Beneficial effects of metoprolol treatment in congestive heart failure: reversal of sympathetic-induced alterations of immunologic function. Circulation

Background Little information is available to explain why,X-blockers are beneficial in certain patients with congestive heart failure (CHF). Since catecholamines alter immune func-tion, we asked whether fl-blocker treatment leads to enhance-ment of immune function. Methods and Results Fifteen patients with New York Heart Association class III-IV CHF secondary to dilated cardiomy-opathy were titrated to a minimum dose of metoprolol 25 mg BID on a background therapy of digoxin, diuretic, and an-giotensin-converting enzyme inhibitors. Cardiac and immuno-logic studies were done before and 6 months to 1 year after treatment. While these patients served as their own controls, an additional population of patients with heart failure was followed for a similar time period on traditional medications. A panel of seven delayed hypersensitivity skin tests were placed at 6- to 12-month intervals on the patient's forearm