Effects of β-adrenergic blocking therapy on left ventricular diastolic relaxation properties in patients with dilated cardiomyopathy
The hemodynamic mechanism for the improvement in left ventricle (LV) end-diastolic pressure in cardiomyopathy patients treated with beta-adrenergic blocking agents is controversial. We hypothesized that the salutary effect of this kind of therapy on LV end-diastolic pressure would be indicative of a...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 1999-08, Vol.100 (7), p.729-735 |
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| container_title | Circulation (New York, N.Y.) |
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| creator | KIM, M. H DEVLIN, W. H DAS, S. K PETRUSHA, J MONTGOMERY, D STARLING, M. R |
| description | The hemodynamic mechanism for the improvement in left ventricle (LV) end-diastolic pressure in cardiomyopathy patients treated with beta-adrenergic blocking agents is controversial. We hypothesized that the salutary effect of this kind of therapy on LV end-diastolic pressure would be indicative of an improvement in late, passive diastolic relaxation properties.
We studied 14 cardiomyopathy patients in normal sinus rhythm with no arteriographic evidence of coronary artery disease and an LV ejection fraction of |
| doi_str_mv | 10.1161/01.CIR.100.7.729 |
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We studied 14 cardiomyopathy patients in normal sinus rhythm with no arteriographic evidence of coronary artery disease and an LV ejection fraction of </=40% by radionuclide angiography both before and after 6 months of metoprolol therapy with simultaneous micromanometry and biplane cineventriculography. Four comparable patients who were not treated with metoprolol were studied in a similar fashion and served as control subjects. In those receiving metoprolol, LV end-diastolic pressure decreased (P=0.001). The isovolumic relaxation index, tau(ln), shortened (P=0.03). In a similar fashion, the LV chamber stiffness constant, kappa, decreased (P=0.02), LV volume elastance improved (P=0.04), and the myocardial stiffness constant, kappa(e), decreased (P=0.02). A multiple regression analysis revealed that the decrease in LV end-diastolic pressure was indicative of significant improvements in tau(ln) and kappa(e) with the relationship: LV end-diastolic pressure=-4.73+0.27 tau(ln)+0.54 kappa(e) (r=0.81, P<0.0001). These LV diastolic relaxation properties did not change or worsened in the control cardiomyopathy patients.
We conclude that the decrease in LV end-diastolic pressure in cardiomyopathy patients treated with metoprolol is an indicator of improvement in LV diastolic properties resulting from more complete myocardial relaxation.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.CIR.100.7.729</identifier><identifier>PMID: 10449695</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adrenergic beta-Antagonists - pharmacology ; Adrenergic beta-Antagonists - therapeutic use ; Biological and medical sciences ; Cardiomyopathy, Dilated - drug therapy ; Cardiomyopathy, Dilated - physiopathology ; Cardiovascular system ; Diastole - drug effects ; Female ; Heart Rate - drug effects ; Humans ; Male ; Medical sciences ; Metoprolol - pharmacology ; Metoprolol - therapeutic use ; Middle Aged ; Miscellaneous ; Muscle Relaxation - drug effects ; Myocardial Contraction - drug effects ; Pharmacology. Drug treatments ; Stroke Volume - drug effects ; Ventricular Function, Left - drug effects</subject><ispartof>Circulation (New York, N.Y.), 1999-08, Vol.100 (7), p.729-735</ispartof><rights>1999 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Aug 17, 1999</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-1c1beda46a2c74595d60d40a4bdc39f9ed3ba691758be4afaff49867e243fe2a3</citedby><cites>FETCH-LOGICAL-c393t-1c1beda46a2c74595d60d40a4bdc39f9ed3ba691758be4afaff49867e243fe2a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1929727$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10449695$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>KIM, M. H</creatorcontrib><creatorcontrib>DEVLIN, W. H</creatorcontrib><creatorcontrib>DAS, S. K</creatorcontrib><creatorcontrib>PETRUSHA, J</creatorcontrib><creatorcontrib>MONTGOMERY, D</creatorcontrib><creatorcontrib>STARLING, M. R</creatorcontrib><title>Effects of β-adrenergic blocking therapy on left ventricular diastolic relaxation properties in patients with dilated cardiomyopathy</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>The hemodynamic mechanism for the improvement in left ventricle (LV) end-diastolic pressure in cardiomyopathy patients treated with beta-adrenergic blocking agents is controversial. We hypothesized that the salutary effect of this kind of therapy on LV end-diastolic pressure would be indicative of an improvement in late, passive diastolic relaxation properties.
