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European Journal of Heart Failure 2007 9(6-7):678-683; doi:10.1016/j.ejheart.2007.02.007
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© 2007 European Society of Cardiology

Pronounced improvement in systolic and diastolic ventricular long axis function after treatment with metoprolol

Bente Grüner Sveälv, Margareta Scharin Täng, Finn Waagstein and Bert Andersson*

Department of Molecular and Clinical Medicine/Cardiology, Wallenberg Laboratory, Sahlgrenska Academy at Göteborg University, SE-413 45 Göteborg, Sweden

* Corresponding author. Tel: +46 31 342 75 37, +46 0340 62 15 65 (Home); fax: +46 31 82 37 62. E-mail address: bert.andersson{at}wlab.gu.se


  Abstract

Background: Although it is well known that left ventricular (LV) function improves after treatment with beta-blockers in heart failure, little attention has been paid to the effects on LV long axis (LAX) function.

Aims: To evaluate LV LAX function after treatment with metoprolol, and to assess whether LV LAX contractile reserve could predict future long-term improvement.

Methods: Twenty-four heart failure patients were randomised to metoprolol or placebo for 6 months, followed by 6 months of open treatment with metoprolol. Rest and dobutamine stress echocardiography (DSE) was performed before and after each treatment period.

Results: After treatment with metoprolol, LV LAX function improved significantly, systolic velocity from 29±8 to 32±15 mm/s, p<0.01 (metoprolol) vs. 28±7 to 28±11 mm/s, ns (placebo); atrioventricular plane fractional shortening (AVP-FS) from 5.4±2.1 to 7.4±2.7%, p< 0.001 (metoprolol) vs. 5.9±2.1 to 5.8±2.9%, ns (placebo). The improvement in function was maintained during DSE. LV LAX contractile reserve could not predict treatment response; the treatment effect on LV LAX function was significantly greater than the contractile reserve at baseline. The relative improvement in LV LAX function after metoprolol was 38%, compared with a 20% improvement in LV ejection fraction (EF).

Conclusion: A significant improvement in LV LAX function was observed after treatment with metoprolol. AVP-FS and systolic velocities increased significantly, and to a greater extent than LVEF.

Key Words: Echocardiography • Heart failure • Longitudinal function • Prediction • Recovery • Beta-blockade

Received October 4, 2006; Revised January 4, 2007; Accepted February 26, 2007


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