In:
Cardiology, S. Karger AG, Vol. 105, No. 1 ( 2006), p. 61-66
Abstract:
〈 i 〉 Backgrounds: 〈 /i 〉 Although long-term treatment with beta-blockers has been shown to improve morbidity and mortality in dilated cardiomyopathy (DCM), patient re- sponses are heterogeneous. 〈 i 〉 Methods: 〈 /i 〉 To establish the appropriate indication for the initiation of beta-blocker therapy, we retrospectively analyzed 38 DCM patients treated with beta-blockers (metoprolol or carvedilol) and examined differences in baseline profiles between patients who could continue the therapy (responders) and those who could not (non-responders). 〈 i 〉 Results: 〈 /i 〉 In 13 non-responders, the duration from onset of symptoms to beta-blocker initiation was longer (p 〈 0.05), systolic blood pressure was lower (p 〈 0.001), serum sodium concentration was lower (p 〈 0.05), left ventricular posterior wall thickness was thinner (p 〈 0.05), left ventricular end-diastolic pressure was higher (p 〈 0.05) and left ventricular wall stress was lower (p 〈 0.05) than in 25 responders. In 19 patients receiving carvedilol, 5 non-responders showed higher levels of human atrial natriuretic peptide (p 〈 0.05) and brain natriuretic peptide (p 〈 0.01) than 13 responders. Discriminant analysis with a linear discriminant function showed the following equation predicted response to beta-blocker therapy: h = 0.004 × systolic blood pressure – 0.002 × brain natriuretic peptide + 0.667 (R 〈 sup 〉 2 〈 /sup 〉 = 0.67, p 〈 0.001). The probability of predicting the response was 94.1% with h ≧0.5. 〈 i 〉 Conclusion: 〈 /i 〉 We conclude that h≧0.5 is the appropriate indication for the initiation of beta-blocker therapy in DCM.
Type of Medium:
Online Resource
ISSN:
0008-6312
,
1421-9751
Language:
English
Publisher:
S. Karger AG
Publication Date:
2006
detail.hit.zdb_id:
1482041-9
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