A questionnaire study of beta-adrenergic blockade in dilated cardiomyopathy in Japan

A questionnaire study on the effect of beta-blockade in dilated cardiomyopathy was performed. In 89 cases obtained from 24 institutions, either metoprolol (72 patients, 41.4 +/- 29.3 mg/day, 14.1 +/- 13.2 months, mean +/- SD), propranolol (5 patients, 23.8 +/- 24.3 mg/day, 25.0 +/- 25.3 months), carteolol (4 patients, 7.5 +/- 2.9 mg/day, 9.0 +/- 2.8 months) or another beta-blockers (8 patients) was administered. Nine patients died during the follow-up period. Overall effectiveness as evaluated by the attending physicians showed improvement in 51 patients (57.3%), no change in 26 patients (29.2%), deterioration in 11 patients (12.4%) or was indeterminate in one patient. New York Heart Association (NYHA) functional class improved significantly from 2.6 to 2.3 (p less than 0.01). Heart rate decreased from 83.1 to 70.1 (p less than 0.01). Cardiothoracic ratio decreased from 55.5% to 53.9% (p less than 0.01). Left ventricular ejection fraction of the left ventricle measured by echocardiogram increased from 29.8% to 37.8% (p less than 0.01). Exercise tolerance during a treadmill test and ventricular arrhythmias in Holter electrocardiograms improved significantly. There was no change in blood pressure. When the patients in different functional classes were compared, the patients of NYHA class III improved more frequently than those of NYHA class II (69% vs 53% p less than 0.01). Improvement of left ventricular end-diastolic dimension and left ventricular ejection fraction was more prominent in patients of class III than in those of class II. NYHA functional class and cardiothoracic ratio were significantly improved only in class III.(ABSTRACT TRUNCATED AT 250 WORDS)