The Influence of Metoprolol on Exercise Training Effects in Patients with Ischemic Left Ventricular Dysfunction

The aim of this study was to estimate the influence of chronic metoprolol treatment, which has been added to conventional heart failure, in patients with post infarction left ventricular dysfunction, on the effects of a one year physical training. Eighty-nine patients, who recently suffered myocardial infarction and also had left ventricular dysfunction with ejection fraction of 40% or less, were examined.The first part of the physical training program was carried out as residential rehabilitation in the course of three weeks. At the end of the residential phase of rehabilitation the functional capacity was increased in metoprolol group from 4.9±1.6 METs to 5.8±1.9 METs (p<0.025), and in the non beta blocker group from 4.8±1.8 METs to 5.4±1.8 METs (NS). After residential rehabilitation patients continued with unsupervised physical activity for a one year period. At the end of the one year physical training program the functional capacity increased in metoprolol group from 4.9±1.6 to 6.3±1.7 METs (p<0.001), and in the non beta blocker group from 4.8±1.8 to 5.7±1.9 METs (p<0.01). Both groups of patients have improved functional capacity due to physical training. Patients with metoprolol have shown greater functional capacity improvement (28.7%) than patients without the beta blocker (18.8 %, p<0.05), with statistical significance which appeared from the third month, and remained until the end of the one year training period. There were no complications during the training and no evidence of heart failure deterioration. Incidence of the nonfatal myocardial infarction was lower in metoprolol group, but without statistical significance (6.3% vs10.6 %). Also, annual mortality was lower in metoprolol group, 4.3% vs 7.1%, but again without statistical significance.