Effects of β‐Adrenergic Blockade on Left Ventricular Remodeling Among Hispanics and African Americans With Chronic Heart Failure

Background Although β‐blockers (BBs) have been shown to improve cardiac function, there is individual and ethnic variation in BB clinical response. We examined the effects of BBs on left ventricular remodeling among African Americans (AAs), Hispanics, and Caucasians with systolic heart failure. Hypo...

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Bibliographic Details
Published in:Clinical cardiology (Mahwah, N.J.) N.J.), 2013-10, Vol.36 (10), p.595-602
Main Authors: Kelesidis, Iosif, Varughese, Christopher J., Hourani, Patrick, Zolty, Ronald
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - therapeutic use
African Americans
Aged
Chronic Disease
Clinical Investigation
Clinical Investigations
European Continental Ancestry Group
Female
Heart Failure - diagnosis
Heart Failure - drug therapy
Heart Failure - ethnology
Heart Failure - physiopathology
Hispanic Americans
Humans
Linear Models
Logistic Models
Male
Middle Aged
Mitral Valve Insufficiency - drug therapy
Mitral Valve Insufficiency - ethnology
Mitral Valve Insufficiency - physiopathology
Multivariate Analysis
Odds Ratio
Retrospective Studies
Risk Factors
Stroke Volume - drug effects
Time Factors
Treatment Outcome
United States - epidemiology
Ventricular Function, Left - drug effects
Ventricular Remodeling - drug effects
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Summary:Background Although β‐blockers (BBs) have been shown to improve cardiac function, there is individual and ethnic variation in BB clinical response. We examined the effects of BBs on left ventricular remodeling among African Americans (AAs), Hispanics, and Caucasians with systolic heart failure. Hypothesis There is ethnic variability in the effects of BBs on cardiac remodeling. Methods There were 185 AAs, 159 Hispanics, and 74 Caucasians selected with ejection fraction ≤40% from any etiology. Change in left ventricular ejection fraction (LVEF), left ventricular end‐diastolic dimensions (LVEDD), and degree of mitral regurgitation (MR) in response to 1 year of BBs was evaluated retrospectively. Results Overall, there was a significant improvement in LVEF, LVEDD, and degree of MR in AAs and Caucasians after 1 year of BBs (P < 0.001 vs baseline). Compared with other races, Hispanics (%) had no significant improvement in LVEDD and degree of MR, and had fewer patients with reverse remodeling: LVEF (42.77%), LVEDD (5.03%), and MR (16.35%). In multivariable analysis, Hispanic and AA race were important predictors of LVEF and LVEDD (P < 0.01) but not MR response. Conclusions Although most patients demonstrated improvement of LVEF, there seems to be ethnic variability in the effects of BBs on cardiac remodeling. Degree of MR and LVEDD failed to show improvement among Hispanics.
ISSN:0160-9289
1932-8737
DOI:10.1002/clc.22164