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European Heart Journal 1997 18(7):1115-1121;
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European Society of Cardiology

More favourable haemodynamic effects from metoprolol than from captopril in patients with dilated cardiomyopathy

K. Jansson, K.-E. Karlberg, E. Nylander, E. Karlsson, O. Nyquist and U. Dahlström

Linköping Heart Center, Linköping University Hospital and Department of Cardiology, Huddinge University Hospital Sweden

revised 24 January 1997; accepted 29 January 1997.

Correspondence: Kjell Jansson, Dept of Cardiology, Linköping Heart Center, University Hospital, 581 85 Linköping, Sweden

Abstract

AIM: The object of this study was to investigate and compare the haemodynamic effects of treatment with a beta receptor blocker (metoprolol) or an angiotensin-converting-enzyme inhibitor (captopril) in 54 patients with idiopathic dilated cardiomyopathy.

METHOD: All patients had cardiac catheterization performed at rest and during exercise, before and after 3 months of treatment.

RESULTS: The mean dose of metoprolol was 135 mg.day–1 and of captopril 98 mg. day–1. After treatment there was a significant reduction in left ventricular filling pressure both at rest (from 16 to 12 mmHg) and during exercise (from 27 to 20 mmHg) in the metoprolol group. In the captopril group a significant reduction was seen only during exercise (25 to 20 mmHg), compared to baseline. The stroke volume increased significantly after 3 months of therapy in the metoprolol group, both at rest (53 to 70 ml) and during exercise (56 to 79 ml). In the captopril group the increase reached significance only during exercise (72 to 79 ml). Cardiac output was maintained in both groups.

CONCLUSION: There were positive effects on left ventricular function in the metoprolol group as well as in the captopril group. Metoprolol reduced left ventricular filling pressure at rest and increased stroke volume both at rest and during exercise signficantly more than captopril.

Key Words: Dilated cardiomyopathy • beta-blocker • ACE-inhibitor • therapy


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