Corea L, Bentivoglio M, Verdecchia P, Provvidenza M, Motolese M
Int J Clin Pharmacol Ther Toxicol. 1984 Jul;22(7):365-70.
The long-term effects of metoprolol monotherapy, 100 mg b.i.d., for 16-18 months, were investigated in 8 previously untreated essentially hypertensive patients (resting blood pressure greater than 155/95 mmHg) and echocardiographic evidence of left ventricular hypertrophy (LVH) (left ventricular mass by Penn Cube formula greater than 215 g). Echocardiographic studies, according to the American Society of Echocardiography recording techniques and measurements criteria, were performed before starting treatment and at the end of follow-up. Metoprolol induced a decrease in systolic and diastolic blood pressure and heart rate, accompanied by a reduction of interventricular septum and posterior wall thickness (from 1.21 cm to 1.10 cm, and from 1.15 cm to 1.06 cm, respectively), left ventricular mass index and mean wall stress. All these changes were significant (p less than 0.01). Cardiac index decreased from 3017 ml/m2 to 2632 ml/m2 (p less than 0.01), mostly because of the reduction in the heart rate. In fact, stroke index, ejection fraction and fractional shortening all slightly increased during treatment in respect to pre-treatment values. Plasma renin activity fell from 1.45 ng/ml/h to 0.81 ng/ml/h (p less than 0.01), whereas both plasma noradrenaline and adrenaline concentration at rest did not change. Results indicate that in essentially hypertensive patients who have already developed LVH as a consequence of the hypertension, a long-term metoprolol therapy can successfully induce a reversal of LVH together with an effective blood pressure control, without noticeable adverse effects of changes in cardiac performance.
对8名未经治疗的原发性高血压患者（静息血压大于155/95 mmHg）且有左心室肥厚（LVH）超声心动图证据（根据Penn Cube公式计算左心室质量大于215 g）进行了研究，观察美托洛尔单药治疗（100 mg，每日两次，持续16 - 18个月）的长期效果。根据美国超声心动图学会的记录技术和测量标准，在开始治疗前及随访结束时进行了超声心动图研究。美托洛尔可使收缩压和舒张压以及心率降低，同时伴有室间隔和后壁厚度减小（分别从1.21 cm降至1.10 cm和从1.15 cm降至1.06 cm）、左心室质量指数和平均壁应力降低。所有这些变化均具有显著性（p小于0.01）。心脏指数从3017 ml/m²降至2632 ml/m²（p小于0.01），主要是由于心率降低。实际上，治疗期间每搏输出量指数、射血分数和缩短分数相对于治疗前值均略有增加。血浆肾素活性从1.45 ng/ml/h降至0.81 ng/ml/h（p小于0.01），而静息时血浆去甲肾上腺素和肾上腺素浓度均未改变。结果表明，在因高血压已发生LVH的原发性高血压患者中，长期美托洛尔治疗可成功诱导LVH逆转并有效控制血压，且对心脏功能变化无明显不良影响。
