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Atenolol in dilated cardiomyopathy: a clinical instrumental study
A V Mattioli1, M G Modena, G Fantini
1Cattedra di Malattie Cardiovascolari, Università di Modena, Italy.
Insights
Beta blockers, like atenolol, may improve clinical status and left ventricular performance in some patients with dilated cardiomyopathy. This study observed improved heart function metrics in patients with congestive heart failure.
Area of Science:
- Cardiology
- Pharmacology
Background:
- The efficacy of beta blockers in treating congestive heart failure (CHF) remains a subject of debate.
- Dilated cardiomyopathy (DCM) is a significant cause of heart failure, often requiring complex management.
Purpose of the Study:
- To investigate the effects of adding atenolol to conventional therapy in patients with dilated cardiomyopathy and NYHA class III heart failure.
- To assess changes in clinical status, exercise capacity, and left ventricular performance.
Main Methods:
- Eleven patients with DCM (NYHA class III) on digoxin and diuretics received atenolol 50 mg daily.
- Evaluations included clinical assessment (NYHA class), chest x-ray, exercise testing, and echocardiography before and after 3 months of treatment.
Main Results:
- Five patients showed improvement in NYHA class.
- Echocardiography revealed significant improvements in end-systolic diameter (p<0.02), fractional shortening (p<0.05), radius/thickness ratio (p<0.05), and reduced wall stress (p<0.02).
- Exercise tests did not show statistically significant improvements in total work performed.
Conclusions:
- Adding beta blockers like atenolol may enhance clinical status and improve left ventricular performance in select patients with dilated cardiomyopathy.
- While not all parameters improved, echocardiographic findings suggest beneficial effects on cardiac remodeling and function.
Abstract:
The usefulness of beta blockers in the treatment of congestive heart failure has been questioned. We selected 11 patients, mean age 47.1 +/- 13.8, affected by dilated cardiomyopathy in NYHA class III, who had been taking digoxin and diuretics for a long time. Atenolol 50 mg was added to conventional therapy. Both before and 3 months after treatment a clinical evaluation, chest x-ray, an exercise test, and an echocardiogram were performed. We observed an improvement of NYHA class in five patients. However, the exercise test showed no improvement: 2310 +/- 1299 vs. 2902 +/- 983 total kgm (ns). The echocardiogram showed improvements of the end-systolic diameter (from 6.3 +/- 1 cm to 5.9 +/- 0.8 cm; p less than 0.02), the fractional shortening (from 13.6 +/- 6.3% to 15.2 +/- 5.6%; p less than 0.05) the radius/thickness ratio (from 4.14 +/- 0.5 to 3.5 +/- 0.5; p less than 0.05), and the wall stress (from 208.4 +/- 49 g/cm2 to 163.5 +/- 41 g/cm2; p less than 0.02). The inotropic state index did not show any changes. We conclude that in some patients with dilated cardiomyopathy beta blockers may improve the clinical status and left ventricular performance.