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Pronounced improvement in systolic and diastolic ventricular long axis function after treatment with metoprolol

Bente Grüner Sveälv1, Margareta Scharin Täng, Finn Waagstein

  • 1Department of Molecular and Clinical Medicine/Cardiology, Wallenberg Laboratory, Sahlgrenska Academy at Göteborg University, SE-413 45 Göteborg, Sweden.

European Journal of Heart Failure
|April 24, 2007
PubMed

Insights

Metoprolol significantly improved left ventricular (LV) long axis (LAX) function in heart failure patients, with greater gains than ejection fraction (EF). This enhancement in LV LAX function was sustained and did not depend on baseline contractile reserve.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Pharmacology

Background:

  • Beta-blockers are known to improve left ventricular (LV) function in heart failure.
  • Limited research exists on the impact of beta-blockers on LV long axis (LAX) function.

Purpose of the Study:

  • To evaluate changes in LV LAX function following metoprolol treatment in heart failure patients.
  • To determine if LV LAX contractile reserve predicts long-term functional improvement.

Main Methods:

  • A randomized trial involving 24 heart failure patients treated with metoprolol or placebo for 6 months.
  • Rest and dobutamine stress echocardiography (DSE) assessed LV LAX function before and after treatment periods.

Main Results:

  • Metoprolol significantly improved LV LAX systolic velocity and atrioventricular plane fractional shortening (AVP-FS).
  • Improvements in LV LAX function were maintained during dobutamine stress and were greater than improvements in LV ejection fraction (EF).
  • LV LAX contractile reserve did not predict treatment response.

Conclusions:

  • Metoprolol treatment leads to significant improvements in LV LAX function in heart failure.
  • The increase in AVP-FS and systolic velocities exceeds the improvement seen in LVEF.
Abstract

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