DOES CONGESTIVE CARDIOMYOPATHY RESPOND TO β-BLOCKADE?
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DOES CONGESTIVE CARDIOMYOPATHY RESPOND TO An earlier affirmative report cannot be confirmed in this study It has been reported that may provide clinical improvement and prolonged survival in patients with congestive cardiomyopathy, but severe pulmonary oedema and cardiogenic shock have been reported by others. In a double- blind. crO!>"SOver trial, 17 such pat ient s were give n I months' trea tment with ace bulol ol, 200mg orall y bid, and placebo in random order. Acebutolol has some partial agonist activity and a certain cardioseleaivity. At the end of the treatment period it was found that acebutolol significantly reduced exercise endurance time, rest ing and maximum hean rates, and resting and maximum systolic BP. There were some small but non-significant effects on echoca rdiographic measurements (systolic and di asto li c diameters), left atri al si ze, left ventri cu lar end-di as to lic and end-systolic vol umes, ej ect ion fr acti on, fi brill ation, extrasystoles and fu nct ional class_ One patient was withdrawn due to profound hypotension and I died on placebo. Thus the clini cal improvement seen by others was not confirmed in this tri aJ. ' Until the matter is resolved by rendomi sad double - blind study in adequate numbers of pati ents, routine administration of beta blockade in conges tive cardiomyopathy cannot be recommended .' Ikram. H. and Fittpatritk.IJ .: Uncet 2: .(90 (S Sep 198 1) 10 INPliAflMA26$ep 1981 0156_2703/ 81 / 0926-0010 $00.50/ 0 O AOIS Press
Transcript of DOES CONGESTIVE CARDIOMYOPATHY RESPOND TO β-BLOCKADE?
DOES CONGESTIVE CARDIOMYOPATHY RESPOND TO ~-BLOCKADEl
An earlier affirmative report cannot be confirmed in this study It has been reported that ~-blockade may provide clinical improvement and prolonged survival in patients with congestive cardiomyopathy, but severe pulmonary oedema and cardiogenic shock have been reported by others. In a double-blind. crO!>"SOver trial, 17 such patients were given I months' treatment with acebulolol, 200mg orally bid, and placebo in random order. Acebutolol has some partial agonist activity and a certain cardioseleaivity. At the end of the treatment period it was found that acebutolol significantly reduced exercise endurance time, resting and maximum hean rates, and resting and maximum systolic BP. There were some small but non-significant effects on echocardiographic measurements (systolic and diastolic diameters), left atrial size, left ventricular end-diastolic and end-systolic volumes, ejection fraction, fibrillation, extrasystoles and functional class_ One patient was withdrawn due to profound hypotension and I died on placebo. Thus the clinical improvement seen by others was not confirmed in this tr iaJ. ' Until the matter is resolved by rendomisad doubleblind study in adequate numbers of patients, routine administration of beta blockade in conges tive cardiomyopathy cannot be recommended .' Ikram. H. and Fittpatritk.IJ .: Uncet 2: .(90 (S Sep 1981)
10 INPliAflMA26$ep 1981 0156_2703/ 81 / 0926-0010 $00.50/ 0 O AOIS Press
