© 2007 European Society of Cardiology
Prescription of beta-blockers in patients with advanced heart failure and preserved left ventricular ejection fraction. Clinical implications and survival
a Northern Centre for Healthcare Research, University Medical Centre Groningen University of Groningen, The Netherlands
b Department of Cardiology, Thoraxcenter, University Medical Centre Groningen University of Groningen, The Netherlands
c Department of Cardiology Rijnland Hospital, Leiderdorp, The Netherlands
d Department of Clinical Pharmacology, University Medical Centre Groningen University of Groningen, The Netherlands
* Corresponding author. Northern Centre for Health Care Research, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands. Tel.: +31 50 363 86 59; fax: +31 50 363 24 06. E-mail address: d.dobre{at}med.umcg.nl
 |
Abstract |
|---|
Background: The effects of β-blockers in patients with heart failure (HF) and preserved left ventricular ejection fraction (LVEF) are not well established.
Aims: To assess the association between β-blocker prescription at discharge and mortality in a cohort of patients with advanced HF and preserved LVEF.
Methods and results: We prospectively studied a cohort of 443 patients with advanced HF and preserved LVEF (LVEF
40%). Mean age was 78years, 56% female, 33% NYHA class IV. Overall, 227 patients (51%) had a β-blocker prescribed at discharge. Mean duration of follow-up was 25 (±18) months. Death (all cause) occurred in 40 patients (17.6%) who were receiving a β-blocker at discharge and 73 patients (33.8%) who were not on a β-blocker. In multivariate Cox analysis, including adjustment for propensity score, prescription of a β-blocker remained associated with a 43% relative mortality risk reduction (HR 0.57, 95% CI 0.37 to 0.88, p=0.01).
Conclusions: In this cohort of patients with advanced HF and preserved LVEF, prescription of a β-blocker was associated with a significant mortality reduction. This beneficial effect of β-blocker use needs to be further confirmed in prospective, randomised clinical trials.
Key Words: Heart failure • Preserved ejection fraction • β-blockers • Mortality
Received February 17, 2006; Revised June 7, 2006; Accepted July 20, 2006
The study was financed through an unconditional scholarship at the University of Groningen, The Netherlands.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  W. J. Paulus and J. J.M. van Ballegoij Treatment of Heart Failure With Normal Ejection Fraction: An Inconvenient Truth! J. Am. Coll. Cardiol., February 9, 2010; 55(6): 526 - 537. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Zhou, H. Shi, J. Zhang, Y. Lu, M. Fu, J. Ge, and for the ss-PRESERVE Study Investigators Rationale and design of the {beta}-blocker in heart failure with normal left ventricular ejection fraction ({beta}-PRESERVE) study Eur J Heart Fail, February 1, 2010; 12(2): 181 - 185. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Hamdani, W. J. Paulus, L. van Heerebeek, A. Borbely, N. M. Boontje, M. J. Zuidwijk, J. G.F. Bronzwaer, W. S. Simonides, H. W. M. Niessen, G. J. M. Stienen, et al. Distinct myocardial effects of beta-blocker therapy in heart failure with normal and reduced left ventricular ejection fraction Eur. Heart J., August 1, 2009; 30(15): 1863 - 1872. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. van Veldhuisen, A. Cohen-Solal, M. Bohm, S. D. Anker, D. Babalis, M. Roughton, A. J.S. Coats, P. A. Poole-Wilson, M. D. Flather, and SENIORS Investigators Beta-blockade with nebivolol in elderly heart failure patients with impaired and preserved left ventricular ejection fraction: Data From SENIORS (Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors With Heart Failure). J. Am. Coll. Cardiol., June 9, 2009; 53(23): 2150 - 2158. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Lester, A. J. Tajik, R. A. Nishimura, J. K. Oh, B. K. Khandheria, and J. B. Seward Unlocking the Mysteries of Diastolic Function Deciphering the Rosetta Stone 10 Years Later. J. Am. Coll. Cardiol., February 19, 2008; 51(7): 679 - 689. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Kjekshus Letters to the Editor Eur J Heart Fail, September 1, 2007; 9(9): 962 - 962. [Full Text] [PDF]
|
|
|
|
|
|
D. Dobre, D. J. van Veldhuisen, M. J.L. deJongste, and F. M. Haaijer-Ruskamp Prescription of beta-blockers in patients with advanced heart failure and preserved left ventricular ejection fraction. Clinical implications and survival Eur J Heart Fail, September 1, 2007; 9(9): 962 - 963. [Full Text] [PDF]
|
|