Beta-1-selectivity is not essential to achieve therapeutic efficacy with beta-blockade therapy for idiopathic dilated cardiomyopathy.
This study investigated the therapeutic efficacy of two different beta-blockers, metoprolol (beta 1-selective) and nipradilol (nonselective) for the treatment of idiopathic dilated cardiomyopathy (DCM). The New York Heart Association functional class improved in the metoprolol group (n = 9) and the nipradilol group (n = 9), but not in the control group who received conventional therapy (n = 8). The left ventricular ejection fraction increased in both the beta-blocker groups (p < 0.01, p < 0.05). Lymphocyte beta-adrenoceptors were upregulated in the nipradilol group (p < 0.01). Cardiac events were less common in both the beta-blocker groups than in the control group (both p < 0.05). Thus, nipradilol improved symptoms and cardiac function with a favorable effect on sympathoneuronal activity as well as metoprolol in patients with DCM. Therefore, beta 1-selectivity is not essential to achieve therapeutic efficacy with beta-blockade therapy for DCM.
Yoshikawa
T
T
Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Handa
S
S
Akaishi
M
M
Mitamura
H
H
Ogawa
S
S
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism; D015986:Confounding Factors, Epidemiologic; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use*; D008875:Middle Aged; D011412:Propanolamines / Q000627:therapeutic use*; D015635:Radionuclide Ventriculography; D011943:Receptors, Adrenergic, beta / Q000187:drug effects*; D016277:Ventricular Function, Left / Q000187:drug effects*
D000319:Adrenergic beta-Antagonists; D011412:Propanolamines; D011943:Receptors, Adrenergic, beta; C036089:nipradilol; D008790:Metoprolol