Congestive heart failure is a common and serious complication in patients undergoing chronic dialysis. However, there have been no studies on preferential medical therapies to improve left ventricular function in haemodialysis patients. β-Blocker treatment is known to improve left ventricular function in patients with dilated cardiomyopathy; moreover, plasma levels of noradrenaline and natriuretic peptides are sensitive markers of left ventricular dysfunction. The present study investigated whether β-blocker treatment could improve left ventricular function in haemodialysis patients with a dilated left ventricle. Our study group comprised 14 haemodialysis patients with a dilated left ventricle, who had undergone maintenance haemodialysis for a mean of 11 years. The following haemodynamic parameters were evaluated before and after 4 months of treatment with the β-blocker metoprolol: left ventricular dimension at end-systole and end-diastole, and fractional shortening. Plasma levels of noradrenaline, atrial natriuretic peptide and brain natriuretic peptide were also determined. Dry body weight and haemoglobin concentration showed no significant change after compared with before treatment with metoprolol. Heart rate decreased significantly, from 79±9 beats/min to 69±9 beats/min, but systolic blood pressure remained unchanged. The left ventricular dimension both at end-systole and at end-diastole was decreased, and fractional shortening increased significantly. Plasma levels of noradrenaline did not change significantly, but those of atrial natriuretic peptide and brain natriuretic peptide decreased markedly [from 100±89 pg/ml to 46±29 pg/ml (P = 0.0051) and from 549±516 pg/ml to 140±128 pg/ml (P = 0.0035) respectively]. In conclusion, β-blocker therapy with metoprolol can markedly attenuate left ventricular remodelling and decrease the plasma levels of natriuretic peptides in haemodialysis patients with a dilated left ventricle.
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September 2001
Research Article|
August 03 2001
Beneficial effect of β-adrenergic blockade on left ventricular function in haemodialysis patients
Yuji HARA;
*The Second Department of Internal Medicine, Ehime University School of Medicine, Shigenobu-cho, Onsen-gun, Ehime 791-0925, Japan
Correspondence: Dr Yuji Hara (e-mail yujihara@m.ehime-u.ac.jp).
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Mareomi HAMADA;
Mareomi HAMADA
*The Second Department of Internal Medicine, Ehime University School of Medicine, Shigenobu-cho, Onsen-gun, Ehime 791-0925, Japan
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Yuji SHIGEMATSU;
Yuji SHIGEMATSU
*The Second Department of Internal Medicine, Ehime University School of Medicine, Shigenobu-cho, Onsen-gun, Ehime 791-0925, Japan
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Bonpei MURAKAMI;
Bonpei MURAKAMI
†The Department of Internal Medicine, Murakami Memorial Hospital, 739 Oh-machi, Saijo city, Ehime 793-0030, Japan
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Kunio HIWADA
Kunio HIWADA
*The Second Department of Internal Medicine, Ehime University School of Medicine, Shigenobu-cho, Onsen-gun, Ehime 791-0925, Japan
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Clin Sci (Lond) (2001) 101 (3): 219–225.
Article history
Received:
January 10 2001
Revision Received:
March 12 2001
Accepted:
April 27 2001
Citation
Yuji HARA, Mareomi HAMADA, Yuji SHIGEMATSU, Bonpei MURAKAMI, Kunio HIWADA; Beneficial effect of β-adrenergic blockade on left ventricular function in haemodialysis patients. Clin Sci (Lond) 1 September 2001; 101 (3): 219–225. doi: https://doi.org/10.1042/cs1010219
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