TY - JOUR
T1 - Effects of β-adrenergic blockade on left ventricular remodeling among hispanics and African Americans with chronic heart failure
AU - Kelesidis, Iosif
AU - Varughese, Christopher J.
AU - Hourani, Patrick
AU - Zolty, Ronald
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2013
Y1 - 2013
N2 - 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.
AB - 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.
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U2 - 10.1002/clc.22164
DO - 10.1002/clc.22164
M3 - Article
C2 - 23893765
AN - SCOPUS:84885478527
VL - 36
SP - 595
EP - 602
JO - Clinical Cardiology
JF - Clinical Cardiology
SN - 0160-9289
IS - 10
ER -