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      Recovery from Left Ventricular Asynergy in Ischemic Cardiomyopathy following Long-Term Beta Blockade Treatment

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          Abstract

          It has been suggested that long-term beta blockade treatment in congestive heart failure might be less effective in patients with ischemic cardiomyopathy as compared with patients having idiopathic dilated cardiomyopathy. This study was performed to evaluate the effect of long-term adrenergic beta blockade treatment on regional myocardial function in patients with ischemic cardiomyopathy. The regional wall motion (RWM) was evaluated in 12 patients with ischemic cardiomyopathy before and after long-term open treatment with metoprolol. On average, the patients were treated over 11 months (range 6-36 months). The regional left ventricular function was assessed using two-dimensional echocardiographic recordings by two independent blinded observers. The RWM score was evaluated in 16 segments of the left ventricle on a scale from 0 (hypercontractility) to 5 (dyskinesia). Following treatment, there was an improvement in general ventricular function (ejection fraction 0.24-0.31; p = 0.01) as well as in RWM (86 improved segments, 48 deteriorated, 49 unchanged; p < 0.002). Ventricular segments with poor contractility (RWM score ≧ 3.5) tended to improve (53 improved segments, 16 deteriorated, 13 unchanged; p < 0.0001), whereas less severely impaired segments (RWM score < 3.5) did not improve (33 improved segments, 32 deteriorated, 36 unchanged; NS). It is suggested that poorly contracting myocardial segments might improve following beta blockade treatment, while an effect on less impaired segments might be lacking. An improvement in overall myocardial function would then be harder to detect.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1994
          1994
          18 November 2008
          : 85
          : 1
          : 14-22
          Affiliations
          Wallenberg Laboratory for Cardiovascular Research, Division of Cardiology, Department of Clinical Physiology, Sahlgrenska Sjukhuset, University of Göteborg, Sweden
          Article
          176641 Cardiology 1994;85:14–22
          10.1159/000176641
          7954553
          © 1994 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 9
          Categories
          General Cardiology

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