اثر آتنولول در درمان كارديوميوپاتي اتساعي

Effect of atenolol in treatment of DCM

Background and purpose: DCM is the major cause of heart failure. No definite treatment has been found so for. Aim of this research is to evaluate the effect of atenolol on clinical and cardiographic improvement as an alternative in patients suffering from DCM, so, to provide an appropriate method of treatment for those patients cardiac transplantation is indicated as main treatment transplantation.Cardiac transplantation is less possible in Iran, because of being expensive, advanced technique and non availability of proper donor. Materials and methods: In this double-blind clinical trial, 23 patients with DCM (both ischemic and idiopatic), referring to Imam khomeini hospital in sari were selected randomly and divided in to two groups (12 for case and 11 for control), matched for age, sex, FC (NYHA), LVEF, and lack of presence of associated diseases. At first FC (based on NYHA) and echocardiographic parameters such as Left ventricular ejection fraction (LVEF), Left ventricular end diastolic dimention (LVESD), Left ventricular end systollic dimention (LVESD), Left ventricular posterior wall dimention (LVPWD), Intra ventricular septal dimention (IVSD), E point septa) separation (EPSS) were measured. Then previouse drugs like digoxin, ACEIs, diuretics, aspirin, and nitrates were administered to both groups. In addition atenolol, 25-50 mg daily, was administered to the case group. Each patient were followed for 3 months and at the end, the above mentioned parameters were measured again. flowerer, 4 patients (one of case group and three of control), were excluded from the study. Results : Analysis of the collected data showed that, EPSS and LVEF were changed significantly in the case group,as Compared to the control group (EPSS from 22 mm to 17.7 mm and LVEF from 27.7% to 32.9%), (P<0.02 and P<0.05), but there was no significant changes in the other parameters. Conclusion: Using atenolol in treatment of DCM for 3 months will improve some echocardiographic parameters (LVEF, EPSS) and cardic function, but will not improve significantly FC and functional capacity of the patients.