Monday, March 03, 2014

The prognosis of heart failure patients with recovered ejection fraction after beta blocker treatment

From a recent paper:

Methods and Results—We included in this analysis 174 consecutive patients with LVSD who had a LVEF greater than or equal to 45% after betablockade. We performed a long-term echocardiographic follow-up (median 7.6 [4 - 9.9] years) and clinical follow-up (median 9.2 [7.2 - 10.8] years). LVEF improved from 33±8% to 54±6% after beta-blockade (p less than 0.0001). At the last echocardiographic evaluation, 26% of the patients had a LVEF less than 45% (mean±SD: 34±6%), while 74% still had a LVEF greater than or equal to 45% (mean±SD: 54±6%). Independent predictors of LVEF deterioration were a post beta-blockade low LVEF, a high left ventricular end-diastolic diameter and a low heart rate after beta-blockade, and the presence of a complete left bundle branch block. In the overall study population, survival rates were 90% at 5 years and 75% at 10 years. Cardio-vascular death rate was 9%, non cardio-vascular death rate was 11%, and unknown death rate was 3%. Patients with subsequent LVEF deterioration had a higher cardiovascular mortality compared to patients with sustained recovered LVEF (22% vs 4%).

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