We studied 14 cardiomyopathy patients in normal sinus rhythm with no arteriographic evidence of coronary artery disease and an LV ejection fraction of </=40% by radionuclide angiography both before and after 6 months of metoprolol therapy with simultaneous micromanometry and biplane cineventriculography. Four comparable patients who were not treated with metoprolol were studied in a similar fashion and served as control subjects. In those receiving metoprolol, LV end-diastolic pressure decreased (P=0.001). The isovolumic relaxation index, tau(ln), shortened (P=0.03). In a similar fashion, the LV chamber stiffness constant, kappa, decreased (P=0.02), LV volume elastance improved (P=0.04), and the myocardial stiffness constant, kappa(e), decreased (P=0.02). A multiple regression analysis revealed that the decrease in LV end-diastolic pressure was indicative of significant improvements in tau(ln) and kappa(e) with the relationship: LV end-diastolic pressure=-4.73+0.27 tau(ln)+0.54 kappa(e) (r=0.81, P<0.0001). These LV diastolic relaxation properties did not change or worsened in the control cardiomyopathy patients.
We conclude that the decrease in LV end-diastolic pressure in cardiomyopathy patients treated with metoprolol is an indicator of improvement in LV diastolic properties resulting from more complete myocardial relaxation.</description><subject>Adrenergic beta-Antagonists - pharmacology</subject><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cardiomyopathy, Dilated - drug therapy</subject><subject>Cardiomyopathy, Dilated - physiopathology</subject><subject>Cardiovascular system</subject><subject>Diastole - drug effects</subject><subject>Female</subject><subject>Heart Rate - drug effects</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metoprolol - pharmacology</subject><subject>Metoprolol - therapeutic use</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Muscle Relaxation - drug effects</subject><subject>Myocardial Contraction - drug effects</subject><subject>Pharmacology. Drug treatments</subject><subject>Stroke Volume - drug effects</subject><subject>Ventricular Function, Left - drug effects</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkcGKFDEQhoMo7uzq3ZMEEW89Jul0Z3OUYdWFBUH0HKqTyk7WTGdM0q7zAL6QD-IzGZkBxVPxV31_UdRPyDPO1pyP_DXj6831xzVnbK3WSugHZMUHITs59PohWTHGdKd6Ic7IeSl3TY69Gh6TM86k1KMeVuTHlfdoa6HJ018_O3AZZ8y3wdIpJvslzLe0bjHD_kDTTCP6Sr_hXHOwS4RMXYBSU2x4xgjfoYZG7XPaY64BCw1NtWZzFHof6rYZIlR01EJ2Ie0OqY23hyfkkYdY8OmpXpDPb68-bd53Nx_eXW_e3HS2133tuOUTOpAjCKvkoAc3MicZyMk1wGt0_QSj5mq4nFCCB--lvhwVCtl7FNBfkFfHve3ErwuWanahWIwRZkxLMaNuX-EDa-CL_8C7tOS53WYEF0ryQfIGsSNkcyolozf7HHaQD4Yz8ycfw7hp-TTJjDItn2Z5ftq7TDt0_xiOgTTg5QmAYiH6DLMN5S-nhVZC9b8BlAKceg</recordid><startdate>19990817</startdate><enddate>19990817</enddate><creator>KIM, M. H</creator><creator>DEVLIN, W. H</creator><creator>DAS, S. K</creator><creator>PETRUSHA, J</creator><creator>MONTGOMERY, D</creator><creator>STARLING, M. R</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>19990817</creationdate><title>Effects of β-adrenergic blocking therapy on left ventricular diastolic relaxation properties in patients with dilated cardiomyopathy</title><author>KIM, M. H ; DEVLIN, W. H ; DAS, S. K ; PETRUSHA, J ; MONTGOMERY, D ; STARLING, M. R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-1c1beda46a2c74595d60d40a4bdc39f9ed3ba691758be4afaff49867e243fe2a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adrenergic beta-Antagonists - pharmacology</topic><topic>Adrenergic beta-Antagonists - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Cardiomyopathy, Dilated - drug therapy</topic><topic>Cardiomyopathy, Dilated - physiopathology</topic><topic>Cardiovascular system</topic><topic>Diastole - drug effects</topic><topic>Female</topic><topic>Heart Rate - drug effects</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metoprolol - pharmacology</topic><topic>Metoprolol - therapeutic use</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Muscle Relaxation - drug effects</topic><topic>Myocardial Contraction - drug effects</topic><topic>Pharmacology. Drug treatments</topic><topic>Stroke Volume - drug effects</topic><topic>Ventricular Function, Left - drug effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KIM, M. H</creatorcontrib><creatorcontrib>DEVLIN, W. H</creatorcontrib><creatorcontrib>DAS, S. K</creatorcontrib><creatorcontrib>PETRUSHA, J</creatorcontrib><creatorcontrib>MONTGOMERY, D</creatorcontrib><creatorcontrib>STARLING, M. 