Publication in refereed journal
香港中文大学研究人员 ( 现职)
| 胡锦生教授 |
| 孙德生教授 (医学院) |
全文
| 数位物件识别号 (DOI) http://dx.doi.org/10.1136/hrt.79.1.86 |
引用次数
Web of Sciencehttp://aims.cuhk.edu.hk/converis/portal/Publication/30WOS source URL
Scopushttp://aims.cuhk.edu.hk/converis/portal/Publication/42Scopus source URL
其它资讯
摘要Objective - To determine whether a third generation vasodilating β blocker (celiprolol) has long term clinical advantages over metoprolol in patients with chronic heart failure. Design - A double blind placebo controlled randomised trial. Setting - University teaching Hospital. Patients - 50 patients with stable chronic heart failure (NYHA class H-IV) due to idiopathic dilated, ischaemic, or hypertensive cardiomyopathy, with left ventricular ejection fraction < 0.45. Interventions - Celiprolol 200 mg daily (n = 21), metoprolol 50 mg twice daily (n = 19), or placebo (n = 10) for three months with a four week dose titration period. After the double blind period, patients entered an open label study (with placebo group receiving β blockers) and were assessed after one year. Main outcome measures - Clinical response, efficacy, and tolerance were assessed by the Minnesota heart failure symptom questionnaire, six minute walk test. Doppler echocardiography (systolic and diastolic function), radionuclide ventriculography, and atrial and brain natriuretic peptides measured at baseline and after three months. Results - In the metoprolol group at 12 weeks v baseline there was a 47% reduction in symptom score (p < 0.001), improvement of NYHA class (mean (SEM), 2.6 (0.12) to 1.9 (0.13), p = 0.001), exercise distance (1246 (54) to 1402 (52) feet, p < 0.001), and left ventricular ejection fraction (26.9(3.1)% to 31(3.0)%, p = 0.016), and a fall in heart rate (resting, 79 (3) to 62 (3) beats/min, p < 0.001). In the celiprolol group there was a 38% reduction in symptom score (p = 0.02), less improvement in exercise distance (1191 (55) to 1256 (61) feet, p = 0.05), and no significant changes in NYHA class, left ventricular ejection fraction, or heart rate. Mortality at one year was 11% in metoprolol and 19% in the celiprolol group, and symptomatic improvement was maintained in the survivors. Conclusions - Both drugs were well tolerated but the vasodilator properties of celiprolol do not seem to provide any obvious additional benefit in the long term treatment of heart failure.
着者Sanderson J.E., Chan S.K.W., Yu C.M., Yeung L.Y.C., Chan W.M., Raymond K., Chan K.W., Woo K.S.
期刊名称Heart
出版年份1998
月份5
日期5
卷号79
期次1
出版社BMJ Publishing Group
出版地United Kingdom
页次86 - 92
国际标準期刊号1355-6037
电子国际标準期刊号1468-201X
语言英式英语
关键词Celiprolol, Heart failure, Metoprolol, β Blockers
