Zhang Qian, Shu Qiuhong, Wu Liyong, Zhang Ran, Meng Yong
Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, People's Republic of China,
Ther Clin Risk Manag. 2018 Dec 18;15:23-31. doi: 10.2147/TCRM.S188123. eCollection 2019.
The objective of the study was to evaluate the dose-related influence of metoprolol on cardiac performance, motor function, quality of life (QoL), and mental status in Chinese patients with chronic heart failure (CHF).
This was a prospectively designed single-center study which enrolled CHF patients with resting heart rate (HR) >80 bpm belonging to the New York Heart Association (NYHA) III/IV functional classification. Patients were initiated with 12.5 mg of metoprolol, and every second week, the dose was escalated until the target HR level (60-70 bpm) was achieved during the follow-up at 1st, 3rd, 6th, and 12th months. Patients were divided into two groups depending on the doses administered: 47.5 mg (n=37) and 118.75 mg (n=74), respectively, for comparison in terms of change in cardiac function, motor function, QoL, and mental status.
Among the 111 patients with CHF, no significant difference was shown between the two doses administered. Irrespective of the dose, the cardiac performance, motor function, QoL, and anxiety improved and there was an increase in depression, whereas the effect on burnout, calculated as Copenhagen Burnout Inventory (CBI), equally was insignificant throughout the 1-year follow-up period in both the CHF patient groups.
Lower dose of metoprolol (47.5 mg) is as effective as higher dose (118.75 mg) in Chinese population with CHF to improve the cardiac function, motor function, QoL, and mental status.
本研究旨在评估美托洛尔对中国慢性心力衰竭（CHF）患者心脏功能、运动功能、生活质量（QoL）和精神状态的剂量相关影响。
这是一项前瞻性设计的单中心研究，纳入纽约心脏协会（NYHA）III/IV级功能分级、静息心率（HR）>80次/分钟的CHF患者。患者起始服用12.5mg美托洛尔，每隔一周剂量递增，直至在第1、3、6和12个月随访期间达到目标心率水平（60 - 70次/分钟）。根据给药剂量将患者分为两组：分别为47.5mg（n = 37）和118.75mg（n = 74），以比较心脏功能、运动功能、QoL和精神状态的变化。
在111例CHF患者中，两种给药剂量之间未显示出显著差异。无论剂量如何，心脏功能、运动功能、QoL和焦虑均有所改善，抑郁有所增加，而在两个CHF患者组的1年随访期内，以哥本哈根倦怠量表（CBI）计算的倦怠影响同样不显著。
在中国CHF患者中，较低剂量的美托洛尔（47.5mg）与较高剂量（118.75mg）在改善心脏功能、运动功能、QoL和精神状态方面同样有效。
