Effect of metoprolol on cardiac and pulmonary function in chronic obstructive pulmonary disease

We evaluated the effects of oral metoprolol, 200 mg daily, on cardiac and pulmonary function in 6 patients with chronic reversible airways obstruction and no cardiac dysfunction. The patients were clinically stable. In all patients, baseline forced expiratory volume in 1 second (FEV1) was less than 60% predicted, and increased at least 15% after isoproterenol inhalation. Resting control first pass right and left ventricular radionuclide ejection fractions were normal or only slightly depressed. Compared to placebo, metoprolol did not significantly affect FEV1 or forced vital capacity. Metoprolol did not significantly alter left or right ventricular ejection fraction, measured by first pass radionuclide technique. On patient experienced increased dyspnea on metoprolol, which was not accompanied by changes in clinical exam, spirometry, or ejection fraction. We conclude that metoprolol may be safely administered to a subset of stable patients with chronic reactive airways disease.