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Beneficial effects of metoprolol on myocardial sympathetic function: Evidence from a randomized, placebo-controlled study in patients with congestive heart failure
We sought to investigate whether beta-blockers exert a presynaptic effect in the myocardium as measured by 123I-metaiodobenzylguanidine. The study comprised 59 patients with congestive heart failure, New York Heart Association class II or III, and left ventricular ejection fraction
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| Published in: | The American heart journal 2002-08, Vol.144 (2), p.E3-E3 |
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| container_end_page | E3 |
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| container_title | The American heart journal |
| container_volume | 144 |
| creator | de Milliano, Paul A R de Groot, Andre C Tijssen, Jan G P van Eck-Smit, Berthe L F Van Zwieten, Pieter A Lie, Kong I |
| description | We sought to investigate whether beta-blockers exert a presynaptic effect in the myocardium as measured by 123I-metaiodobenzylguanidine.
The study comprised 59 patients with congestive heart failure, New York Heart Association class II or III, and left ventricular ejection fraction |
| format | article |
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The study comprised 59 patients with congestive heart failure, New York Heart Association class II or III, and left ventricular ejection fraction <35%. After an open label titration phase, patients were randomized to their maximal tolerable dose of metoprolol or placebo. Myocardial MIBG uptake was measured before the titration phase and after 6 months of treatment. Other parameters were maximal oxygen consumption, 6-minute walking test, plasma neurohormones, and echocardiographic parameters.
We found a 21.9% increase in mean myocardial MIBG uptake after 6 months of treatment with metoprolol. In contrast, MIBG uptake decreased by 7.8% in the placebo group (P = 0.03 compared with metoprolol). Left ventricular end-diastolic diameter decreased from 74 +/- 11 mm to 67 +/- 10 mm (P <.05, within-group comparison) and LVEF increased from 25.3% +/- 7.4% to 32.6% +/- 9.6% (P <.05, within-group comparison) in the metoprolol group. Placebo-treated patients showed no significant changes. Comparison of changes in left ventricular end-diastolic diameter and LVEF between metoprolol and placebo did not reach statistical significance (P = 0.2).
This randomized, placebo-controlled study demonstrates that metoprolol has a presynaptic effect as measured by myocardial MIBG scintigraphy in both ischemic and nonischemic cardiomyopathy.</description><identifier>EISSN: 1097-6744</identifier><identifier>PMID: 12177661</identifier><language>eng</language><publisher>United States</publisher><subject>3-Iodobenzylguanidine - pharmacokinetics ; Adrenergic beta-Antagonists - administration & dosage ; Adrenergic beta-Antagonists - pharmacokinetics ; Aged ; Double-Blind Method ; Down-Regulation ; Female ; Heart - drug effects ; Heart - innervation ; Heart Failure - diagnosis ; Heart Failure - drug therapy ; Heart Rate - drug effects ; Hemodynamics - drug effects ; Humans ; Male ; Metoprolol - administration & dosage ; Metoprolol - pharmacokinetics ; Middle Aged ; Myocardium - metabolism ; Presynaptic Terminals - drug effects ; Radiopharmaceuticals ; Tomography, Emission-Computed, Single-Photon</subject><ispartof>The American heart journal, 2002-08, Vol.144 (2), p.E3-E3</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12177661$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Milliano, Paul A R</creatorcontrib><creatorcontrib>de Groot, Andre C</creatorcontrib><creatorcontrib>Tijssen, Jan G P</creatorcontrib><creatorcontrib>van Eck-Smit, Berthe L F</creatorcontrib><creatorcontrib>Van Zwieten, Pieter A</creatorcontrib><creatorcontrib>Lie, Kong I</creatorcontrib><title>Beneficial effects of metoprolol on myocardial sympathetic function: Evidence from a randomized, placebo-controlled study in patients with congestive heart failure</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>We sought to investigate whether beta-blockers exert a presynaptic effect in the myocardium as measured by 123I-metaiodobenzylguanidine.
