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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

beta-Blocker therapy for cirrhotic cardiomyopathy: a randomized-controlled trial

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Author(s):
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Silvestre, Odilson M. [1] ; Farias, Alberto Q. [2] ; Ramos, Danusa S. [2] ; Furtado, Meive S. [3] ; Rodrigues, Ana C. [3] ; Ximenes, Rafael O. [2] ; de Campos Mazo, Daniel F. [2] ; Yoshimura Zitelli, Patricia M. [2] ; Diniz, Marcio A. [2] ; Andrade, Jose L. [3] ; Strunz, Celia [1] ; Friedmann, Antonio A. [2] ; Lee, Samuel S. [4] ; Carrilho, Flair J. [2] ; D'Albuquerque, Luiz A. C. [2] ; Bacal, Fernando [1]
Total Authors: 16
Affiliation:
[1] Univ Sao Paulo, Sch Med, Heart Inst InCor, Sao Paulo - Brazil
[2] Univ Sao Paulo, Sch Med, Div Gastroenterol & Hepatol, Dept Gastroenterol, Sao Paulo - Brazil
[3] Univ Sao Paulo, Sch Med, Dept Radiol, Sao Paulo - Brazil
[4] Univ Calgary, Liver Unit, Calgary, AB - Canada
Total Affiliations: 4
Document type: Journal article
Source: EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY; v. 30, n. 8, p. 930-937, AUG 2018.
Web of Science Citations: 3
Abstract

Background Cirrhotic cardiomyopathy is characterized by an attenuated contractile response to stress. Long-term exposure of beta-adrenergic receptors to persistently high levels of catecholamines has been implicated in its pathogenesis. We hypothesized that beta-blockade with metoprolol could reverse the changes in heart function and morphology in cirrhotic cardiomyopathy. Patients and methods In this prospective randomized trial, we included 78 patients aged between 18 and 60 years with abnormal cardiac output response under dobutamine stress echocardiography, without primary cardiac disease or a history of alcohol intake. Patients were assigned randomly to receive metoprolol or placebo for 6 months. The primary endpoint was the improvement in cardiac output response to stress, measured by an increase in the left ventricle stroke volume more than 30%. Results Three (7.3%) patients in the metoprolol group and nine (24.3%) patients in the placebo group showed improved stroke volume (P=0.057). Diastolic dysfunction was found in two (4.8%) patients before and in five (15.6%) patients after therapy in the metoprolol group, and in 10 (27%) patients before and nine (31%) patients after therapy in the placebo group (P=0.67). After treatment, no echocardiography parameter of morphology was significantly different between metoprolol or placebo groups. No significant differences were observed in noradrenaline, plasma renin activity, and troponin levels between groups. Cirrhosis-related clinical events, including hospitalizations and mortality, were not significantly different between the two groups. Six months of therapy with beta-blocker did not ameliorate heart function and morphology in patients with cirrhotic cardiomyopathy. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved. (AU)

FAPESP's process: 10/12223-6 - Effect of metoprolol in the reversal of cardiac dysfunction in cirrhotic non-alcoholic: randomised study
Grantee:Fernando Bacal
Support Opportunities: Regular Research Grants