Therapy of idiopathic dilated cardiomyopathy with chronic β-adrenergic blockade
Tóm tắt
Conventional therapy of patients with idiopathic dilated cardiomyopathy is currently directed at the control of heart failure. However, the morbidity and mortality of idiopathic dilated cardiomyopathy remains very high despite such interventions. One promising new approach to therapy of idiopathic dilated cardiomyopathy is β-blockade. The potential mechanisms for benefit from β-blockade include protection from catecholamine cardiotoxicity, upregulation of myocardial β-adrenergic receptors, reduction in sudden death, reduction in heart rate, improved ventricular diastolic function, and reduction in afterload. Several reports have suggested that longterm β-blockade may improve hemodynamic function, clinical symptoms, and survival in patients with idiopathic dilated cardiomyopathy. However, data from controlled trials are limited and some reports have been negative. This paper will summarize the rationale for the use of β-blocker therapy in idiopathic dilated cardiomyopathy and review the clinical experience with this therapy.
Tài liệu tham khảo
McKee PA, Castelli UP, McNamara PM, et al. (1971) The natural history of congestive heart failure: The Framingham study. N Engl J Med 285:1441–1446
Torp A (1978) Incidence of congestive cardiomyopathy. Postgrad Med J 54:435–437
Gorlin R (1983) Incidence, etiology and prognosis of heart failure. Cardiovasc Rev Rep 4:765
Franciosa JA, Wilen M, Ziesche S, Cohn JN (1983) Survival in men with severe chronic left ventricular failure due to either coronary heart disease or idiopathic dilated cardiomyopathy. Am J Cardiol 51:831–836
Cohn JN, Archibald DG, Ziesche S, Franciosa JA, Harston WE, Tristani FE, Dunkman WB, Jacobs W, Francis GS, Flohr KH, Goldman S, Cobb FR, Shah PM, Saunders R, Fletcher RD, Loeb HS, Hughes VC, Baker B (1986) Effect of vasodilator therapy on mortality in chronic congestive heart failure. N Engl J Med 314:1547–1552
CONSENSUS Trial Study Group (1987) Effects of enalapril on mortality in severe congestive heart failure: Results of the cooperative North Scandinavian enalapril survival study (CONSENSUS). N Engl J Med 316:1429–1435
Waagstein F, Hjalmmarson A, Varnauskas E, Wallentin I (1975) Effect of chronic beta-adrenergic receptor blockade in congestive cardiomyopathy. Br Heart J 37:1022–1036
Sonnenblick EH, Factor SM, Strobeck JE, et al. (1982) The pathophysiology of heart failure: The primary role of microvascular hyper-reactivity and spasm in the development of congestive cardiomyopathies. In: Braunwald E, Mock MB, Watson J (eds) Congestive heart failure: Current research and clinical applications. Grune and Stratton, New York, pp 87–97
Levine TB, Francis GS, Goldsmith SR, et al. (1982) Activity of the sympathetic nervous system and renin angiotensin system assessed by plasma hormone levels and their relationship to hemodynamic abnormalities in congestive heart failure. Am J Cardiol 49:1659–1660
Braunwald E, Harrison DC, Chidsey CA (1964) The heart as an endocrine organ. Am J Med 36:1–4
Thomas JA, Marks BH (1978) Plasma norepinephrine in congestive heart failure. Am J Cardiol 41:233–243
Francis GS, Goldsmith SR, Ziesche SM, Cohen JN (1982) Response of plasma norepinephrine and epinephrine to dynamic exercise in patients with congestive heart failure. Am J Cardiol 49:1152–1156
Bito K, Kubo S, Saimyoji H (1980) Role of endocrine factors in chronic congestive heart failure, with emphasis on catecholamines. Jpn Circ J 44:117–127
Chidsey CA, Braunwald E, Morrow AG (1965) Catecholamine excretion and cardiac stores of norepinephrine in congestive heart failure. Am J Med 39:442–451
Rose CP, Burgess JH, Cousineau D (1985) Tracer norepinephrine kinetics in coronary circulation of patients with heart failure secondary to chronic pressure and volume overload. J Clin Invest 76:1740–1747
Hasking GJ, Esler MD, Jennings GL, Burton D, Korner PI (1986) Norepinephrine spillover to plasma in patients with congestive heart failure: Evidence of increased overall and cardiorenal sympathetic nervous activity. Circulation 73:615–621
