Beta-blocker use is associated with prevention of left ventricular remodeling in recovered dilated cardiomyopathy

Nobuyuki Enzan, Shouji Matsushima, Tomomi Ide, Hidetaka Kaku, Takeshi Tohyama, Kouta Funakoshi, Taiki Higo, Hiroyuki Tsutsui

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Withdrawal of optimal medical therapy has been reported to relapse cardiac dysfunction in patients with dilated cardiomyopathy (DCM) whose cardiac function had improved. However, it is unknown whether beta-blockers can prevent deterioration of cardiac function in those patients. We examined the effect of beta-blockers on left ventricular ejection fraction (LVEF) in recovered DCM. METHODS AND RESULTS: We analyzed the clinical personal record of DCM, a national database of the Japanese Ministry of Health, Labor and Welfare, between 2003 and 2014. Recovered DCM was defined as a previously documented LVEF <40% and a current LVEF ≥40%. Patients with recovered DCM were divided into 2 groups according to the use of beta-blockers. A one-to-one propensity case-matched analysis was used. The primary outcome was defined as a decrease in LVEF >10% at 2 years of follow-up. Of 5370 eligible patients, 4104 received beta-blockers. Propensity score matching yielded 1087 pairs. Mean age was 61.9 years, and 1619 (74.5%) were men. Mean LVEF was 49.3±8.2%, and median B-type natriuretic peptide was 46.6 (interquartile range, 18.0–118.1) pg/mL. The primary outcome was observed less frequently in the beta-blocker group than in the no-beta-blocker group (19.6% versus 24.0%; odds ratio [OR], 0.77; 95% CI, 0.63– 0.95; P=0.013). Subgroup analysis demonstrated that female patients (women: OR, 0.54; 95% CI, 0.36– 0.81; men: OR, 0.88; 95% CI, 0.69–1.12; P for interaction=0.040) were benefited by beta-blockers. CONCLUSIONS: Beta-blocker use could prevent deterioration of left ventricular systolic function in patients with recovered DCM.

Original languageEnglish
Article numbere019240
JournalJournal of the American Heart Association
Volume10
Issue number12
DOIs
Publication statusPublished - 2021

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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