PMID- 32743714
OWN - NLM
STAT- MEDLINE
DCOM- 20211025
LR  - 20211025
IS  - 1573-7322 (Electronic)
IS  - 1382-4147 (Linking)
VI  - 26
IP  - 1
DP  - 2021 Jan
TI  - Effect of beta-blockers on heart failure severity in patients with heart failure 
      with preserved ejection fraction: a meta-analysis of randomized controlled 
      trials.
PG  - 165-171
LID - 10.1007/s10741-020-10013-5 [doi]
AB  - Patients with heart failure with preserved ejection fraction (HFpEF) are often 
      elderly and likely to have cardiac comorbidities such as coronary artery disease 
      (CAD) and atrial fibrillation (AF). The primary chronic symptom of HFpEF patients 
      is severe exercise intolerance. The inability to adequately increase heart rate 
      during exercise is commonly present in HFpEF patients and contributes to their 
      exercise intolerance. Although beta-blockers are frequently used for the 
      treatment of myocardial ischemia and tachycardia in HFpEF patients, there is a 
      concern that slowing heart rate by beta-blockers may worsen chronotropic 
      incompetence and further exacerbate their symptoms. Although the effect of 
      beta-blockers on heart failure severity in HFpEF patients has been examined in 
      randomized controlled trials (RCTs), results are inconsistent due partly to 
      limited power. We aimed to conduct a meta-analysis of RCTs on the effect of 
      beta-blockers on heart failure severity in HFpEF patients. The search of 
      electronic databases identified 5 RCTs including 538 patients. In pooled 
      analyses, beta-blockers did not significantly change the New York Heart 
      Association (NYHA) class, exercise capacity expressed as metabolic equivalents, 
      or plasma B-type natriuretic peptide (BNP) levels compared with control but with 
      substantial heterogeneity across trials. In meta-regression analyses, the higher 
      proportion of CAD or AF in the included trials was associated with a decrease in 
      NYHA class and BNP levels and with an increase in exercise capacity. Thus, we 
      found no clear beneficial effect of beta-blockers on heart failure severity in 
      HFpEF patients. However, beta-blockers may be beneficial in HFpEF patients with 
      CAD or AF.
FAU - Fukuta, Hidekatsu
AU  - Fukuta H
AUID- ORCID: 0000-0002-9577-6586
AD  - Core Laboratory, Nagoya City University Graduate School of Medical Sciences, 1 
      Kawasumi Mizuho-cho Mizuho-ku, Nagoya, 467-8601, Japan. 
      fukuta-h@med.nagoya-cu.ac.jp.
FAU - Goto, Toshihiko
AU  - Goto T
AD  - Department of Cardiology, Nagoya City University Graduate School of Medical 
      Sciences, Nagoya, Japan.
FAU - Wakami, Kazuaki
AU  - Wakami K
AD  - Department of Cardiology, Nagoya City University Graduate School of Medical 
      Sciences, Nagoya, Japan.
FAU - Kamiya, Takeshi
AU  - Kamiya T
AD  - Department of Medical Innovation, Nagoya City University Graduate School of 
      Medical Sciences, Nagoya, Japan.
FAU - Ohte, Nobuyuki
AU  - Ohte N
AD  - Department of Cardiology, Nagoya City University Graduate School of Medical 
      Sciences, Nagoya, Japan.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - United States
TA  - Heart Fail Rev
JT  - Heart failure reviews
JID - 9612481
RN  - 0 (Adrenergic beta-Antagonists)
SB  - IM
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Aged
MH  - *Atrial Fibrillation
MH  - *Heart Failure/complications/drug therapy
MH  - Humans
MH  - Randomized Controlled Trials as Topic
MH  - Stroke Volume
OTO - NOTNLM
OT  - Beta-blockers
OT  - Heart failure
OT  - Meta-analysis
OT  - Pharmacotherapy
OT  - Randomized controlled trial
EDAT- 2020/08/04 06:00
MHDA- 2021/10/26 06:00
CRDT- 2020/08/04 06:00
PHST- 2020/08/04 06:00 [pubmed]
PHST- 2021/10/26 06:00 [medline]
PHST- 2020/08/04 06:00 [entrez]
AID - 10.1007/s10741-020-10013-5 [pii]
AID - 10.1007/s10741-020-10013-5 [doi]
PST - ppublish
SO  - Heart Fail Rev. 2021 Jan;26(1):165-171. doi: 10.1007/s10741-020-10013-5.