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European Journal of Heart Failure 2000 2(2):175-181; doi:10.1016/S1388-9842(00)00078-7
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© 2000 European Society of Cardiology

MIC trial: metoprolol in patients with mild to moderate heart failure: effects on ventricular function and cardiopulmonary exercise testing

Sabine Genth-Zotza, Rainer J. Zotza, Martin Sigmundb, Peter Hanrathb, Dagmar Hartmannc, Michael Böhmc, Finn Waagsteind, Norbert Treesea, Jürgen Meyera and Harald Dariusa,*

a Department of Medicine II, Johannes Gutenberg-University Langenbeckstraße 1, 55131 Mainz, Germany
b Department of Medicine I, RWTH Aachen Germany
c Department of Medicine III, University Cologne, Germany
d Sahlgrenska University Hospital Göteborg, Sweden

* Corresponding author. Tel.: +49-6131-173628; fax: +49-6131-176613. E-mail address: harald.darius{at}2-med.klinik.uni-mainz.de (H.Darius).


  Abstract

Beta-blocker therapy results in a functional benefit in patients with heart failure (CHF) due to idiopathic dilated cardiomyopathy (DCM). This study assessed if similar effects were observed in patients with ischemic heart disease (CAD), NYHA II–III after 6 months of therapy with metoprolol.

Methods and results: Fifty-two patients with CHF secondary to DCM (26 patients) and CAD (26 patients) and a left ventricular ejection fraction (EF) < 40% were enrolled in the placebo-controlled study. The study medication was titrated over 6 weeks, the mean final dosage was 135 mg/day. Three patients died due to cardiogenic shock, two received placebo and one metoprolol. Eight patients did not complete the study due to non-compliance. Metoprolol significantly reduced heart rate at rest and after submaximal and maximal exercise. Vo2-max and Vo2-AT as well as the 6-min walk test improved significantly after metoprolol treatment. There was a significant increase in EF at rest (27.3–35.2%), submaximal (28.5–37.7%) and maximal exercise (28.7–40.9%) in the metoprolol-treated patients. No differences were found between patients with CAD and DCM. We also observed reduced left ventricular volumes.

Conclusion: The additional therapy with metoprolol improved cardiac function and the cardiopulmonary exercise capacity in patients with CHF.

Key Words: Congestive heart failure • Beta-receptor blockers • Left ventricular function • Exercise capacity

Received June 17, 1999; Revised February 17, 2000; Accepted February 23, 2000


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