Background: The possible role exerted by modulation of sympathetic outflow in the clinical effects of beta-blockade in chronic heart failure was tested during short- and long-term treatment.
Methods And Results: Oral metoprolol (30-150 mg/day) was added to conventional therapy in 14 patients with idiopathic dilated cardiomyopathy, left ventricular ejection fraction (LVEF) of <0.45, and New York Heart Association class II or III. Norepinephrine plasma levels, which are an index of sympathetic activation, decreased by 27.57 +/- 18.03% after 1 month (P < .005), but returned to pretreatment levels after 6 months. LVEF increased by 7.7 +/- 6.0 ejection fraction units after 6 months (P < .005 vs baseline and P < .05 vs 1 month). Long-term beta-blockade resulted in nonsignificant improvements in functional class, symptom score, and oxygen consumption at peak exercise. After 1 month, the reduction in plasma norepinephrine levels and the changes in LVEF were inversely correlated (P < .01). No other correlation emerged during short- or long-term treatment.
Conclusion: In conclusion, the reduction in plasma norepinephrine levels during short-term beta-blockade was not proportional to the clinical benefits and may have been attributed to the direct inhibition of sympathetic outflow. The early reduction in circulating norepinephrine levels may decrease cardiac performance through withdrawal of sympathetic support when the favorable effects of beta-blockade have not had time to occur. The role that sympathetic modulation may exert in the long-term clinical benefits of metoprolol deserves further investigation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/s1071-9164(98)80004-3 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Pregnancy-related chronic type A aortic dissection highlights the importance of thorough prenatal maternal examination.
J Cardiothorac Surg
January 2025
Semmelweis University Heart and Vascular Centre, Budapest, 1122, Hungary.
Background: Aortic dissection occurs rarely during pregnancy but carries a significantly high vital risk for both the mother and the fetus. Early diagnosis and treatment are critical for a successful outcome.
Case Presentation: A 32-year-old pregnant woman at 31 weeks of gestation began experiencing shortness of breath, chest pain, and palpitations, which were attributed to an anxiety disorder she had been previously diagnosed with.
Cardiometabolic index as a predictor of gallstone incidence in U.S. adults: insights from NHANES 2017-2020.
BMC Gastroenterol
January 2025
Department of Nephrology, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, People's Republic of China.
Background: Gallstone disease (GSD) is associated with obesity. The Cardiometabolic Index (CMI), a metric that accurately assesses central adiposity and visceral fat, has not been extensively studied in relation to GSD risk. This study investigates the link between CMI and GSD incidence in U.
View Article and Find Full Text PDFRole of PGC-1α in the proliferation and metastasis of malignant tumors.
J Mol Histol
January 2025
Department of Thoracic Surgery, Lung Cancer Diagnosis and Treatment Center of Dalian, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
Malignant tumors are among the major diseases threatening human survival in the world, and advancements in medical technology have led to a steady increase in their detection rates worldwide. Despite unique clinical presentations across the spectrum of malignancies, treatment modalities generally adhere to common strategies, encompassing primarily surgical intervention, radiation therapy, chemotherapy, and targeted treatments. Uncovering the genetic elements contributing to cancer cell proliferation, metastasis, and drug resistance remains a pivotal pursuit in the development of novel targeted therapeutics.
View Article and Find Full Text PDFEngineered heart muscle allografts for heart repair in primates and humans.
Nature
January 2025
German Centre for Cardiovascular Research (DZHK), Partner Site Lower Saxony, Göttingen, Germany.
Cardiomyocytes can be implanted to remuscularize the failing heart. Challenges include sufficient cardiomyocyte retention for a sustainable therapeutic impact without intolerable side effects, such as arrhythmia and tumour growth. We investigated the hypothesis that epicardial engineered heart muscle (EHM) allografts from induced pluripotent stem cell-derived cardiomyocytes and stromal cells structurally and functionally remuscularize the chronically failing heart without limiting side effects in rhesus macaques.
View Article and Find Full Text PDFPrediction of mortality in heart failure by machine learning. Comparison with statistical modeling.
Eur J Intern Med
January 2025
Istituti Clinici Scientifici Maugeri, IRCCS, Institute of Bari, Bari, Italy.
Background: Assessing the relative performance of machine learning (ML) methods and conventional statistical methods in predicting prognosis in heart failure (HF) still remains a challenging research field.
Methods: The primary outcome was three-year mortality. The following 5 machine learning approaches were used for modeling: Random Forest (RF), Gradient Boosting, Extreme Gradient Boosting (XGBoost), Support Vector Machine, and Multilayer perceptron.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!