In this trial, the investigators will assess the effect of metoprolol in patients with hypertrophic cardiomyopathy who underwent alcohol septal ablation. The investigators will evaluate the quality of life, exercise tolerance, echocardiographic parameters and laboratory marker of heart failure and myocardial injury.
In this trial, the investigators will assess the effect of metoprolol in patients with hypertrophic cardiomyopathy who underwent alcohol septal ablation. The investigators will evaluate the quality of life, exercise tolerance, echocardiographic parameters and laboratory marker of heart failure and myocardial injury. The investigators will enroll 50 patients that will meet all the inclusion criteria and will agree to participate in the trial. In patients with preceding beta-blocker medication, it will be discontinued and a washout period of one month will be provided. The investigators will assess baseline characteristics and then divide patients randomly into two arms based on their date of birth (even/odd days of the month). Arm A will be given metoprolol 50 mg daily for three months, after this period the effect will be evaluated and metoprolol discontinued. A month-long washout period will follow and after an additional three months without metoprolol medication, patients will be reevaluated. Arm B will be without metoprolol for three months and will be evaluated thereafter. Then the patients will be given metoprolol 50 mg daily for three months followed by a reevaluation. The investigators will evaluate the effect of metoprolol by multiple methods at the end of the 5th and 9th months of the trial. Quality of life will be assessed by a questionnaire (The Kansas City Cardiomyopathy Questionnaire), exercise tolerance by a spiroergometry (VO2 max). A conventional echocardiographic examination and an examination focused on exercise-induced left ventricular outflow tract obstruction will be performed. The investigators will also measure NTproBNP from a blood sample as a laboratory marker of heart failure and high sensitive troponin as a marker of myocardial injury.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
22
metoprolol 50 mg daily for three months
Motol University Hospital
Prague, Czech Republic, Czechia
Change in exercise tolerance with and without metoprolol
VO2max during bicycle ergometer exercise test
Time frame: At baseline, after three months of metoprolol medication, after three months without metoprolol medication
Change of quality of life with and without metoprolol: The Kansas City Cardiomyopathy Questionnaire
The Kansas City Cardiomyopathy Questionnaire, score 0-100 (higher score means better outcome)
Time frame: After three months of metoprolol medication, after three months without metoprolol medication
Change of concentration of biomarker of heart failure with and without metoprolol
N-Terminal Pro-Brain Natriuretic Peptide concentration in blood sample
Time frame: After three months of metoprolol medication, after three months without metoprolol medication
Change of concentration of a biomarker of myocardial injury with and without metoprolol
High sensitivity troponin concentration in blood sample
Time frame: After three months of metoprolol medication, after three months without metoprolol medication
Change in exercise induced pressure gradient in left ventricular outflow tract with and without metoprolol
mmHg
Time frame: After three months of metoprolol medication, after three months without metoprolol medication
Change in left ventricular diastolic function at rest with and without metoprolol
Echocardiographic parameters of the transmitral flow and tissue Doppler
Time frame: After three months of metoprolol medication, after three months without metoprolol medication
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