Long-term (2 year) beneficial effects of beta-adrenergic blockade with bucindolol in patients with idiopathic dilated cardiomyopathy
JL Anderson,
EM Gilbert,
JB O'Connell,
D Renlund,
F Yanowitz,
M Murray,
M Roskelley,
P Mealey,
K Volkman,
D Deitchman,
et al.
University of Utah Heart Failure Treatment Program, LDS Hospital, Salt Lake City 84143.
Beta-adrenergic blockade represents a promising therapeutic approach to idiopathic dilated cardiomyopathy. Bucindolol, a new beta-blocker, showed favorable effects in a short-term (3 month) trial in idiopathic dilated cardiomyopathy. To assess long-term response, 20 study patients (7 of 9 patients previously assigned to the placebo group and 13 of 14 patients previously assigned to bucindolol therapy) received long-term bucindolol therapy and were followed up for a mean of 23 +/- 4 months (range 17 to 30). The mean patient age was 49 years (range 29 to 66) and the median duration of disease was 11 months (range 1 to 190). Ten patients were in functional class II and 10 were in class III; 15 patients were men. At the end of the common follow-up time, all 20 patients were alive, 17 continued to receive bucindolol (mean dose 176 mg/day, range 25 to 200), and 2 underwent cardiac transplantation. Left ventricular ejection fraction increased from a baseline value of 25 +/- 8% to 35 +/- 13% (n = 19 pairs, p less than 0.001). Functional class improved in 12, was unchanged in 5 and deteriorated in 3 (p = 0.056). Exercise time was maintained (9.4 +/- 3.1 versus 9.1 +/- 3.5 min, n = 19, p = NS), as was maximal oxygen uptake (19.2 +/- 4.9 versus 18.8 +/- 5.7 ml/kg per min, n = 19, p = NS). Thus, long-term bucindolol therapy leads to substantial increases in ejection fraction and to improved functional class while stable exercise performance is maintained.(ABSTRACT TRUNCATED AT 250 WORDS)
This article has been cited by other articles:

|
 |

|
 |
 
N. F. Murphy, C. O'Loughlin, M. Ledwidge, D. McCaffrey, and K. McDonald
Improvement but no cure of left ventricular systolic dysfunction in treated heart failure patients
Eur J Heart Fail,
December 1, 2007;
9(12):
1196 - 1204.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. S.H. Bell
Heart Failure: The frequent, forgotten, and often fatal complication of diabetes
Diabetes Care,
August 1, 2003;
26(8):
2433 - 2441.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. Andreka, N. Aiyar, L. C. Olson, J. Q. Wei, M. S. Turner, K. A. Webster, E. H. Ohlstein, and N. H. Bishopric
Bucindolol Displays Intrinsic Sympathomimetic Activity in Human Myocardium
Circulation,
May 21, 2002;
105(20):
2429 - 2434.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. Gullestad, C. Manhenke, T. Aarsland, R. Skardal, H. Fagertun, J. Wikstrand, and J. Kjekshus
Effect of metoprolol CR/XL on exercise tolerance in chronic heart failure -- a substudy to the MERIT-HF trial
Eur J Heart Fail,
August 1, 2001;
3(4):
463 - 468.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
H Kakuchi, T Sasaki, Y Ishida, K Komamura, and K Miyatake
Clinical usefulness of 123I meta-iodobenzylguanidine imaging in predicting the effectiveness of beta blockers for patients with idiopathic dilated cardiomyopathy before and soon after treatment
Heart,
February 1, 1999;
81(2):
148 - 152.
[Abstract]
[Full Text]
|
 |
|

|
 |

|
 |
 
A Di Lenarda, R De Maria, A Gavazzi, D Gregori, M Parolini, G Sinagra, L Salvatore, F Longaro, E Bernobich, and F Camerini
Long term survival effect of metoprolol in dilated cardiomyopathy
Heart,
April 1, 1998;
79(4):
337 - 344.
[Abstract]
[Full Text]
|
 |
|

|
 |

|
 |
 
E. M. Gilbert, W. T. Abraham, S. Olsen, B. Hattler, M. White, P. Mealy, P. Larrabee, and M. R. Bristow
Comparative Hemodynamic, Left Ventricular Functional, and Antiadrenergic Effects of Chronic Treatment With Metoprolol Versus Carvedilol in the Failing Heart
Circulation,
December 1, 1996;
94(11):
2817 - 2825.
[Abstract]
[Full Text]
|
 |
|

|
 |

|
 |
 
B. Andersson, K. Caidahl, A. di Lenarda, S. E. Warren, F. Goss, A. Waldenstrom, S. Persson, I. Wallentin, A. Hjalmarson, and F. Waagstein
Changes in Early and Late Diastolic Filling Patterns Induced by Long-term Adrenergic -Blockade in Patients With Idiopathic Dilated Cardiomyopathy
Circulation,
August 15, 1996;
94(4):
673 - 682.
[Abstract]
[Full Text]
|
 |
|
|