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英文誌(2004-)

Journal of Medical Ultrasonics

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1992 - Vol.19

Vol.19 No.06

Case Report(症例報告)

(0425 - 0431)

Metoprolol治療による著しい心機能の改善を心エコー図により経時的に観察しえたDCMの1例

Serial Echocardiographic Observation in a Patient with Dilated Cardiomyopathy Treated bv Metoorolol

曽根 利久1, 近藤 真言2, 杉山 基明1, 谷尾 仁志2, 霜野 幸雄2

Toshihisa SONE1, Makoto KONDO2, Motoaki SUGIYAMA1, Hitoshi TANIO2, Yukio SHIMONO2

1島田市民病院臨床検査科, 2島田市民病院循環器科

1Department of Laboratory, Shimada Municipal Hospital, 2Department of Cardiology, Shimada Municipal Hospital

キーワード : Dilated cardiomyopathy, β-blocker, Echocardiography

We report a patient of dilated cardiomyopathy (DCM) treated with metoprolol, a 硫1-selective sympathetic blocking agent, who showed marked improvement of cardiac function by serial echocardiographic study. For 4 years before the metoprolol therapy, we treated this 56-year-old man with salt restriction and constant dose of diuretics. He complained dyspnea or fatigue on mild exertion despite the treatment. Then he received incremental doses (5, 10, 20, 30, 40, 50, and 60 mg/day) of metoprolol. The administration of metoprolol decreased the heart rate (128 to 67/min.) and left ventricular (LV) diastolic dimension (62.4 to 54.4 mm), on the other hand, increased LV fractional shortening (6 to 20%) and LV ejection fraction (18 to 48%). In consequence, it markedly improved LV wall motion. His symptom became NYHA class II after this therapy. These results suggest that metoprolol can improve cardiac function of some DCM patients and that echocardiography is the useful method for the observation of serial changes of the therapeutic effect.