抄録
A questionnaire study on the effect of p-blockade in dilated cardiomyopathy was performed. In 89 cases obtained from 24 institutions, either metoprolol (72 patients, 41.4±29.3 mg/day, 14.1±13.2 months, mean±SD), propranolol (5 patients, 23.8±24.3 mg/day, 25.0±25.3 months), carteolol (4 patients, 7.5±2.9 mg/day, 9.0±2.8 months) or another p-blockers (8 patients) was administered. Nine patients died during the follow-up period. Overall effectiveness as evaluated by the attending physicians showed improvement in 51 patients (57.3%), no change in 26 patients (29.2%), deterioration in 11 patients (12.4%) or was indeterminate in one patient. New York Heart Association (NYHA) functional class improved significantly from 2.6 to 2.3 (p<0.01). Heart rate decreased from 83.1 to 70.1 (p<0.01). Cardiothoracic ratio decreased from 55.5% to 53.9% (p<0.01). Left ventricular ejection fraction of the left ventricle measured by echocardiogram increased from 29.8% to 37.8% (p<0.01). Exercise tolerance during a treadmill test and ventricular arrhythmias in Holter electrocardiograms improved significantly. There was no change in blood pressure. When the patients in different functional classes were compared, the patients of NYHA class III improved more frequently than those of NYHA class II (69% vs 53% p<0.01). Improvement of left ventricular end-diastolic dimension and left ventricular ejection fraction was more prominent in patients of class III than in those of class II. NYHA functional class and cardiothoracic ratio were significantly improved only in class III. NYHA functional class began to improve at 2 weeks, but ejection fraction increased significantly after 3 months. It is concluded that β-adrenergic blockade has a beneficial effect in most patients with dilated cardiomyopathy.