The study comprised 59 patients with congestive heart failure, New York Heart Association class II or III, and left ventricular ejection fraction <35%. After an open label titration phase, patients were randomized to their maximal tolerable dose of metoprolol or placebo. Myocardial MIBG uptake was measured before the titration phase and after 6 months of treatment. Other parameters were maximal oxygen consumption, 6-minute walking test, plasma neurohormones, and echocardiographic parameters.
We found a 21.9% increase in mean myocardial MIBG uptake after 6 months of treatment with metoprolol. In contrast, MIBG uptake decreased by 7.8% in the placebo group (P = 0.03 compared with metoprolol). Left ventricular end-diastolic diameter decreased from 74 +/- 11 mm to 67 +/- 10 mm (P <.05, within-group comparison) and LVEF increased from 25.3% +/- 7.4% to 32.6% +/- 9.6% (P <.05, within-group comparison) in the metoprolol group. Placebo-treated patients showed no significant changes. Comparison of changes in left ventricular end-diastolic diameter and LVEF between metoprolol and placebo did not reach statistical significance (P = 0.2).
This randomized, placebo-controlled study demonstrates that metoprolol has a presynaptic effect as measured by myocardial MIBG scintigraphy in both ischemic and nonischemic cardiomyopathy.</description><subject>3-Iodobenzylguanidine - pharmacokinetics</subject><subject>Adrenergic beta-Antagonists - administration & dosage</subject><subject>Adrenergic beta-Antagonists - pharmacokinetics</subject><subject>Aged</subject><subject>Double-Blind Method</subject><subject>Down-Regulation</subject><subject>Female</subject><subject>Heart - drug effects</subject><subject>Heart - innervation</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Rate - drug effects</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>Male</subject><subject>Metoprolol - administration & dosage</subject><subject>Metoprolol - pharmacokinetics</subject><subject>Middle Aged</subject><subject>Myocardium - metabolism</subject><subject>Presynaptic Terminals - drug effects</subject><subject>Radiopharmaceuticals</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><recordid>eNo1kMtOwzAQRSMkRMvjF9CsWBEpcVI7YQdVeUiV2MA6mthjauTYIXaKwu_wowRRVrM5OvfeOUqWeVaLlIuyXCSnIbxnWcZZxU-SRc5yITjPl8n3HTnSRhq0QFqTjAG8ho6i7wdvvQXvoJu8xEH9MmHqeow7ikaCHp2Mxrsb2OyNIicJ9OA7QBjQKd-ZL1LX0FuU1PpUehdnoyUFIY5qAuNgVhlyc-SniTuYiTcK0ewJdoRDBI3GjgOdJ8cabaCLwz1LXu83L-vHdPv88LS-3aZ9zlhMGRarklpZroQqJNelEFggsqqq86IsMpVJqmQpBSOldFvMTLXSgiFDzbNSF2fJ1Z93Xv4xzk2azgRJ1qIjP4ZG5HVVcy5m8PIAjm1HqukH0-EwNf9vLX4Ar814CA</recordid><startdate>200208</startdate><enddate>200208</enddate><creator>de Milliano, Paul A R</creator><creator>de Groot, Andre C</creator><creator>Tijssen, Jan G P</creator><creator>van Eck-Smit, Berthe L F</creator><creator>Van Zwieten, Pieter A</creator><creator>Lie, Kong I</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>200208</creationdate><title>Beneficial effects of metoprolol on myocardial sympathetic function: Evidence from a randomized, placebo-controlled study in patients with congestive heart failure</title><author>de Milliano, Paul A R ; de Groot, Andre C ; Tijssen, Jan G P ; van Eck-Smit, Berthe L F ; Van Zwieten, Pieter A ; Lie, Kong I</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p122t-2a354ebc457d3c6f477a3aa288913430d0ce8c4c72eddfb33c685f72a2af604f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>3-Iodobenzylguanidine - pharmacokinetics</topic><topic>Adrenergic beta-Antagonists - administration & dosage</topic><topic>Adrenergic beta-Antagonists - pharmacokinetics</topic><topic>Aged</topic><topic>Double-Blind Method</topic><topic>Down-Regulation</topic><topic>Female</topic><topic>Heart - drug effects</topic><topic>Heart - innervation</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Rate - drug effects</topic><topic>Hemodynamics - drug