The value of repeated echocardiographic evaluation in patients with idiopathic dilated cardiomyopathy during treatment with metoprolol or captopril

Serial echocardiographic investigations were carried out on patients with i diopathic dilated cardiomyopathy, to evaluate treatment effects on left ven tricular (LV) performance during therapy with either metoprolol or captopri l. Thirty-two patients (23 males and 9 females) with mild to moderate sympt oms of heart failure (NYHA II-III) and a mean age of 49 years were included in the investigation. The patients were investigated with Doppler echocard iography before treatment, after 3 and 6 months of treatment (either metopr olol or captopril) and 1 month after withdrawal of treatment. Intra- and in ter-investigator reproducibility was acceptable, with a coefficient of vari ation of less than 5% for LV dimensions. A reduction in LV dimensions was s een in both treatment groups. In the metoprolol group there was also an inc rease in LV stroke volume and fractional shortening. The non-invasive data were in accordance with invasive measurements of stroke volume and LV filli ng pressure. In patients with idiopathic dilated cardiomyopathy and mild to moderate symptoms of heart failure, echocardiography seemed to be sufficie ntly reproducible to be used for determination of treatment effects in a lo ngitudinal heart failure study. Both metoprolol and captopril were well tol erated and had favourable effects on LV performance.