Swedberg K, Viquerat C, Roulean JL, Roizen M, Atherton B, Parmley W, Chatterjee K (1984) Comparison of myocardial catecholamine balance in chronic congestive heart failure and in angina pectoris without failure. Am J Cardiol 54:783–786
Sandoval AB, Gilbert EM, Rose CP, Bristow MR (1989) Cardiac norepinephrine uptake and release is decreased in dilated cardiomyopathy. Circulation 80(II):393
Bristow MR, Ginsburg R, Minobe W, Cubicciotti RS, Sageman WS, Lurie K, Billingham ME, Harrison DC, Stinson EB (1982) Decreased catecholamine sensitivity and β-adrenergic-receptor density in failing human hearts. N Engl J Med 307:205–211
Colucci WS, Alexander RW, Williams GH, Rude RE, Holman BL, Konstam MA, Wynne J, Mudge GH, Braunwald E (1981) Decreased lymphocyte beta-adrenergic-receptor density in patients with heart failure and tolerance to the beta-adrenergic agonist pirbuterol. N Engl J Med 305:185–190
Gordon EP, Bristow MR, Laser JA, Minobe WA, Fowler MB, Savin WM (1983) Correlation between β-adrenergic receptors in human lymphocytes and heart. Circulation 68(III):99
Weiss RJ, Tobes M, Wertz CE, Smith CB (1983) Platelet alpha2 adrenoreceptors in chronic congestive heart failure. Am J Cardiol 52:101–105
Sandoval A, Gilbert EM, Ginsburg R, Rasmussen R, Minobe W, Larrabee P, Bristow MR (1988) Is β1 receptor down-regulation in the failing human heart the result of exposure to cardiac-derived norepinephrine? JACC 11:117A
Fowler MB, Laser JA, Hopkins GL, Minobe W, Bristow MR (1986) Assessment of the β-adrenergic receptor pathway in the intact failing human heart: Progressive receptor down-regulation and subsensitivity to agonist response. Circulation 74:1290–1302
Ginsburg R, Bristow MR, Billingham ME, Stinson EB, Schroeder JS, Harrison DC (1983) Study of the normal and failing isolated human heart: Decreased response of failing heart to isoproterenol. Am Heart J 106:535–540
Ginsburg R, Esserman LJ, Bristow MR (1983) Myocardial performance in extracellular ionized calcium in a severely failing human heart. Ann Int Med 98:603–606
Reichenbach DD, Benditt EP (1970) Catecholamines and cardiomyopathy: The pathogenesis and potential importance of myofibrillar degeneration. Hum Pathol 1:125–150
Raum WJ, Laks MM, Garner D, Swerdloff RS (1983) β-adrenergic receptor and cyclic norepinephrine infusion: Implications for hypertrophic cardiomyopathy. Circulation 68:693–699
Tse J, Powell JR, Baste CA, Priest RE, Kuo JF (1979) Isoproterenol-induced cardiac hypertrophy: Modifications in characteristics of β-adrenergic receptor, adenylate cyclase, and ventricular contraction. Endocrinology 105:246–255
Nino AF, Berman MM, Gluck EH, Conway MM, Fisher JP, Dougherty JE, Rossi MA (1987) Drug-induced left ventricular failure in patients with pulmonary disease. Chest 92:732–736
Rosenbaum JS, Tsujimoto G, Billigham ME, Lurie KG, Hoffman BB (1984) Pheochromocytoma and catecholamine-induced cardiomyopathy. Fed Proc 43:835
Cohn JN, Levine TB, Olivari MT, et al. (1984) Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med 311:819–823
Heilbrunn SM, Shah P, Bristow MR, Valantine HA, Ginsburg R, Fowler MB (1989) Increased β-receptor density and improved hemodynamic response to catecholamine stimulation during long-term metoprolol therapy in heart failure from dilated cardiomyopathy. Circulation 79:483–490
Anderson JL, Rodier HE, Green LS (1983) Comparative effects of beta-adrenergic blocking drugs on experimental ventricular fibrillation threshold. Am J Cardiol 51:1196–1202
Furberg CD, Hawkins CM, Lichstein E (1984) Effect of propranolol in postinfarction patients with mechanical or electrical complication. Circulation 69:761–765
Alderman J, Grossman W (1985) Are β-adrenergic-blocking drugs useful in the treatment of dilated cardiomyopathy? Circulation 71:854–857
Packer DL, Brady GH, Gallagher JJ, Worley SJ, Smith MS, German LD (1984) Tachycardia induced cardiomyopathy: A reversible form of left ventricular dysfunction. J Am Coll Cardiol 3:521
