Heart failure & cardiomyopathiesSecondary analysis
β-Blocker Withdrawal and Functional Capacity Improvement in Patients With Heart Failure With Preserved Ejection Fraction
- Secondary analysis of the PRESERVE-HR randomised trial
- post hoc
- crossover
- investigator-blinded
- multicentre
Authors' conclusion
In this study, results showed that in patients with HFpEF and chronotropic incompetence receiving treatment with β-blocker, lower iLVESV may identify those with a greater short-term improvement in maximal functional capacity after stopping β-blocker treatment.
Study context
- Population
- Stable heart failure with preserved ejection fraction (HFpEF) (NYHA II–III) on β-blocker with chronotropic incompetencecrossover
- Participants
- 52 participants
- Comparison
- β-blocker withdrawal vs continuation
- Primary endpoint
- Association between β-blocker withdrawal and short-term change in % predicted peak VO2 across iLVEDV, iLVESV and left ventricular ejection fraction (LVEF)
- Follow-up
- 2 weeks
Primary result
As reported in the abstract
Change in % predicted peak VO2 after β-blocker withdrawal, across iLVESV
Withdrawal differentially associated with change in % peak VO2 across indexed left ventricular systolic volumes (iLVESV); greater benefit with lower iLVESV
P for interaction = .02
Further findings
| Outcome | median increase (bpm) (95% CI) | P value | |
|---|---|---|---|
| Peak HR after stopping β-blocker treatment | 30 (25–35) | P < 0.001 | |
| −2002040Difference, bpm (linear scale) |
Original publication
β-Blocker Withdrawal and Functional Capacity Improvement in Patients With Heart Failure With Preserved Ejection Fraction. JAMA Cardiol. Published 1 April 2024. doi:10.1001/jamacardio.2023.5500
Summarised from the published abstract; every number is checked against it