Introduction:
Beta-blockers may be indicated for treatment of hypertension or atrial arrhythmias in patients with degenerative mitral valve prolapse (MVP) and moderate-severe mitral regurgitation (MR). However the influence of beta-blockade on the mitral regurgitant volume is uncertain.
Methods:
The influence of metoprolol on regurgitant volume was studied in 25 asymptomatic patients with moderate-severe MR due to MVP in a randomized double-blind cross over study. Metoprolol or placebo were titrated by an independent investigator according to symptoms, blood pressure and resting heart rate (mean dose 119mg, range 23.75 to 195mg/day). Severity of MR was assessed by cardiac magnetic resonance imaging (MRI) and echo-Doppler after 10 –14 days on each treatment. Regurgitant fraction was calculated using MRI from the difference between stroke volume by LV volumetry and aortic forward flow by phase contrast analysis.
Results. Conclusion:
Although metoprolol decreased heart rate and systolic blood pressure it does not influence the mitral regurgitant volume in patients with degenerative mitral valve prolapse.
Heart rate and blood pressure in mitral valve prolapse patients: divergent effects of long-term propranolol therapy. Correlations with catecholamines
