{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T23:42:16Z","timestamp":1768434136617,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,7,6]],"date-time":"2016-07-06T00:00:00Z","timestamp":1467763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovascular Therapeutics"],"published-print":{"date-parts":[[2016,8]]},"abstract":"Summary<\/jats:title>Introduction<\/jats:title>Chronic mitral regurgitation (MR<\/jats:styled-content>) is characterized by adverse ventricular remodeling and progressive LV<\/jats:styled-content> dysfunction leading to heart failure (HF<\/jats:styled-content>). Beta\u2010blockers (BB<\/jats:styled-content>) improve LV<\/jats:styled-content> remodeling and prognosis in patients with HF<\/jats:styled-content>. As chronic severe MR<\/jats:styled-content> results in neuroendocrine activation similar to HF<\/jats:styled-content>, it is likely that BB<\/jats:styled-content> may also exert favorable effects in these patients. No study has assessed the role of oral BB<\/jats:styled-content> therapy in chronic rheumatic MR<\/jats:styled-content>.<\/jats:p><\/jats:sec>Aims<\/jats:title>A total of 100 patients of chronic rheumatic MR<\/jats:styled-content> (mean age 30\u00b113.48\u00a0years, NYHA<\/jats:styled-content> 2.2\u00b10.5) were randomized to BB<\/jats:styled-content> (Metoprolol, 37\u00b113.5\u00a0mg, n=48) vs no BB<\/jats:styled-content> (n=52) in addition to standard therapy.<\/jats:p><\/jats:sec>Results<\/jats:title>Baseline BNP<\/jats:styled-content> and echocardiographic parameters were comparable in the two groups. At 3\u00a0months, BB<\/jats:styled-content> therapy resulted in significantly lower NYHA<\/jats:styled-content> class (1.97 vs 2.35), BNP<\/jats:styled-content> (141 vs 207\u00a0pg\/mL), LV<\/jats:styled-content> end\u2010systolic (35.89 vs 51.30) and LV<\/jats:styled-content> end\u2010diastolic volumes (101 vs 128\u00a0mL\/m2<\/jats:sup>), LV<\/jats:styled-content> end\u2010systolic stress (81.1 vs 93.3\u00a0dyn\/cm2<\/jats:sup>), LV<\/jats:styled-content> mass (122 vs 154\u00a0gm\/m2<\/jats:sup>), and LV<\/jats:styled-content> work (737.02 vs 952.82\u00a0mm\u00a0Hg\u00a0L\/min, all P<\/jats:italic> significant). Therapy with BB<\/jats:styled-content> resulted in a \u221215.6%, \u221210.4%,\u221212.1%, and \u22127.3% reduction in LV<\/jats:styled-content> end\u2010systolic and end\u2010diastolic dimensions and LVESV<\/jats:styled-content>i and LVEDV<\/jats:styled-content>i, respectively. Following BB<\/jats:styled-content> therapy, BNP<\/jats:styled-content> levels, end\u2010systolic stress, indexed LV<\/jats:styled-content> mass, and LV<\/jats:styled-content> work also reduced significantly by 27.3%, 15.6%, 8.7%, and 28%, respectively. The control group had no significant change. The MR<\/jats:styled-content> grade reduced from severe to moderate in 11% of those on BB<\/jats:styled-content> (controls: no change). At 6\u00a0months, the BB<\/jats:styled-content> group had further improvement in all echocardiographic parameters ranging from +9.1 to \u221218.2%.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In this first study of BB<\/jats:styled-content> in rheumatic MR<\/jats:styled-content>, targeting the sympatho\u2010adrenergic axis exerted favorable effects on NYHA<\/jats:styled-content> class, LV<\/jats:styled-content> volumes, LV<\/jats:styled-content> end\u2010systolic stress, and LV<\/jats:styled-content> work. Further studies are required to elucidate the role of BB<\/jats:styled-content> in rheumatic MR<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1755-5922.12196","type":"journal-article","created":{"date-parts":[[2016,5,24]],"date-time":"2016-05-24T20:37:25Z","timestamp":1464122245000},"page":"261-267","source":"Crossref","is-referenced-by-count":8,"title":["Targeting the sympatho\u2010adrenergic link in chronic rheumatic mitral regurgitation: assessing the role of oral beta\u2010blockers"],"prefix":"10.1111","volume":"34","author":[{"given":"Dhabaleswar","family":"Sahoo","sequence":"first","affiliation":[{"name":"Department of Cardiology Sanjay Gandhi PGIMS Lucknow UP India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aditya","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Department of Cardiology Sanjay Gandhi PGIMS Lucknow UP 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