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The effect of metoprolol succinate on the cardiac function of patients with thalassaemia cardiomyopathy: a double-blind randomised study
  1. Javad Kojury1,2,
  2. Abdolali Zolghadrasli1,
  3. Mehran Karimi3,
  4. Mohammad Ali Babaee Beighi1,2,
  5. Soha Namazi4
  1. 1Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Fars, Islamic Republic of Iran
  2. 2Shiraz Cardiovascular Research Center, Shiraz, Fars, Islamic Republic of Iran
  3. 3Hematology Research Centre, Shiraz University of Medical Sciences, Shiraz, Fars, Islamic Republic of Iran
  4. 4Department of Pharmacology, Shiraz University of Medical Sciences, Shiraz, Fars, Islamic Republic of Iran
  1. Correspondence to Dr Mohammad Ali Babaee Beighi, Shiraz University of Medical Sciences, Zand Street, Namazi Hospital, Cardiology Office, Po Box 71937–11351 Shiraz, Fars, Islamic Republic of Iran; m babaee-med@yahoo.com

Abstract

Background Heart failure is the most common cause of mortality in β-thalassaemia major. However, the management of this disease, apart from chelation therapy, is largely empirical. Therefore, we decided to evaluate the effect of metoprolol succinate on patients with thalassaemia cardiomyopathy (TCM).

Materials and methods In this clinical trial, 45 patients with TCM were randomised to receive either metoprolol (n=26) or placebo (n=19). Echocardiography and a 6 min walk test were performed at baseline and repeated after 6 months and the values compared.

Results In the metoprolol group, left ventricular ejection fraction (LVEF) rose from 38.65% to 42.84% (p<0.001), while it decreased in the placebo group from 37.89% to 35.84% (p=0.01); the difference between the two groups was significant (p<0.001). Left ventricular (LV) mass in the metoprolol group decreased from 154.31 to 144.26 g (p=0.02), while in the placebo group it increased from 174.32 to 200.15 g (p=0.68); the difference between the two groups was significant (p<0.001). End systolic volume (ESV) decreased in the metoprolol group from 42.19 to 36.73 cm3 (p<0.001) but increased from 47.37 to 57.42 cm3 in the placebo group (p=0.144); the difference between the groups was significant (p<0.001). No differences in exercise capacity or pulmonary capillary wedge pressure were seen between the two groups (p=0.268 and p=0.535, respectively).

Conclusions Metoprolol succinate as a β-blocker may have the potential to significantly improve systolic function in patients with TCM and reverse LV remodelling to the same extent as in other types of cardiomyopathy.

Trial registration number NCT01863173.

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