Russian Heart Failure Journal 2012year Evaluation of metoprolol succinate effectiveness in NYHA II CHF patients


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2012/№3

Evaluation of metoprolol succinate effectiveness in NYHA II CHF patients

Kanorsky S. G., Tregubov V. G., Rutenko S. V., Pokrovsky V. M.

Keywords: metoprolol succinate, regulatory and adaptive status, heart and breathing synchronism, CHF

DOI: 10.18087 / rhfj.2012.3.1448

Relevance. Arterial hypertension is the most frequent cause of CHF development. Due to the fact that effectiveness of separate classes of antihypertensive agents might be different even for the similar cohort of patients there are situations in which certain agents might seem preferential. That’s why CHF drug therapy requires sensitive control methods taking into account not only dynamics of the cardiovascular remodeling but the functional state of the body – its ability to regulation and adaptation. A test of cardio-breathing synchronism (CBS) is proposed for objective quantitative evaluation of the regulatory and adaptive status (RAS), it reflects interconnection of two most important functions of vegetative maintenance – cardiac and breathing one. Objective. To determine effectiveness of β-blocker therapy by metoprolol succinate for NYHA II CHF patients with arterial hypertension (AH) of Stage II at the basis of evaluation of its effect on RAS. Materials and methods. The study included 53 patients with NYHA II CHF on the background of AH Stage II (29 men and 24 women, age 52.9±2.3 years). The therapy by Indapamid Retard at a dose of 1.5 mg per day was supplemented by slow release metoprolol succinate at a dose of 97.3±9.5 mg per day. At the initial point and in 6 months SDS test was done, 6 min walking test, diurnal monitoring of arterial pressure, tread-mill test with evaluation of maximum oxygen consumption at load, EchoCG, the level of N-end precursor of the brain natriiuretic hormone (NT-proBNP) was determined. Results. Therapy by metoprolol succinate didn’t significantly affect RAS of the patients, structural state of myocardium and tolerance to physical exercise, moderately improved diastolic LV function and reduced neurohumoral activity. Conclusion. Consequently, βAB can’t always be the optimum therapeutic choice for patients with NYHA II CHF on the background of Stage II AH.
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Kanorsky S. G., Tregubov V. G., Rutenko S. V. et al. Evaluation of metoprolol succinate effectiveness in NYHA II CHF patients. Russian Heart Failure Journal. 2012;13(3):138-142

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