Article

Hypertension complicated with left ventricular hypertrophy (LVH) and
diastolic dysfunction is one of the most common risks for heart failure with
preserved ejection fraction (HFpEF). This study was designed to evaluate the
influences of long-term beta-blocker prescription in these patients. METHODS:
This retrospective analysis included eligible patients diagnosed with
hypertension, LVH (left ventricular (LV) mass index >125 g/m(2) for men and >110
g/m(2) for women) and suspected diastolic dysfunction (E/E' ratio between 8 and
15) and without clinical signs or symptoms of heart failure in our hospital
medical record database (January 2005-December 2009). A total of eligible 1498
patients were enrolled, of whom 803 received beta-blocker prescription and 695
accepted non-beta-blocker therapy. RESULTS: With a median follow-up of 7.2 years,
the new-onset symptomatic HFpEF occurred in 48 of 803 patients in the
beta-blocker group (6.0%) and 92 of 695 patients in the non-beta-blocker group
(13.2%, p < 0.001). Beta-blockers also generated more prominent improvement in
diastolic function and LVH. And Cox proportional hazards model revealed that
beta-blocker (hazard ratio (HR) 0.327, 95% confidence interval (CI): 0.121-0.540,
p = 0.009) or angiotensin-converting enzyme inhibitor/angiotensin II receptor
blocker (ACEI/ARB) exposure (HR 0.422, 95% CI: 0.210-0.699, p = 0.015) was
associated with a reduced risk of new onset of symptomatic HFpEF, and the
elevation of LVMI (HR 1.210, 95% CI: 1.069-1.362, p = 0.040) or E/E' (HR 1.398,
95% CI: 1.306-1.541, p = 0.032) was associated with a high risk of new onset of
symptomatic HFpEF. CONCLUSIONS: Long-term beta-blocker exposure was associated
with protective effects in terms of the incidence of new-onset symptomatic HFpEF,
LV diastolic dysfunction and LVH, which might be beneficial for the delay of
HFpEF progression.
CI - (c) The European Society of Cardiology 2016.

Langue : ANGLAIS