Metoprolol for AR Trial design: Patients with chronic asymptomatic severe aortic regurgitation (AR) were randomized to metoprolol CR/XL 200 mg or matching.

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Presentation transcript:

Metoprolol for AR Trial design: Patients with chronic asymptomatic severe aortic regurgitation (AR) were randomized to metoprolol CR/XL 200 mg or matching placebo. They were followed for 6 months. Results (p = 0.32) Primary endpoint, LVEDV on CMR at 6 months for metoprolol vs. placebo: 267 vs. 256 ml, p = 0.32 LVESV on CMR: 117 vs. 117 ml, p = 0.44; EF: 57 vs. 55%, p = 0.04; stroke volume: 151 vs. 139 ml, p = 0.04 Peak VO2 at 6 months: 34.9 vs. 36.6 ml/kg/min, p = 0.08; NT-proBNP: 142 vs. 58 pg/ml, p < 0.001 ml Conclusions Long-acting metoprolol does not improve LVEDV or LVESV in asymptomatic patients with moderate to severe AR compared with placebo On the one hand, some measures were better with beta-blocker use such as EF and stroke volume; on the other hand, peak VO2 diminished and NT-proBNP levels went up, suggesting harm Primary endpoint Metoprolol (n = 37) Placebo (n = 38) Broch K, et al. Heart 2016;102:191-7