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

• Published in: Clinical cardiology (Mahwah, N.J.) Vol. 36; no. 10; pp. 595 - 602
• Main Authors: Kelesidis, Iosif, Varughese, Christopher J., Hourani, Patrick, Zolty, Ronald
• Format: Journal Article
• Language: English
• Published: New York Wiley Periodicals, Inc 01.10.2013
• 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; United States
• DOI: 10.1002/clc.22164
• ISSN: 0160-9289

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.