Skip Navigation

European Heart Journal 1986 7(6):468-474;
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 OLSSON, G.
Right arrow Articles by REHNQVIST, N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by OLSSON, G.
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

Effect of metoprolol in postinfarction patients with increased heart size

G. OLSSON and N. REHNQVIST

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

Received 2 December 1985; revised 13 January 1986; .

Address for correspondence: Gunnar Olsson, M.D., Department of Medicine, Karolinska Institutet, Danderyd Hospital, S-182 88 Danderyd, Sweden

Abstract

Mortality was analysed in relation to clinical and radiological signs of left ventricular failure in a doubleblind randomized comparison of 154 post-myocardial infarction patients assigned to metoprolol (100 mg b.i.d.) and 147 patients assigned to placebo treatment. The maximal respiratory rate in the coronary care unit and the relative heart size measured by chest X-ray examination prior to discharge from hospital were used for evaluation of myocardial function. In the placebo group mortality was higher in those with elevated maximal respiratory rate (11% vs. 27%, P<0.05) and in those with larger hearts (8% vs. 33%, P<0.001). No increase in mortality in patients with findings of left ventricular dysfunction was found in the metoprolol treated group. This was not due to an excess mortality in patients with preserved left ventricular function, but rather due to a reduction in mortality among patients with impaired left ventricular function. In patients with relative heart sizes > 460 ml m–2 ( = median), mortality was higher in the placebo treated patients as compared to metoprolol treated patients (33% vs 16%, P<0.05).

During the three year follow-up, repeat chest X-ray examinations showed similar heart sizes in the two treatment groups. Furthermore, treatment with digitalis and diuretics were similar in the two treatment groups although more patients in the metoprolol group were withdrawn due to uncontrolled left ventricular heart failure (7 vs 1, P<0.05).

We conclude that elevated maximal respiratory rate in the coronary care unit and heart enlargement on a pre-discharge chest X-ray, indicate a worsened prognosis. This excess mortality is reduced by metoprolol treatment during a three year follow-up.

Key Words: Metoprolol • myocardial infarction • heart size • prognosis


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.