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Effect of β-Blocker Withdrawal on Functional Capacity in Heart Failure and Preserved Ejection Fraction
dc.contributor.author | Palau, Patricia | |
dc.contributor.author | Seller, Julia | |
dc.contributor.author | Domínguez Mafé, Eloy | |
dc.contributor.author | Sastre, Clara | |
dc.contributor.author | Ramón, Jose María | |
dc.contributor.author | De la Espriella, Rafael | |
dc.contributor.author | Santas, Enrique | |
dc.contributor.author | Miñana, Gema | |
dc.contributor.author | Bodí, Vicent | |
dc.contributor.author | Sanchis, Juan | |
dc.contributor.author | Valle, Alfonso | |
dc.contributor.author | Chorro, F. Javier | |
dc.contributor.author | Llácer, Pau | |
dc.contributor.author | Bayes-Genis, Antoni | |
dc.contributor.author | Núñez, Julio | |
dc.date.accessioned | 2022-03-09T08:28:54Z | |
dc.date.available | 2022-03-09T08:28:54Z | |
dc.date.issued | 2021-11-15 | |
dc.identifier.citation | Palau, P., Seller, J., Domínguez, E., Sastre, C., Ramón, J. M., de La Espriella, R., ... & Núñez, J. (2021). Effect of β-blocker withdrawal on functional capacity in heart failure and preserved ejection fraction. Journal of the American College of Cardiology, 78(21), 2042-2056. | ca_CA |
dc.identifier.issn | 0735-1097 | |
dc.identifier.uri | http://hdl.handle.net/10234/196972 | |
dc.description.abstract | BACKGROUND Chronotropic incompetence has shown to be associated with a decrease in exercise capacity in heart failure with preserved ejection fraction (HFpEF), yet b-blockers are commonly used in HFpEF despite the lack of robust evidence. OBJECTIVES This study aimed to evaluate the effect of b-blocker withdrawal on peak oxygen consumption (peak VO2) in patients with HFpEF and chronotropic incompetence. METHODS This is a multicenter, randomized, investigator-blinded, crossover clinical trial consisting of 2 treatment periods of 2 weeks separated by a washout period of 2 weeks. Patients with stable HFpEF, New York Heart Association functional classes II and III, previous treatment with b-blockers, and chronotropic incompetence were first randomized to withdrawing from (arm A: n ¼ 26) versus continuing (arm B: n ¼ 26) b-blocker treatment and were then crossed over to receive the opposite intervention. Changes in peak VO2 and percentage of predicted peak VO2 (peak VO2%) measured at the end of the trial were the primary outcome measures. To account for the paired-data nature of this crossover trial, linear mixed regression analysis was used. RESULTS The mean age was 72.6 13.1 years, and most of the patients were women (59.6%) in New York Heart Association functional class II (66.7%). The mean peakVO2 and peak VO2% were 12.4 2.9 mL/kg/min, and 72.4 17.8%, respectively. No significant baseline differences were found across treatment arms. Peak VO2 and peak VO2% increased significantly after b-blocker withdrawal (14.3 vs 12.2 mL/kg/min [D þ2.1 mL/kg/min]; P < 0.001 and 81.1 vs 69.4% [D þ11.7%]; P < 0.001, respectively). CONCLUSIONS b-blocker withdrawal improved maximal functional capacity in patients with HFpEF and chronotropic incompetence. b-blocker use in HFpEF deserves profound re-evaluation. (b-blockers Withdrawal in Patients With HFpEF and Chronotropic Incompetence: Effect on Functional Capacity [PRESERVE-HR]; NCT03871803; 2017-005077-39) (J Am Coll Cardiol 2021;78:2042–2056) © 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. | ca_CA |
dc.format.extent | 15 p. | ca_CA |
dc.format.mimetype | application/pdf | ca_CA |
dc.language.iso | eng | ca_CA |
dc.publisher | Elsevier | ca_CA |
dc.publisher | American College of Cardiology | ca_CA |
dc.relation.isPartOf | JACC VOL. 78, NO. 21, 2021 | ca_CA |
dc.relation.uri | https://www.jacc.org/doi/suppl/10.1016/j.jacc.2021.08.073/suppl_file/mmc1.docx | ca_CA |
dc.rights | Copyright © 2021, The Authors. Published by Elsevier on Behalf of The American College of Cardiology | ca_CA |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | ca_CA |
dc.subject | β-blockers | ca_CA |
dc.subject | heart rate | ca_CA |
dc.subject | peak Vo2 | ca_CA |
dc.subject | crossover trial | ca_CA |
dc.subject | percentage of predicted peakVo2 | ca_CA |
dc.subject | chronotropic incompetence | ca_CA |
dc.subject | HFpEF | ca_CA |
dc.title | Effect of β-Blocker Withdrawal on Functional Capacity in Heart Failure and Preserved Ejection Fraction | ca_CA |
dc.type | info:eu-repo/semantics/article | ca_CA |
dc.identifier.doi | http://dx.doi.org/10.1016/j.jacc.2021.08.073 | |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | ca_CA |
dc.type.version | info:eu-repo/semantics/publishedVersion | ca_CA |
project.funder.name | Ministerio de Economía y Competitividad (Spain) | ca_CA |
oaire.awardNumber | PI17/01426 | ca_CA |
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