僧帽弁閉鎖不全症モデル犬に対するβ遮断薬（メトプロロール）の作用効果の検討
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概要
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To determine the chronic effects of β-blocker on hemodynamics, left ventricular (LV) function and geometry in dogs with chronic heart failure due to mitral regurgitation (MR), metoprolol (MP) was administered to dogs with experimentally produced severe (n =4) and mild (n =3) MR. Oral administration of MP was started at a dose of 1.5mg/kg/day and gradually increased up to a maintenance dose of 4.5mg/kg/day. Clinical status, heart rate, arterial blood pressure, and LV function and geometry were evaluated at baseline and after 10 days, 20 days, 1 month, 3 months, and 6 months of treatment. Serum norepinephrine (NE) and atrial natriuretic peptide (ANP) concentrations were also examined. As a result, clinical status was worsened in severe MR group after 3 months of treatment, but not in mild MR group throughout the study. MP reduced heart rate, systolic and diastolic blood pressures, and LV fractional shortening in both MR groups. MP caused a significant increase in regurgitant volume and a decrease in stroke volume in severe MR group. In contrast, such changes were not observed in mild MR group. Relative LV wall thickness to chamber diameter increased in mild MR group, whereas LV chamber dilatation with wall thinning was seen in severe MR group. Serum NE and ANP concentrations were elevated in severe MR group associated with deterioration of clinical status. These results suggest that monotherapy of MP achieve negative chronotrophic and inotrophic effects without aggravation of cardiac function and clinical status in mild MR, whereas these effects may lead to progressive worsening of mitral regurgitation and clinical status in severe MR.
- 日本獣医循環器学会の論文
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