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.