PMID- 23949921
OWN - NLM
STAT- MEDLINE
DCOM- 20140428
LR  - 20221207
IS  - 1179-6901 (Electronic)
IS  - 1174-5886 (Print)
IS  - 1174-5886 (Linking)
VI  - 13
IP  - 3
DP  - 2013 Sep
TI  - Effect of race on left ventricular ejection fraction decline after initial 
      improvement with beta blockers in patients with non-ischemic cardiomyopathy: a 
      retrospective analysis.
PG  - 183-90
LID - 10.1007/s40268-013-0021-9 [doi]
AB  - BACKGROUND: Although beta blockers (BBs) are established therapy in heart 
      failure, some patients whose left ventricular ejection fraction (LVEF) initially 
      increases on BB therapy experience a subsequent LVEF decline. This study aimed to 
      evaluate the proportion of patients with non-ischemic cardiomyopathy (NICM) whose 
      LVEF declines while on BB therapy and determine important predictors of LVEF 
      decline. METHODS: A retrospective analysis of 238 patients receiving a BB 
      (carvedilol, metoprolol succinate, or tartrate), with an ejection fraction of 
      </=40% and NICM, whose LVEF initially rose >/=5% after 1 year of BB therapy, was 
      conducted. Post-response LVEF decline >/=5% to a final LVEF of </=35% was evaluated 
      within 4 years of BB initiation. RESULTS: In our study, we had 52 Caucasians 
      (22%), 78 Hispanics (33%), and 108 African Americans (45%). Overall, 32 patients 
      (13.44 %) had post-response LVEF decline. The nadir LVEF of patients with 
      post-response LVEF decline was 25% (interquartile range 20-27). Compared with 
      others, Hispanics had lower nadir LVEF (22%, p < 0.001). Important predictors of 
      LVEF decline were Hispanic race (odds ratio (OR) 6.094, p < 0.001), New York 
      Heart Association (NYHA) class (OR 2.287, p < 0.05), baseline LVEF (OR 1.075, p < 
      0.05), and age (OR 0.933, p < 0.001). CONCLUSION: A significant proportion 
      (13.44%) of NICM patients with LVEF increase over 1 year of BB therapy 
      experienced subsequent LVEF decline. Race, NYHA class, baseline LVEF, and age are 
      important predictors of this decline.
FAU - Kelesidis, Iosif
AU  - Kelesidis I
AD  - Division of Cardiology, Department of Medicine, Albert Einstein College of 
      Medicine, 1300 Morris Park Avenue, Bronx, NY, USA, ikelesid@gmail.com.
FAU - Hourani, Patrick
AU  - Hourani P
FAU - Varughese, Christopher
AU  - Varughese C
FAU - Zolty, Ronald
AU  - Zolty R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - New Zealand
TA  - Drugs R D
JT  - Drugs in R&D
JID - 100883647
RN  - 0 (Adrenergic beta-Antagonists)
SB  - IM
MH  - Adrenergic beta-Antagonists/administration & dosage/adverse effects/*therapeutic 
      use
MH  - Black or African American
MH  - Cardiomyopathies/*drug therapy/*ethnology/etiology/physiopathology
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Hispanic or Latino
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - New York City/epidemiology
MH  - Retrospective Studies
MH  - Sex Factors
MH  - Stroke Volume/*drug effects
MH  - Time Factors
MH  - Ventricular Function, Left/*drug effects
MH  - White People
PMC - PMC3784061
EDAT- 2013/08/21 06:00
MHDA- 2014/04/29 06:00
PMCR- 2013/08/15
CRDT- 2013/08/17 06:00
PHST- 2013/08/17 06:00 [entrez]
PHST- 2013/08/21 06:00 [pubmed]
PHST- 2014/04/29 06:00 [medline]
PHST- 2013/08/15 00:00 [pmc-release]
AID - 21 [pii]
AID - 10.1007/s40268-013-0021-9 [doi]
PST - ppublish
SO  - Drugs R D. 2013 Sep;13(3):183-90. doi: 10.1007/s40268-013-0021-9.