congestive heart failure
Springer Online Journal Archives 1860-2000
Summary The usefulness of beta blockers in the treatment of congestive heart failure has been questioned. We selected 11 patients, mean age 47.1±13.8, affected by dilated cardiomyopathy in NYHA class III, who had been taking digoxin and diuretics for a long time. Atenolol 50 mg was added to conventional therapy. Both before and 3 months after treatment a clinical evaluation, chest x-ray, an exercise test, and an echocardiogram were performed. We observed an improvement of NYHA class in five patients. However, the exercise test showed no improvement: 2310±1299 vs. 2902±983 total kgm (ns). The echocardiogram showed improvements of the end-systolic diameter (from 6.3±1 cm to 5.9±0.8 cm; p〈0.02), the fractional shortening (from 13.6±6.3% to 15.2±5.6%; p〈0.05) the radius/thickness ratio (from 4.14±0.5 to 3.5±0.5; p〈0.05), and the wall stress (from 208±49 g/cm2 to 163.5±41 g/cm2; p〈0.02). The inotropic state index did not show any changes. We conclude that in some patients with dilated cardiomyopathy beta blockers may improve the clinical status and left ventricular performance.
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