Taha Maher, Dahat Purva, Toriola Stacy, Satnarine Travis, Zohara Zareen, Adelekun Ademiniyi, Seffah Kofi D, Salib Korlos, Dardari Lana, Arcia Franchini Ana P
Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Pathology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Cureus. 2023 Aug 9;15(8):e43197. doi: 10.7759/cureus.43197. eCollection 2023 Aug.
Hypertrophic cardiomyopathy (HCM) is the most common genetic heart disease and is a prevalent cause of sudden cardiac death (SCD). This study aims to establish the benefits and therapeutic value metoprolol or verapamil offer to patients who suffer from symptoms caused by HCM, with regard to resolving left ventricular outflow tract obstruction (LVOTO), as well as improving a patient's quality of life and reducing symptoms. We conducted a systematic review to find clinical studies that described the use of metoprolol or verapamil in the management of HCM. Three databases were analyzed for studies, PubMed, Google Scholar, and ScienceDirect. We discovered 6,260 potentially eligible records across all the databases. According to our eligibility criteria, we included four studies in this review. Metoprolol showed median left ventricular outflow tract (LVOT) gradients of 25 mm Hg versus 72 mm Hg (P = 0.007) at rest, 28 mm Hg versus 62 mm Hg (P < 0.001) at peak exercise, and 45 mm Hg versus 115 mm Hg (P < 0.001) post-exercise. Verapamil also showed a statistically significant increase in exercise capacity. Both drugs have been shown to be safe to use with a good side effect profile; however, metoprolol was better tolerated in the patient population that was tested in the studies collected. In this study, metoprolol was effective in reducing LVOT and improving the quality of life in patients, while verapamil showed variable effects on both exercise capacity and baseline hemodynamics.
肥厚型心肌病（HCM）是最常见的遗传性心脏病，也是心源性猝死（SCD）的常见原因。本研究旨在确定美托洛尔或维拉帕米对患有HCM所致症状的患者在解决左心室流出道梗阻（LVOTO）、改善患者生活质量和减轻症状方面的益处及治疗价值。我们进行了一项系统评价，以查找描述美托洛尔或维拉帕米用于HCM治疗的临床研究。对三个数据库PubMed、谷歌学术和科学Direct进行了研究分析。我们在所有数据库中发现了6260条潜在符合条件的记录。根据我们的纳入标准，本评价纳入了四项研究。美托洛尔在静息时左心室流出道（LVOT）梯度中位数为25 mmHg，而对照组为72 mmHg（P = 0.007）；运动峰值时为28 mmHg，而对照组为62 mmHg（P < 0.001）；运动后为45 mmHg，而对照组为115 mmHg（P < 0.001）。维拉帕米也显示出运动能力有统计学意义的提高。两种药物均已证明使用安全，副作用较小；然而，在收集的研究中所测试的患者群体中，美托洛尔的耐受性更好。在本研究中，美托洛尔可有效降低LVOT并改善患者生活质量，而维拉帕米对运动能力和基线血流动力学的影响则各不相同。
