelli, G
  • Boyne, T
  • Fallen, Ernest Leo
  • Panju, Akbar
  • Woodcock, G
  • Kent, E
  • Kitching, Allan
  • Sullivan, Hugh
  • Tomson, D
  • McKelvie, RS
  • Tsuyuki, RT
  • Yusuf, S
  • Chan, YK
  • Thomson, D
  • Arnold, JMO
  • Hurwitz, G
  • Miles, R
  • Baker, A
  • Haspect, A
  • Smith, S
  • Bedard, J
  • Lavoie, L
  • Dufort, L
  • Harvey, R
  • Lepage, S
  • Elstein, E
  • Fitchett, D
  • Serpa, A
  • Day, L
  • Racine, N
  • Savard, D
  • Sestier, F
  • Gosselin, G
  • Rouleau, JL
  • White, M
  • Whittom, L
  • Kiwan, G
  • Kouz, SM
  • Laforest, M
  • Ouimet, H
  • Carmichael, P
  • Lenis, J
  • Auger, P
  • Grondin, F
  • Saulnier, D
  • Campeau, J
  • Dupuis, R
  • Lauzon, C
  • Genest, M
  • Robitaille, NM
  • Beaudoin, J
  • Belanger, N
  • Houde, G
  • Talbot, P
  • Cossett, J
  • Koilpillai, C
  • Sheridan, WJ
  • Tobin, M
  • Sussex, B
  • Ascoli, G
  • Fraticelli, A
  • Paciaroni, E
  • Como, CO
  • Belluschi, R
  • Ruffa, F
  • Tettamanti, F
  • Cobelli, F
  • Salvucci, F
  • Arpesella, R
  • Campana, C
  • Gavazzi, A
  • Cirrincione, V
  • Ingrilli, F
  • Sciortino, E
  • Boccanelli, A
  • Cacciatore, G
  • Menichelli, M
  • Bosimini, E
  • Giannuzzi, P
  • Marcassa, C
  • Porcu, M
  • Salis, S
  • Sanna, A
  • Comerio, G
  • Gronda, E
  • Mangiavacchi, M
  • Moccetti, T
  • Pasotti, E
  • Sessa, F
  • Levy, WC
  • Probstfield, J
  • Thompson, J
  • Gramberg, M
  • Grover, J
  • Towery, D
  • Ogunyankin, K
  • Singh, BN
  • Celano, J
  • Graham, S
  • Kohn, RM
  • Pande, P
  • Sass, A
  • Wiener, RS
  • Rydzinski, S
  • Starling, RC
  • Young, J
  • Hays, L
  • Naftilan, A
  • Miller, A
  • Varga, A
  • Wofford, R
  • Barnhill, S
  • Brito, RD
  • Harris, L
  • Haspect, A
  • Cristina, T
  • Jarosz, M
  • Kellen, J
  • Kingry, C
  • Letterer, R
  • La Forge, D
  • Liuni, C
  • MacKenzie, J
  • Magi, A
  • Stevens, K
  • Squires, P
  • Yusuf, S
  • Rouleau, JL
  • Maggioni, A
  • Arnold, JMO
  • Avezum, A
  • Burns, R
  • Floras, J
  • Gavazzi, A
  • Held, P
  • Hjalmarson, A
  • Isaac, D
  • Latini, R
  • Lindgren, E
  • McKelvie, RS
  • Piegas, LS
  • Pericak, D
  • Pogue, J
  • Probstfield, J
  • Smith, S
  • Swedberg, K
  • Teo, KK
  • Tsuyuki, RT
  • Vint-Reed, C
  • Wang, Y
  • White, M
  • Wiecek, EM
  • Young, J
  • Johnstone, D
  • Armstrong, PW
  • Packer, M
  • Wedel, H
  • Teo, KK
  • Gavazzi, A
  • Tsuyuki, RT
  • White, M
  • McKelvie, Robert
  • Anderson, M
  • Holadyk-Gris, I
  • Kucemba, K
  • MacKay, J
  • McKelvie, RS
  • Micks, M
  • Pericak, D
  • Pogue, J
  • Reeve, S
  • Robinson, L
  • Tsuyuki, RT
  • Tucker, J
  • Wiecek, EM
  • Wang, Y
  • Yusuf, S
  • Cernacek, P
  • Joyal, M
  • Poitras, N
  • Rouleau, JL
  • White, M
  • Sirois, P
  • Bevilacqua, M
  • Latini, R
  • Masson, S
  • Torri, M
  • Hall, C
  • Burns, RJ
  • Heeney, T
  • Tadros, S
  • White, M
  • Yusuf, Salim
  • McKelvie, RS
  • Pericak, D
  • Young, J
  • Latini, R
  • Pogue, J
  • Burns, RJ
  • Probstfield, J
  • Tsuyuki, RT
  • Maggioni, AP
  • Avezum, A
  • Rouleau, JL

publication date

  • February 2000

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