Drug treatment of heart failure caused by dilated cardiomyopathy: Effect on clinical status, left ventricular systolic function and remodeling

Aim of the study. To assess effects of enalapril and metoprolol on clinical status, left ventricular remodeling and systolic function in patients with heart failure due to dilated cardiomyopathy. Study structure. Randomized, open, controlled, duration - 6 months. Patients. Seventy one patients with dilated cardiomyopathy (mean age 47 years). Treatment groups. Standard trea tment (glycosides, diuretics, peripheral vasodilators) - 23 patients; stand ard therapy plus enalapril (10-20 mg/day) - 24 patients; standard therapy p lus metoprolol (slow titration from 10 to a maximum 100 mg/day) - 24 patien ts. Criteria of evaluation. NYHA functional class, 6-minute walk test, qual ity of life according to Minnesota Living with Heart Failure (MLHF) questio nnaire, echocardiographical parameters of left ventricular remodeling and s ystolic function. Results. Standard therapy did not change clinical status or left ventricular systolic function, while some parameters of remodeling deteriorated. Enalapril and metoprolol improved quality of life and left ve ntricular systolic function, and affected favorably left ventricular remode ling. Metoprolol compared with enalapril produced more pronounced decreases of heart rate and indexes of sphericity of left ventricular cavity. Conclu sion. Metoprolol compared with enalapril produced greater influence on left ventricular remodeling but effects of both drugs on clinical status of pat ients with dilated cardiomyopathy during 6 months of therapy were similar.