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Sustained restoration of autonomic balance with long- but not short-acting metoprolol in patients with heart failure.

Abstract：

BACKGROUND:The purpose of this study was to compare the effects of immediate-release (IR) metoprolol and extended-release (XL) metoprolol on measures of heart rate variability in chronic systolic heart failure patients. METHODS AND RESULTS:Thirteen metoprolol-treated heart failure patients were randomized to a 2-way crossover study of equal daily doses of metoprolol IR and metoprolol XL, each administered for 3 weeks. After each 3-week interval, patients underwent 24-hour Holter and ambulatory blood pressure monitoring. Over the entire 24-hour period, the ratio of high to total variability (normalized measure of parasympathetic activity) was significantly greater (P < .05), the ratio of low to total variability (normalized measure of sympathetic activity) was significantly lower (P < .05), and the ratio of high to low variability (index of parasympathetic to sympathetic balance) was greater (P < .08) for metoprolol XL compared with metoprolol IR. Over the entire 24-hour period, both systolic and diastolic blood pressure were significantly lower for metoprolol XL compared with metoprolol IR (P < .0001, and .0005, respectively). CONCLUSION:These data suggest that with twice daily dosing, metoprolol IR is inferior to metoprolol XL in its effects on heart rate variability, autonomic balance, and blood pressure in patients with heart failure.

journal_name

J Card Fail

journal_title

Journal of cardiac failure

authors

Aquilante CL,Terra SG,Schofield RS,Pauly DF,Hatton PS,Binkley PF,Johnson JA

doi

10.1016/j.cardfail.2005.12.002

subject

Has Abstract

pub_date

2006-04-01 00:00:00

pages

171-6

issue

3

eissn

1071-9164

issn

1532-8414

pii

S1071-9164(05)01400-4

journal_volume

12

pub_type

杂志文章,随机对照试验

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