Reversal of severe pulmonary hypertension with βblockade in a patient with end stage left ventricular failure

摘要

A 52 year old man with severe chronic left ventricular failure (New York Heart As- sociation class IV) was considered unsuit- able for cardiac transplantation because of high and irreversible pulmonary vascular resistance (PVR). In an attempt to produce symptomatic improvement, metoprolol was cautiously introduced, initially at 6.25 mg twice daily. This was slowly in- creased to 50 mg twice daily over a two month period and continued thereafter.