Effects of long-term .BETA.-blockade (metoprolol) therapy in patients with dilated cardiomyopathy.

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Abstract
Twenty-two patients with dilated cardiomyopathy (DCM) were treated with metoprolol and their clinical courses were compared with those of 26 patients untreated with β-blocking agents (non β group). Of the 22 patients treated with metoprolol, 19 ( β group) were treated for a long period. 3 patients left the study within its first 6 months. Using the NYHA classification, 4 patients of the β group were evaluated as having clinically improved. while none was aggravated. excluding 2 cases of death which occurred during the follow up period. In the non-β group. clinical improvement was found for 2 patients and aggravation in functional class for 10. The left ventricular diameter was significantly decreased and parameters of systolic function and exercise tolerance were significantly improved in patients of the β group. while no such improvements occurred in patients of the non-β group. Twenty-four-hour ECG monitoring demonstrated a significant reduction in incidences of ventricular extrasystole in the β group but not in those of the non-β group. Improvement of arrhythmias, evaluated using Lown's grading system, was also identified more frequently in the β group than in the non-p group. During the follow-up period. 2 patients of the β group and 10 patients of the non-β group died. The survival curve for patients of the β group prepared using the Caplan Meier Method was better than that for patients of the non-β group. Metoprolol was therefore found to be useful for treatment of DCM.

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