Therapy of idiopathic dilated cardiomyopathy with chronic beta-adrenergic blockade.
Conventional therapy of patients with idiopathic dilated cardiomyopathy is currently directed at the control of heart failure. However, the morbidity and mortality of idiopathic dilated cardiomyopathy remains very high despite such interventions. One promising new approach to therapy of idiopathic dilated cardiomyopathy is beta-blockade. The potential mechanisms for benefit from beta-blockade include protection from catecholamine cardiotoxicity, upregulation of myocardial beta-adrenergic receptors, reduction in sudden death, reduction in heart rate, improved ventricular diastolic function, and reduction in afterload. Several reports have suggested that long-term beta-blockade may improve hemodynamic function, clinical symptoms, and survival in patients with idiopathic dilated cardiomyopathy. However, data from controlled trials are limited and some reports have been negative. This paper will summarize the rationale for the use of beta-blocker therapy in idiopathic dilated cardiomyopathy and review the clinical experience with this therapy.
Division of Cardiology, University of Utah School of Medicine, Salt Lake City 84132.
E M
EM
Gilbert
J B
JB
O'Connell
M R
MR
Bristow
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy* / Q000503:physiopathology; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006352:Heart Ventricles / Q000187:drug effects / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D011412:Propanolamines / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D011412:Propanolamines; C024307:bucindolol