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Effect of metoprolol on rest and exercise left ventricular systolic and diastolic function in idiopathic dilated

I P Clements1, W L Miller

  • 1Division of Cardiovascular Disease and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minn.

American Heart Journal
|February 15, 2001
PubMed

Insights

In idiopathic dilated cardiomyopathy (IDCM), heart rate significantly impacts systolic and diastolic cardiac function, even after beta-blockade therapy. This relationship persists during rest and exercise, highlighting heart rate

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Pharmacology

Background:

  • Idiopathic dilated cardiomyopathy (IDCM) is a complex condition affecting heart muscle function.
  • Understanding the interplay between heart rate and cardiac performance is crucial for managing IDCM.
  • Previous studies suggest heart rate influences systolic and diastolic function, but its behavior under beta-blockade and exercise in IDCM requires further elucidation.

Purpose of the Study:

  • To investigate the effects of heart rate on systolic and diastolic function in patients with IDCM.
  • To determine if beta-blockade and exercise alter the relationship between heart rate and left ventricular function in IDCM patients.

Main Methods:

  • Eighteen IDCM patients were enrolled in a 3-month, double-blind, randomized trial comparing metoprolol and placebo.
  • Resting and exercise radionuclide left ventriculograms were performed before and after the 3-month treatment period.
  • These assessments evaluated left ventricular systolic and diastolic function parameters.

Main Results:

  • Metoprolol significantly reduced heart rate and improved left ventricular ejection fraction at rest and during exercise compared to placebo.
  • Exercise in the metoprolol group showed decreased heart rate, increased ejection fraction, prolonged filling time, and reduced peak filling rate.
  • Pre-treatment, heart rate correlated negatively with ejection fraction and positively with peak filling rate; these correlations persisted for peak filling rate after metoprolol treatment.

Conclusions:

  • In IDCM patients, heart rate is intrinsically linked to both systolic and diastolic cardiac function.
  • This relationship between heart rate and diastolic function remains evident even after beta-blockade treatment, both at rest and during exercise.
Abstract

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