Braunwald E, Frye RL, Ross J (1960) Studies on Starling's law of the heart. Circ Res 8:1254–1263
Mitchell JH, Linden RJ, Sarnoff SJ (1960) Influence of cardiac sympathetic and vagal nerve stimulation on the relation between left ventricular diastolic pressure and myocardial segment length. Circ Res 8:1100–1107
Grossman W, McLaurin LP, Rolett EL (1979) Alterations in left ventricular relaxation and diastolic compliance in congestive cardiomyopathy. Cardiovasc Res 13:514–522
Swedberg K, Waagstein F, Hjalmarson S, Wallentin I (1979) Prolongation of survival in congestive cardiomyopathy by beta receptor blockade. Lancet I:1374–1376
Swedberg K, Waagstein F, Hjalmarson A, Wallentin I (1980) Beneficial effects of long-term beta blockade in congestive cardiomyopathy. Br Heart J 44:117–133
Swedberg K, Waagstein F, Hjalmarson A, Wallentin I (1980) Adverse effects of beta blockade withdrawal in patients with congestive cardiomyopathy. Br Heart J 44:134–142
Waagstein F, Hjalmarson A, Swedberg K, Wallentin I (1983) Beta-blockers in dilated cardiomyopathies: They work. Eur Heart J 4:173–178
Weber KT, Likoff MJ, McCarthy D (1982) Low-dose beta blockade in the treatment of chronic cardiac function. Am Heart J 104:877–881
Majid PA, Niznick J, Nishizaki S, Morris WM, Sole MJ (1986) Favorable effects of pindolol in dilated cardiomyopathy. Chest 90:777–779
Ikram H, Fitzpatrick D (1981) Double-blind trial of chronic oral beta-blockade in congestive cardiomyopathy. Lancet II:490–493
Currie PJ, Kelly MJ, McKenzie A, Harper RW, Lim YL, Federman J, Anderson ST, Pitt A (1984) Oral beta-adrenergic blockade with metoprolol in chronic severe dilated cardiomyopathy. J Am Coll Cardiol 3:203–209
Anderson JL, Lutz JR, Gilbert EM, Sorenson SG, Yanowitz FG, Menlove RL, Bartholomew M (1985) A randomized trial of low dose β-blockade therapy for idiopathic dilated cardiomyopathy. Am J Cardiol 55:471–475
Engelmeier RS, O'Connell JB, Walsh R, Rad N, Scanlon PJ, Gunnar RM (1985) Improvement in symptoms and exercise tolerance by metoprolol in patients with dilated cardiomyopathy: A double-blind, randomized, placebo-controlled trial. Circulation 72:526–546
Waagstein F, Caidahl K, Wallentin I, Bergh C-H, Hjalmarson A (1989) Long-term β-blockade in dilated cardiomyopathy. Circulation 80:551–563
Hoffbrand BI (1980) β-adrenergic blockade in congestive cardiomyopathy. Lancet I:1031–1033
Bristow MR, Hershberger RE, Port JD, Minobe W, Rasmussen R (1989) β1- and β2-adrenergic receptormediated adenylate cyclase stimulation in nonfailing and failing human ventricular myocardium. Mol Pharmacol 35:295–303
Deitchman D, LaBudde JA, Seidehamel RJ (1983) Bucindolol. In: Scriabine A (ed) New drugs annual: Cardiovascular drugs. Raven, New York, pp 1–18
Gilbert EM, Anderson JL, Deitchman D, Yanowitz FG, O'Connell JB, Renlund DG, Bartholomew M, Mealey PC, Larrabee P, Bristow MR (1990) Long-term β-blocker vasodilator therapy improves cardiac function in idiopathic dilated cardiomyopathy: A double-blind, randomized study of bucindolol versus placebo. Am J Med 88:223–229
Anderson J, Gilbert E, O'Connell J, Renlund D, Yanowitz F, Bartholomew M, Murray M, Mealey P, Volkman K, Bristow M (1989) Beneficial effects of longterm beta-blockade with bucindolol in patients with idiopathic dilated cardiomyopathy. JACC 13:117A
Eichhorn EF, Bedotto J, Hatfield B, et al. (1989) Improvement in contractile performance in patients with congestive failure by chronic beta-blocker therapy with bucindolol. Circulation 80(II):117
Woodley SL, Gilbert EM, Anderson JL, Deitchman D, Mealey P, O'Connell JB, Renlund DG, Bristow MR (1989) Differing effect of chronic β-blockade with bucindolol on cardiac function in patients with idiopathic vs ischemic cardiomyopathy. Circulation 80(II):118
Gilbert EM, Mestroni L, Anderson JL, Woodley SL, Bristow MR (1989) Can response to β-blocker therapy in idiopathic dilated cardiomyopathy be predicted by baseline parameters? Circulation 80(II):428
Gilbert EM, Bristow MR, Mason JW (1987) Acute hemodynamic response to low dose enoximone (MDL 17,043): An oral dose-range study. Am J Cardiol 60:57C–62C