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Protective Respiratory Effect of Beta‐Blockade Therapy in Heart Failure Patients
Author(s) -
Uithoven Katelyn E,
Snyder Eric M,
Olson Thomas P
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.lb657
Subject(s) - dlco , medicine , ejection fraction , cardiology , heart failure , body mass index , lung , diffusing capacity , lung function
INTRODUCTION Treatment with β‐antagonists in heart failure (HF) elicits known cardioprotective benefits. Recent work has suggested that administration of a β‐agonist can induce lung fluid clearance in healthy subjects and HF patients. However, the impact of β‐antagonists on the diffusing capacity of the lungs for carbon monoxide (DLCO, to assess lung fluid changes) remains unclear. PURPOSE To examine the relationship between β‐antagonist use and lung diffusion in HF patients. METHODS A retrospective analysis was performed on 102 HF patients seen at Mayo Clinic between 1995–2010. Patients were divided into two groups: BB=patients prescribed β‐antagonists (n=70) and NB=patients not prescribed β‐antagonists (n=32). Medical records were examined ±1 year from the time of the most recent exercise stress test for age (yrs), sex, height (cm), weight (kg), body mass index (BMI) and β‐antagonist status. Outcome variables included DLCO, left ventricular ejection fraction (LVEF), cardiac output (Q), and cardiac output corrected for body surface area (CI). Independent‐samples t‐test compared age, height, weight, and BMI between BB and NB. A Chi‐Squared test compared New York Heart Association (NYHA) classification and sex between NB and BB. Comparison of DLCO, LVEF, Q, CI, DLCO corrected for CI (DLCO/CI), and DLCO corrected for Q (DLCO/Q) between NB and BB was performed with an independent‐samples t‐test. Data are reported as mean ± standard deviation (SD) or frequency (percentage) where applicable. RESULTS There were no differences in age (75±12 vs. 76±13yrs), height (172±10 vs. 173±9cm), weight (84±20 vs. 86±18kg), or BMI (28±6 vs. 29±5kg/m 2 ) between NB vs. BB, respectively. Neither NYHA classification (χ 2 =0.159; p =0.98) or sex (χ 2 =0.066; p =0.80) were different between NB and BB groups. No differences were found for LVEF (36.8±17.3 vs. 31.6±15.6%) or DLCO (20.32±7.6 vs. 19.35±5.7ml/min/mmHg) for NB vs. BB, respectively. Compared to NB, the BB group demonstrated lower CI (0.72±0.3 vs. 0.56±0.3, p =0.006) and Q (1.47±0.6 vs. 1.15±0.6, p =0.01), while both DLCO/CI and DLCO/Q were higher in BB (31.32±14.1 vs. 43.84±29.5, p =0.005 and 15.84±7.5 vs. 21.93±16.2, p =0.01, respectively). CONCLUSIONS These data suggest that HF patients prescribed β‐antagonist therapy demonstrate better lung diffusion for a given cardiac output compared to HF patients not prescribed β‐antagonist therapy.