TY - JOUR
T1 - Impact of heart rate reduction with maximal tolerable dose of bisoprolol on left ventricular reverse remodeling
AU - Choi, Suk Won
AU - Han, Seongwoo
AU - Shim, Wan Joo
AU - Choi, Dong Ju
AU - Kim, Yong Jin
AU - Yoo, Byung Su
AU - Hwang, Kyung Kuk
AU - Jeon, Hui Kyung
AU - Shin, Mi Seung
AU - Ryu, Kyu Hyung
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Background: We aimed to evaluate effect of heart rate (HR) reduction on left ventricular reverse remodeling (LVRR) in Korean patients with heart failure with reduced ejection fraction (HFrEF). Methods: Ambulatory patients with HFrEF, who had paired echocardiograms, N-terminal prohormone brain natriuretic peptide (NT-proBNP), and global assessment score (GAS) at baseline and 6-month (n = 157), were followed up on preset treatment schedule with bisoprolol. Results: The LVRR occurred in 49 patients (32%) at 6-month. In multivariable analysis, independent predictors associated with LVRR were use of anti-aldosterone agent (odds ratio [OR], 4.18; 95% confidence interval [CI], 1.80-9.71), young age (OR, 0.96; 95% CI, 0.92-0.99), high baseline HR (OR, 3.76; 95% CI, 1.40-10.10), and favorable baseline GAS (OR, 1.73; 95% CI, 1.06-2.81). Beneficial effect of bisoprolol, in terms of LVRR, NT-proBNP, and GAS, was remarkable in the high HR group (baseline HR = 75 beats per minute [bpm]), which showed a large HR reduction. Conclusion: High baseline HR (≥ 75 bpm) showed an association with LVRR and improvement of NT-proBNP and GAS in patients with HFrEF. This seems to be due to a large HR reduction after treatments with bisoprolol. Trial registry at www.ClinicalTrials.gov, NCT00749034.
AB - Background: We aimed to evaluate effect of heart rate (HR) reduction on left ventricular reverse remodeling (LVRR) in Korean patients with heart failure with reduced ejection fraction (HFrEF). Methods: Ambulatory patients with HFrEF, who had paired echocardiograms, N-terminal prohormone brain natriuretic peptide (NT-proBNP), and global assessment score (GAS) at baseline and 6-month (n = 157), were followed up on preset treatment schedule with bisoprolol. Results: The LVRR occurred in 49 patients (32%) at 6-month. In multivariable analysis, independent predictors associated with LVRR were use of anti-aldosterone agent (odds ratio [OR], 4.18; 95% confidence interval [CI], 1.80-9.71), young age (OR, 0.96; 95% CI, 0.92-0.99), high baseline HR (OR, 3.76; 95% CI, 1.40-10.10), and favorable baseline GAS (OR, 1.73; 95% CI, 1.06-2.81). Beneficial effect of bisoprolol, in terms of LVRR, NT-proBNP, and GAS, was remarkable in the high HR group (baseline HR = 75 beats per minute [bpm]), which showed a large HR reduction. Conclusion: High baseline HR (≥ 75 bpm) showed an association with LVRR and improvement of NT-proBNP and GAS in patients with HFrEF. This seems to be due to a large HR reduction after treatments with bisoprolol. Trial registry at www.ClinicalTrials.gov, NCT00749034.
KW - Beta Blocker
KW - Heart Failure
KW - Heart Rate
KW - Left Ventricular Reverse Remodeling
UR - http://www.scopus.com/inward/record.url?scp=85048678238&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85048678238&partnerID=8YFLogxK
U2 - 10.3346/jkms.2018.33.e171
DO - 10.3346/jkms.2018.33.e171
M3 - Article
C2 - 29915522
AN - SCOPUS:85048678238
SN - 1011-8934
VL - 33
JO - Journal of Korean Medical Science
JF - Journal of Korean Medical Science
IS - 25
M1 - e171
ER -