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R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of β-adrenergic blocking therapy on left ventricular diastolic relaxation properties in patients with dilated cardiomyopathy</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>1999-08-17</date><risdate>1999</risdate><volume>100</volume><issue>7</issue><spage>729</spage><epage>735</epage><pages>729-735</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>The hemodynamic mechanism for the improvement in left ventricle (LV) end-diastolic pressure in cardiomyopathy patients treated with beta-adrenergic blocking agents is controversial. We hypothesized that the salutary effect of this kind of therapy on LV end-diastolic pressure would be indicative of an improvement in late, passive diastolic relaxation properties.
We studied 14 cardiomyopathy patients in normal sinus rhythm with no arteriographic evidence of coronary artery disease and an LV ejection fraction of </=40% by radionuclide angiography both before and after 6 months of metoprolol therapy with simultaneous micromanometry and biplane cineventriculography. Four comparable patients who were not treated with metoprolol were studied in a similar fashion and served as control subjects. In those receiving metoprolol, LV end-diastolic pressure decreased (P=0.001). The isovolumic relaxation index, tau(ln), shortened (P=0.03). In a similar fashion, the LV chamber stiffness constant, kappa, decreased (P=0.02), LV volume elastance improved (P=0.04), and the myocardial stiffness constant, kappa(e), decreased (P=0.02). A multiple regression analysis revealed that the decrease in LV end-diastolic pressure was indicative of significant improvements in tau(ln) and kappa(e) with the relationship: LV end-diastolic pressure=-4.73+0.27 tau(ln)+0.54 kappa(e) (r=0.81, P<0.0001). These LV diastolic relaxation properties did not change or worsened in the control cardiomyopathy patients.
We conclude that the decrease in LV end-diastolic pressure in cardiomyopathy patients treated with metoprolol is an indicator of improvement in LV diastolic properties resulting from more complete myocardial relaxation.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>10449695</pmid><doi>10.1161/01.CIR.100.7.729</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Circulation (New York, N.Y.), 1999-08, Vol.100 (7), p.729-735 |
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| source | Journals@Ovid Ovid Autoload; MEDLINE; American Heart Association Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Adrenergic beta-Antagonists - pharmacology Adrenergic beta-Antagonists - therapeutic use Biological and medical sciences Cardiomyopathy, Dilated - drug therapy Cardiomyopathy, Dilated - physiopathology Cardiovascular system Diastole - drug effects Female Heart Rate - drug effects Humans Male Medical sciences Metoprolol - pharmacology Metoprolol - therapeutic use Middle Aged Miscellaneous Muscle Relaxation - drug effects Myocardial Contraction - drug effects Pharmacology. Drug treatments Stroke Volume - drug effects Ventricular Function, Left - drug effects |
| title | Effects of β-adrenergic blocking therapy on left ventricular diastolic relaxation properties in patients with dilated cardiomyopathy |
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