The effects of metoprolol therapy on the left ventricular remodeling and function in the patients of ischemic heart disease with cardiac dysfunction

Objective To investigate cardiac function improvement and remodeling process with titrated metoprolol therapy in the patients of coronary artery disease with cardiac dysfunction. Methods In 80 patients with cardiac dysfunction, the ejection fraction of them was ≤0.45. On a basic medical therapy including digitalis, diuretics and ACEI, they were divided randomly into metoprolol group and control group for a 6-month follow-up period. The data of ventricular function were measured by 20-echocardiography at baseline, 1,3 and 6 months after admission. Results The mean dose of metoprolol was titrated to 39.8±13.8mg/day (range 18.75 to 75mg/d). In metoprolol group symptom scores and NYHA class improved, as reflected by the increased left ventricular ejection fraction (48.10±2.50) vs (39.50±2.74) (P=0.002) and the decreased left ventricular end systolic volume (163.50±45.00) vs (181.40±44.00) (P=0.042) compared with those in control group. Moreover, in treatment group, the left ventricular end-diastolic volume decreased at 6-month compared with that at baseline (P0.05), but there was no significant differences between the two groups. Conclusion Based on the medication of digitalis, diuretics and angiotensin-converting enzyme inhibitors, metoprolol therapy can improve left ventricular performance, reverse LV remodeling in patients of coronary artery disease with heart failure and also improve the biological properties of the chronically failing heart. There was no difference of this benefit in the patients with different NYHA classes.