The beneficial effects of β-blocker therapy on the clinical outcomes of heart failure with reduced ejection fraction (HFREF) are attributed to the improvement in ejection fraction (EF) and left ventricular (LV) reverse remodeling. Previous studies only reported the β-blocker therapy-induced improvement of diastolic function accompanied by the increase in EF in HFREF patients. This retrospective study aimed to elucidate whether β-blocker therapy improves diastolic function even without an increase in EF. Out of the consecutive 11,830 echocardiographic reports, HFREF patients without an increase in EF following long-term β-blocker therapy comprised the study subjects (n=19). During the mean follow-up of 17 months, β-blocker therapy significantly decreased peak mitral E-wave velocity (70 ± 25-50 ± 18. cm/s, p<0.01) and ratio of peak mitral E- to A-wave velocities (E/A ratio) (1.4 ± 0.8-0.9 ± 0.4, p<0.05), prolonged deceleration time of the mitral E-wave velocity (DcT) (167 ± 54-206 ± 61. ms, p<0.05), and improved New York Heart Association functional class (2.3 ± 0.7-1.8 ± 0.4, p<0.01) without changes in LV volume. Because DcT and E/A ratio are well known to correlate with LV filling pressures in patients with reduced EF, our results indicate a reduction in LV filling pressures without changes in LV volume, suggesting a reduction in LV stiffness. Thus, long-term β-blocker therapy is likely to improve diastolic function even without a concomitant increase in EF in HFREF patients, which may be also responsible for the β-blocker-induced improvement of their symptoms of heart failure. © 2010 Japanese College of Cardiology.
Tamaki, S., Sakata, Y., Mano, T., Ohtani, T., Takeda, Y., Kamimura, D., … Yamamoto, K. (2010). Long-term β-blocker therapy improves diastolic function even without the therapeutic effect on systolic function in patients with reduced ejection fraction. Journal of Cardiology, 56(2), 176–182. https://doi.org/10.1016/j.jjcc.2010.04.001