BACKGROUND:Although beta blockers (BBs) are established therapy in heart failure, some patients whose left ventricular ejection fraction (LVEF) initially increases on BB therapy experience a subsequent LVEF decline. This study aimed to evaluate the proportion of patients with non-ischemic cardiomyopathy (NICM) whose LVEF declines while on BB therapy and determine important predictors of LVEF decline. METHODS:A retrospective analysis of 238 patients receiving a BB (carvedilol, metoprolol succinate, or tartrate), with an ejection fraction of ≤40% and NICM, whose LVEF initially rose ≥5% after 1 year of BB therapy, was conducted. Post-response LVEF decline ≥5% to a final LVEF of ≤35% was evaluated within 4 years of BB initiation. RESULTS:In our study, we had 52 Caucasians (22%), 78 Hispanics (33%), and 108 African Americans (45%). Overall, 32 patients (13.44 %) had post-response LVEF decline. The nadir LVEF of patients with post-response LVEF decline was 25% (interquartile range 20-27). Compared with others, Hispanics had lower nadir LVEF (22%, p < 0.001). Important predictors of LVEF decline were Hispanic race (odds ratio (OR) 6.094, p < 0.001), New York Heart Association (NYHA) class (OR 2.287, p < 0.05), baseline LVEF (OR 1.075, p < 0.05), and age (OR 0.933, p < 0.001). CONCLUSION:A significant proportion (13.44%) of NICM patients with LVEF increase over 1 year of BB therapy experienced subsequent LVEF decline. Race, NYHA class, baseline LVEF, and age are important predictors of this decline.

译文

背景:尽管β受体阻滞剂(BBs)已被确立为心力衰竭的治疗方法,但一些在BB治疗中最初增加左心室射血分数(LVEF)的患者却经历了随后的LVEF下降。这项研究旨在评估BB治疗时LVEF下降的非缺血性心肌病(NICM)患者的比例,并确定LVEF下降的重要预测指标。
方法:回顾性分析238例接受BB(卡维地洛,美托洛尔琥珀酸盐或酒石酸盐),射血分数≤40%的BB和NICM的患者,这些患者在接受BB治疗1年后LVEF最初升高≥5%。 BB启动后4年内评估反应后LVEF下降≥5%至最终LVEF≤35%。
结果:在我们的研究中,我们有52名高加索人(22%),78名西班牙裔人(33%)和108名非裔美国人(45%)。总体而言,有32例患者(13.44%)的反应后LVEF下降。反应后LVEF下降的患者的最低LVEF为25%(四分位数范围为20-27)。与其他人相比,西班牙裔患者的最低点LVEF较低(22%,p <0.001)。 LVEF下降的重要预测指标是西班牙裔种族(比值比(OR)6.094,p <0.001),纽约心脏协会(NYHA)级别(OR 2.287,p <0.05),基线LVEF(OR 1.075,p <0.05)和年龄(OR 0.933,p <0.001)。
结论:在BB治疗1年以上的NICEF升高的NICM患者中,有相当比例(13.44%)随之而来的是LVEF下降。种族,NYHA等级,基线LVEF和年龄是这一下降的重要预测因素。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录