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Impact of Heart Rate Reduction with Maximal Tolerable Dose of Bisoprolol on Left Ventricular Reverse Remodeling

Authors
Choi, Suk-WonHan, SeongwooShim, Wan JooChoi, Dong-JuKim, Yong-JinYoo, Byung-SuHwang, Kyung-KukJeon, Hui KyungShin, Mi-SeungRyu, Kyu-Hyung
Issue Date
18-6월-2018
Publisher
KOREAN ACAD MEDICAL SCIENCES
Keywords
Heart Failure; Left Ventricular Reverse Remodeling; Beta Blocker; Heart Rate
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.33, no.25
Indexed
SCIE
SCOPUS
KCI
Journal Title
JOURNAL OF KOREAN MEDICAL SCIENCE
Volume
33
Number
25
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/74910
DOI
10.3346/jkms.2018.33.e171
ISSN
1011-8934
Abstract
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.
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