© 2001 European Society of Cardiology
Effect of metoprolol CR/XL on exercise tolerance in chronic heart failure — a substudy to the MERIT-HF trial
a Department of Cardiology, Division of Heart and Lung Diseases Rikshospitalet, 0027 Oslo, Norway
b Hjertelaget Research Foundation Stavanger, Norway
c Scandinavian Statistical Services Oslo, Norway
d Wallenberg Laboratory for Cardiovascular Research, Gøteborg University Gothenburg, Sweden
* Corresponding author. Medical Department, Baerum Hospital, 1306 Baerum Postterminal, Norway. Tel.: +47-67809400; fax: +47-67809556. E-mail address: lagulles{at}online.no (L. Gullestad).
 |
Abstract |
|---|
Background: β-Blockade usually causes a slight reduction in exercise capacity among healthy subjects, while more variable results have been observed in chronic heart failure (CHF), probably related to patients studied, methods and agent used. The effect of metoprolol controlled release/extended release (CR/XL) on peak oxygen uptake (peak VO2) in this patient population has not previously been investigated.
Aims: We examined the effect of long-term treatment with the selective β1-receptor blocker metoprolol CR/XL once daily on exercise capacity in patients with CHF.
Methods: Ninety-four patients (70 males and 24 females; mean age 63.6±10.6 years) with chronic symptomatic heart failure in New York Heart Association (NYHA) functional class II–IV, and with ejection fraction 
40%, stabilized on optimum standard therapy were randomized to metoprolol CR/XL or placebo in a double-blind trial. Exercise capacity was evaluated by peak VO2 at baseline, after 3 months and at the end of study (mean follow-up 11.4±0.4 months).
Results: Compared with placebo metoprolol CR/XL produced a significant decrease in heart rate by 11 beats/min at rest and 18 beats/min at peak exercise. There was a tendency for a temporal decline in peak VO2 after 3 months of therapy in both groups, but altogether peak VO2 remained unchanged from baseline with no difference between the groups at 1 year.
Conclusions: In patients with moderate to severe CHF, 11.4 months of β1-blockade with metoprolol CR/XL had no effect on exercise capacity when compared with placebo or baseline.
Key Words: β-Blockade • Exercise • Oxygen uptake
Received October 10, 2000; Revised February 12, 2001; Accepted February 20, 2001
1 JW is also a senior medical advisor for AstaZeneca, Mølndal, Sweden.
2 On behalf of the MERIT-HF Study Group.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  H. Murai, M. Takamura, M. Maruyama, M. Nakano, T. Ikeda, D. Kobayashi, K.-i. Otowa, H. Ootsuji, M. Okajima, H. Furusho, et al. Altered firing pattern of single-unit muscle sympathetic nerve activity during handgrip exercise in chronic heart failure J. Physiol., June 1, 2009; 587(11): 2613 - 2622. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Fleg Improving Exercise Tolerance in Chronic Heart Failure: A Tale of Inspiration? J. Am. Coll. Cardiol., April 29, 2008; 51(17): 1672 - 1674. [Full Text] [PDF]
|
|
|
|
 |
|
 D. Leosco, G. Rengo, G. Iaccarino, A. Filippelli, A. Lymperopoulos, C. Zincarelli, F. Fortunato, L. Golino, M. Marchese, G. Esposito, et al. Exercise training and beta-blocker treatment ameliorate age-dependent impairment of beta-adrenergic receptor signaling and enhance cardiac responsiveness to adrenergic stimulation Am J Physiol Heart Circ Physiol, September 1, 2007; 293(3): H1596 - H1603. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Abdulla, L. Kober, E. Christensen, and C. Torp-Pedersen Effect of beta-blocker therapy on functional status in patients with heart failure -- A meta-analysis Eur J Heart Fail, August 1, 2006; 8(5): 522 - 531. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. O. O'Neill, J. B. Young, C. E. Pothier, and M. S. Lauer Peak Oxygen Consumption as a Predictor of Death in Patients With Heart Failure Receiving {beta}-Blockers Circulation, May 10, 2005; 111(18): 2313 - 2318. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Momen, D. Bower, J. Boehmer, A. R. Kunselman, U. A. Leuenberger, and L. I. Sinoway Renal blood flow in heart failure patients during exercise Am J Physiol Heart Circ Physiol, December 1, 2004; 287(6): H2834 - H2839. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G.F. Cleland, P. H. Loh, N. Freemantle, A. L. Clark, and A. P. Coletta Clinical trials update from the European Society of Cardiology: SENIORS, ACES, PROVE-IT, ACTION, and the HF-ACTION trial Eur J Heart Fail, October 1, 2004; 6(6): 787 - 791. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Lamp, J. Vogt, H. Schmidt, and D. Horstkotte Impact of cardiopulmonary exercise testing on patient selection for cardiac resynchronisation therapy Eur. Heart J. Suppl., August 1, 2004; 6(suppl_D): D5 - D9. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Reiken, A. Lacampagne, H. Zhou, A. Kherani, S. E. Lehnart, C. Ward, F. Huang, M. Gaburjakova, J. Gaburjakova, N. Rosemblit, et al. PKA phosphorylation activates the calcium release channel (ryanodine receptor) in skeletal muscle: defective regulation in heart failure J. Cell Biol., March 17, 2003; 160(6): 919 - 928. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Remme and K. Swedberg A reply Eur. Heart J., March 1, 2002; 23(5): 426 - 427. [Full Text] [PDF]
|
|