J Korean Med Sci.  2018 Jun;33(25):e171. 10.3346/jkms.2018.33.e171.

Impact of Heart Rate Reduction with Maximal Tolerable Dose of Bisoprolol on Left Ventricular Reverse Remodeling

• Choi SW
• Han S
• Shim WJ
• Choi DJ
• Kim YJ
• Yoo BS
• Hwang KK
• Jeon HK
• Shin MS
• Ryu KH

• KMID: 2413645
• DOI: http://doi.org/10.3346/jkms.2018.33.e171

Abstract

BACKGROUND
We aimed to evaluate effect of heart rate (HR) reduction on left ventricular reverse remodeling (LVRR) in Korean patients with heart failure with reduced ejection fraction (HFrEF).
METHODS
Ambulatory patients with HFrEF, who had paired echocardiograms, N-terminal prohormone brain natriuretic peptide (NT-proBNP), and global assessment score (GAS) at baseline and 6-month (n = 157), were followed up on preset treatment schedule with bisoprolol.
RESULTS
The LVRR occurred in 49 patients (32%) at 6-month. In multivariable analysis, independent predictors associated with LVRR were use of anti-aldosterone agent (odds ratio [OR], 4.18; 95% confidence interval [CI], 1.80-9.71), young age (OR, 0.96; 95% CI, 0.92-0.99), high baseline HR (OR, 3.76; 95% CI, 1.40-10.10), and favorable baseline GAS (OR, 1.73; 95% CI, 1.06-2.81). Beneficial effect of bisoprolol, in terms of LVRR, NT-proBNP, and GAS, was remarkable in the high HR group (baseline HR ≥ 75 beats per minute [bpm]), which showed a large HR reduction.
CONCLUSION
High baseline HR (≥ 75 bpm) showed an association with LVRR and improvement of NT-proBNP and GAS in patients with HFrEF. This seems to be due to a large HR reduction after treatments with bisoprolol. Trial registry at www.ClinicalTrials.gov, NCT00749034.

Keyword

Heart Failure; Left Ventricular Reverse Remodeling; Beta Blocker; Heart Rate

MeSH Terms

Appointments and Schedules
Bisoprolol*
Heart Failure
Heart Rate*
Heart*
Humans
Natriuretic Peptide, Brain
Bisoprolol
Natriuretic Peptide, Brain