Open AccessEffects of β‐Adrenergic Blockade on Left Ventricular Remodeling Among Hispanics and African Americans With Chronic Heart Failure
Author(s) -
Kelesidis Iosif,
Varughese Christopher J.,
Hourani Patrick,
Zolty Ronald
Publication year - 2013
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22164
Subject(s) - medicine , ejection fraction , cardiology , ventricular remodeling , heart failure , diastole , cardiac function curve , mitral regurgitation , blood pressure
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.