Angiotensin-converting enzyme inhibitors and beta-blockers in long-term treatment of dilated cardiomyopathy.

Abstract

This double-blind, randomized, long-term study investigated the effects of the angiotensin-converting enzyme inhibitor enalapril and the beta-blocker metoprolol on clinical, hemodynamic, angiographic, and neurohormonal parameters in patients with dilated cardiomyopathy and moderate cardiac functional impairment (left ventricular ejection fraction [LVEF] 35% +/- 6%). After 12 months of treatment, a 12% reduction in 24-hour heart rate was observed in both groups (p < 0.05), whereas heart rate during exercise was reduced only in the metoprolol group. Echocardiographic fractional shortening increased (enalapril: 17% +/- 6% to 21% +/- 7%; metoprolol: 21% +/- 9% to 29% +/- 7%; both p < 0.05), as did the angiographic LVEF (enalapril: 35% +/- 7% to 43% +/- 12%, p = 0.1; metoprolol: 34% +/- 7% to 44% +/- 9%, p < 0.05), whereas ventricular volume decreased. Initially, both groups were comparable in terms of all parameters investigated. After 12 months fractional shortening was greater, and the heart rate at 50 W was lower in the beta-blocker group. At the doses used, the effect of the beta-blocker on dilated cardiomyopathy with moderate functional impairment was at least as great as that of the angiotensin-converting enzyme inhibitor.

• Authors: V Regitz-Zagrosek, B Leuchs, J Krülls-Münch, E Fleck
• Journal: American heart journal (Am Heart J) Vol. 129 Issue 4 Pg. 754-61 (Apr 1995) ISSN: 0002-8703 [Print] United States
• PMID: 7900628 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Adrenergic beta-Antagonists
• Angiotensin-Converting Enzyme Inhibitors
• Enalapril
• Metoprolol

Topics

• Adrenergic beta-Antagonists (therapeutic use)
• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Cardiac Catheterization
• Cardiomyopathy, Dilated (diagnosis, drug therapy, epidemiology)
• Double-Blind Method
• Echocardiography
• Electrocardiography, Ambulatory
• Enalapril (therapeutic use)
• Exercise Tolerance (drug effects)
• Female
• Hemodynamics (drug effects)
• Humans
• Male
• Metoprolol (therapeutic use)
• Middle Aged
• Prospective Studies
• Time Factors
• Ventricular Function (drug effects)