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Clinical efficacy and safety of cardio-selective β-receptor blocker in management of AECOPD complicated with right heart failure

Aims: To assess the clinical efficacy and safety of administration of a low dosage of cardio-selective β- receptor blocker in treating Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) complicated with right cardiac failure.

Methods: In total, 100 AECOPD patients were randomly assigned into the experimental (n=50) and control groups (n=50). Patients in the control group received standard treatment according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD, 2013 edition). Based upon conventional therapy, those in the experimental group received oral administration of metoprolol tartrate tablets. All patients were followed up for 1 year.

Results: The Forced Expiratory Volume in one second (FEV1) did not significantly differ between two groups (both P>0.05). Prior to the treatment, no statistical significance was observed in heart rate between two groups (P>0.05), whereas heart rate in the experimental group was significantly improved (P<0.05). The length of hospital stay did not significantly differ (P>0.05). In the experimental group, 3 patients (6.3%) suffered from adverse events, and 4 (8.4%) in the control group (P>0.05). In the experimental group, the frequency of acute exacerbation, mortality rate and NT-proBNP level were significantly lower than those in the control group (all P<0.05). Before and after therapy, the scores of COPD Assessment Test (CAT) did not significantly differ between two groups (P>0.05).

Conclusion: Use of a low-dose cardio-selective β-receptor blocker can effectively alleviate AECOPD complicated with right heart failure, improve heart function and decrease the frequency of acute exacerbation. No severe adverse events are noted after administration of cardio-selective β-receptor blocker.

Author(s): Wei He, Gang Xu, Cheng Zhang, Lin Xu, Ting Li, Hua Yin, Hanqiong Zhang, Huawei Li, Xiaorong Hu, Hong Zhou, Lisha Yang