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KMID : 0191120180330250171
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Journal of Korean Medical Science
2018 Volume.33 No. 25 p.171 ~ p.171
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Impact of Heart Rate Reduction with Maximal Tolerable Dose of Bisoprolol on Left Ventricular Reverse Remodeling
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Choi Suk-Won
Han Seong-Woo
Shim Wan-Joo
Choi Dong-Ju
Kim Yong-Jin
Yoo Byung-Su
Hwang Kyung-Kuk
Jeon Hui-Kyung
Shin Mi-Seung
Ryu Kyu-Hyung
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Abstract
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Background: We aimed to evaluate effect of heart rate (HR) reduction on left ventricular reverse remodeling (LVRR) in Korean patients with heart failure with reduced ejection fraction (HFrEF).
Methods: Ambulatory patients with HFrEF, who had paired echocardiograms, N-terminal prohormone brain natriuretic peptide (NT-proBNP), and global assessment score (GAS) at baseline and 6-month (n = 157), were followed up on preset treatment schedule with bisoprolol.
Results: The LVRR occurred in 49 patients (32%) at 6-month. In multivariable analysis, independent predictors associated with LVRR were use of anti-aldosterone agent (odds ratio [OR], 4.18; 95% confidence interval [CI], 1.80?9.71), young age (OR, 0.96; 95% CI, 0.92?0.99), high baseline HR (OR, 3.76; 95% CI, 1.40?10.10), and favorable baseline GAS (OR, 1.73; 95% CI, 1.06?2.81). Beneficial effect of bisoprolol, in terms of LVRR, NT-proBNP, and GAS, was remarkable in the high HR group (baseline HR ≥ 75 beats per minute [bpm]), which showed a large HR reduction.
Conclusion: High baseline HR (≥ 75 bpm) showed an association with LVRR and improvement of NT-proBNP and GAS in patients with HFrEF. This seems to be due to a large HR reduction after treatments with bisoprolol. Trial registry at www.ClinicalTrials.gov,NCT00749034.
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KEYWORD
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Heart Failure, Left Ventricular Reverse Remodeling, Beta Blocker, Heart Rate
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