effects</topic><topic>Humans</topic><topic>Male</topic><topic>Metoprolol - administration & dosage</topic><topic>Metoprolol - pharmacokinetics</topic><topic>Middle Aged</topic><topic>Myocardium - metabolism</topic><topic>Presynaptic Terminals - drug effects</topic><topic>Radiopharmaceuticals</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Milliano, Paul A R</creatorcontrib><creatorcontrib>de Groot, Andre C</creatorcontrib><creatorcontrib>Tijssen, Jan G P</creatorcontrib><creatorcontrib>van Eck-Smit, Berthe L F</creatorcontrib><creatorcontrib>Van Zwieten, Pieter A</creatorcontrib><creatorcontrib>Lie, Kong I</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Milliano, Paul A R</au><au>de Groot, Andre C</au><au>Tijssen, Jan G P</au><au>van Eck-Smit, Berthe L F</au><au>Van Zwieten, Pieter A</au><au>Lie, Kong I</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Beneficial effects of metoprolol on myocardial sympathetic function: Evidence from a randomized, placebo-controlled study in patients with congestive heart failure</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2002-08</date><risdate>2002</risdate><volume>144</volume><issue>2</issue><spage>E3</spage><epage>E3</epage><pages>E3-E3</pages><eissn>1097-6744</eissn><abstract>We sought to investigate whether beta-blockers exert a presynaptic effect in the myocardium as measured by 123I-metaiodobenzylguanidine.
The study comprised 59 patients with congestive heart failure, New York Heart Association class II or III, and left ventricular ejection fraction <35%. After an open label titration phase, patients were randomized to their maximal tolerable dose of metoprolol or placebo. Myocardial MIBG uptake was measured before the titration phase and after 6 months of treatment. Other parameters were maximal oxygen consumption, 6-minute walking test, plasma neurohormones, and echocardiographic parameters.
We found a 21.9% increase in mean myocardial MIBG uptake after 6 months of treatment with metoprolol. In contrast, MIBG uptake decreased by 7.8% in the placebo group (P = 0.03 compared with metoprolol). Left ventricular end-diastolic diameter decreased from 74 +/- 11 mm to 67 +/- 10 mm (P <.05, within-group comparison) and LVEF increased from 25.3% +/- 7.4% to 32.6% +/- 9.6% (P <.05, within-group comparison) in the metoprolol group. Placebo-treated patients showed no significant changes. Comparison of changes in left ventricular end-diastolic diameter and LVEF between metoprolol and placebo did not reach statistical significance (P = 0.2).
This randomized, placebo-controlled study demonstrates that metoprolol has a presynaptic effect as measured by myocardial MIBG scintigraphy in both ischemic and nonischemic cardiomyopathy.</abstract><cop>United States</cop><pmid>12177661</pmid></addata></record> |
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| identifier | EISSN: 1097-6744 |
| ispartof | The American heart journal, 2002-08, Vol.144 (2), p.E3-E3 |
| issn | 1097-6744 |
| language | eng |
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| source | ScienceDirect Freedom Collection 2022-2024 |
| subjects | 3-Iodobenzylguanidine - pharmacokinetics Adrenergic beta-Antagonists - administration & dosage Adrenergic beta-Antagonists - pharmacokinetics Aged Double-Blind Method Down-Regulation Female Heart - drug effects Heart - innervation Heart Failure - diagnosis Heart Failure - drug therapy Heart Rate - drug effects Hemodynamics - drug effects Humans Male Metoprolol - administration & dosage Metoprolol - pharmacokinetics Middle Aged Myocardium - metabolism Presynaptic Terminals - drug effects Radiopharmaceuticals Tomography, Emission-Computed, Single-Photon |
| title | Beneficial effects of metoprolol on myocardial sympathetic function: Evidence from a randomized, placebo-controlled study in patients with congestive heart failure |
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