Cheng XiaoLiang, Zhu Min, Liu Qing, Feng Zhenxia, Meng Yong
Department of Endocrinology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People's Republic of China.
Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People's Republic of China.
Drug Des Devel Ther. 2020 Aug 25;14:3485-3494. doi: 10.2147/DDDT.S263026. eCollection 2020.
To assess gender-, age-, and the dose-related influence of metoprolol on cardiac function, motor function, quality-of-life (QoL), and mental status in Chinese chronic heart failure (CHF) patients.
This single-center, prospective study enrolled CHF patients with resting heart rate (HR) >80 bpm and used metoprolol continuous release tablets. Patients were initiated with 12.5-mg metoprolol. All patients were assessed for change in cardiac function, motor function, QoL, and mental status according to gender (men vs women), age (<60 vs ≥60 years), and metoprolol dose administered (47.5 mg [n=37], 71.25 mg [n=7], 118.75 [n=74], and 142.5 mg [n=19]).
Overall, 154 CHF patients (101 men and 53 women), with median age 66.39 years, were enrolled. In total, 116 and 38 patients were aged ≥60 and <60 years, respectively. We observed a slight decrease in systolic blood pressure (SBP) in women compared with men. HR had increased with an increase in ejection fraction (EF) from baseline to 1 month (35.24±6.15 and 34.79±6.25) and increased to 50.00±4.45 and 50.72±4.09 among both the genders. Cardiac index (CI) and motor function had improved along with better QoL after metoprolol treatment in both the genders. In both age groups (<60 and ≥60 years), improvement in cardiac function, motor function, and QoL was observed; however, there was a difference in mental status. The dose effect of metoprolol on cardiac function, motor function, QoL, and mental status showed a gradual decrease in EF with dose increments, with no change in CI. Motor function, QoL, and mental status did not show much difference with uptitration of metoprolol dose.
Psychological responses to metoprolol treatment differ with gender, with no age-related changes in terms of cardiac function, motor function, QoL, or mental status, except increases in depression, burnout, and anxiety.
评估美托洛尔对中国慢性心力衰竭（CHF）患者心功能、运动功能、生活质量（QoL）及精神状态的性别、年龄和剂量相关影响。
这项单中心前瞻性研究纳入静息心率（HR）>80次/分钟的CHF患者，并使用美托洛尔缓释片。患者起始剂量为12.5毫克美托洛尔。根据性别（男性与女性）、年龄（<60岁与≥60岁）以及美托洛尔给药剂量（47.5毫克[n = 37]、71.25毫克[n = 7]、118.75毫克[n = 74]和142.5毫克[n = 19]）对所有患者的心功能、运动功能、QoL和精神状态变化进行评估。
共纳入154例CHF患者（101例男性和53例女性），中位年龄66.39岁。其中，年龄≥60岁和<60岁的患者分别为116例和38例。我们观察到女性收缩压（SBP）较男性略有下降。从基线到1个月，随着射血分数（EF）增加，HR升高（35.24±6.15和34.79±6.25），且两性HR均升高至50.00±4.45和50.72±4.09。美托洛尔治疗后，两性的心指数（CI）和运动功能均有改善，生活质量也有所提高。在两个年龄组（<60岁和≥60岁）中，均观察到心功能、运动功能和QoL有所改善；然而，精神状态存在差异。美托洛尔对心功能、运动功能、QoL和精神状态的剂量效应显示，随着剂量增加EF逐渐降低，CI无变化。随着美托洛尔剂量上调，运动功能、QoL和精神状态无明显差异。
美托洛尔治疗的心理反应因性别而异，在心功能、运动功能及生活质量或精神状态方面，除抑郁、倦怠和焦虑增加外，无年龄相关变化。
