Skip Navigation

European Heart Journal 1986 7(12):1045-1052;
Copyright © 1986 by the European Society of Cardiology.
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by LINDVALL, K.
Right arrow Articles by REHNQVIST, N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by LINDVALL, K.
Right arrow Articles by REHNQVIST, N.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 1986 The European Society of Cardiology

Left ventricular function following withdrawal of chronic metoprolol treatment in patients with ischaemic heart disease. A double blind study

K. LINDVALL, G. OLSSON and N. REHNQVIST

Department of Medicine, Karolinska Institutet Danderyd Hospital, S-182 88 Danderyd, Sweden

revised 6 June 1986; accepted 26 February 1986.

Address for correspondence: Kaj Lindvall, M.D., Department of Medicine, Danderyd Hospital, S-182 88 Danderyd, Sweden.

Abstract

The effect on left ventricular function of a gradual withdrawal of chronic metoprolol treatment in postinfarction patients was studied. All patients were in a randomized double-blind post-infarction study with metoprolol (M 100–200 mg daily; N=14) or placebo (P; N =18). After three years treatment the study medication was gradually withdrawn during one week. M-mode echocardiography, guided by concomitant cross-sectional recordings, were performed before, one and 12 weeks after the withdrawal. Treatment (i.e. M or P) had to be reinstituted in eight patients (5 M; 3P) because of the development of disabling symptoms during the follow-up. Heart rate was lower in patients treated with M (57±4) than with P (69±10) (p<0.01). One week after withdrawal of M, heart rate had increased to 77± 13(p<0.001), while patients on P showed no significant change. In order to minimize the influence of heart rate on the evaluation of time intervals in the cardiac cycle, heart rate dependent correction factors were used. One week after M withdrawal there was a prolongation of the pre-ejection period (PEP) from 120±15 ms to 133±16 ms (p< 0.01), mainly due to a prolongation of the interval for early isovolumetric contraction (Q Mc) from 87±10 ms to 101±11 ms (N=11; p≤0.001). Simultaneously, values for isovolumetric relaxation increased from 228±28ms to 286±39 MS (n = 11; p≤0.001), starting from a somewhat lower value than P before withdrawal, reaching an insignificantly higher level and returning to the levels of P. During withdrawal of P stable values were encountered. Twelve weeks after withdrawal, there were no longer significant differences between M and P groups. In conclusion, after a one week gradual withdrawal of M in patients with ischaemic heart disease, a transient increase of both isovolumetric contraction and relaxation phases occur, suggesting depressed myocardial function, despite a transient rebound increase in heart rate.

Key Words: M-mode echocardiography • withdrawal of beta-blockade • metoprolol • left ventricular function


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.