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[Tolerance of beta blockader treatment in dilated cardiomyopathy]

A V Mattioli1, G Bettelli, G Mattioli

  • 1Cattedra di Malattie dell'Apparato Cardiovascolare, Università degli Studi, Modena.

Cardiologia (Rome, Italy)
|March 1, 1991
PubMed

Insights

High neurohumoral activation, indicated by elevated norepinephrine and renin activity, may predict poor tolerance to beta-blocker therapy in heart failure patients with dilatative cardiomyopathy.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Dilatative cardiomyopathy is a common cause of heart failure.
  • Beta-blockers are a cornerstone therapy for heart failure, but patient tolerance varies.
  • Identifying predictors of beta-blocker intolerance is crucial for optimizing treatment.

Purpose of the Study:

  • To evaluate hemodynamic and neurohumoral parameters for predicting beta-blocker tolerance in heart failure patients.
  • To identify specific markers associated with intolerance to atenolol therapy.

Main Methods:

  • Seventy-eight patients with dilatative cardiomyopathy and heart failure were assessed.
  • Hemodynamic parameters (e.g., MPAP, cardiac output) and neurohumoral markers (NE, PRA) were measured.
  • Patients received escalating doses of atenolol, and tolerance was assessed.

Main Results:

  • Forty-one out of 78 patients did not tolerate beta-blocker therapy.
  • Intolerant patients exhibited significantly higher mean pulmonary arterial pressure (MPAP), plasma norepinephrine (NE), and plasma renin activity (PRA) at baseline.
  • MPAP (p=0.02), NE (p=0.01), and PRA (p=0.02) were significantly different between tolerant and intolerant groups.

Conclusions:

  • Elevated baseline neurohumoral activation (NE, PRA) and MPAP may indicate poor tolerance to beta-blockers in heart failure patients.
  • These parameters could serve as potential biomarkers to guide beta-blocker therapy selection.

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