Post-exercise Doppler-echocardiographic haemodynamics in idiopathic dilated cardiomyopathy after metoprolol infusion.
1. The physiological effects of the acute administration of a beta-adrenoceptor antagonist in patients with idiopathic dilated cardiomyopathy were assessed by performing post-exercise Doppler-echocardiography study. Eleven patients and six control subjects were studied. According to a double-blind randomized protocol, 5 mg of metoprolol or placebo was administered before cycloergometer exercise. 2. In patients, after metoprolol, a significant decrease in heart rate and systolic blood pressure, as well as in peak aortic acceleration and cardiac output, was observed 2 min after exercise. Left ventricular end-diastolic diameter did not change from baseline values either after placebo or metoprolol. In normal subjects, as compared with placebo, a decrease in heart rate and peak aortic acceleration was observed after metoprolol, whereas systolic blood pressure did not change. A similar increase in cardiac output occurred after metoprolol, as compared with placebo, associated with an increase in left ventricular end-diastolic diameter and stroke volume. 3. Post-exercise Doppler echocardiography is a means of assessing haemodynamic changes occurring during exercise in patients with congestive heart failure. Although acute metoprolol administration does not provide beneficial haemodynamic effects, a decrease in the energy requirements of the heart and a faster recovery after exercise may participate in the long-term beneficial action of beta-adrenoceptor antagonists.
Unité de Recherche U.2, Institut National de la Santé, Recherche Médicale, Créteil, France.
H
H
Perchet
F
F
Pouillart
A M
AM
Duval-Moulin
J F
JF
Heintz
L
L
Hittinger
A
A
Castaigne
J L
JL
Dubois-Randé
D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy* / Q000503:physiopathology; D003864:Depression, Chemical; D004311:Double-Blind Method; D015150:Echocardiography, Doppler; D015444:Exercise / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use*; D008875:Middle Aged; D013318:Stroke Volume / Q000187:drug effects
D008790:Metoprolol