Impact of Heart Rate Reduction with Maximal Tolerable Dose of Bisoprolol on Left Ventricular Reverse Remodeling.
10.3346/jkms.2018.33.e171
- Author:
Suk Won CHOI
1
;
Seongwoo HAN
;
Wan Joo SHIM
;
Dong Ju CHOI
;
Yong Jin KIM
;
Byung Su YOO
;
Kyung Kuk HWANG
;
Hui kyung JEON
;
Mi Seung SHIN
;
Kyu Hyung RYU
Author Information
1. Division of Cardiology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea. khryu@hallym.or.kr
- Publication Type:Original Article
- Keywords:
Heart Failure;
Left Ventricular Reverse Remodeling;
Beta Blocker;
Heart Rate
- MeSH:
Appointments and Schedules;
Bisoprolol*;
Heart Failure;
Heart Rate*;
Heart*;
Humans;
Natriuretic Peptide, Brain
- From:Journal of Korean Medical Science
2018;33(25):e171-
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
