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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
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Beta-blockers in heart failure with preserved ejection fraction: a meta-analysis
Chirag Bavishi1, Saurav Chatterjee, Sameer Ather
1Department of Medicine, Mount Sinai St. Luke's-Roosevelt Hospital, Icahn School of Medicine at Mount Sinai, 1000 Tenth Ave, New York, NY, 10019, USA, chiragpbavishi@gmail.com.
Heart Failure Reviews
|July 19, 2014
Summary
Beta-blockers show potential for reducing mortality in heart failure with preserved ejection fraction (HFpEF) based on observational data. However, randomized trials did not confirm these benefits, necessitating further research.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Beta-blockers are standard treatment for heart failure with reduced ejection fraction.
- Their efficacy in heart failure with preserved ejection fraction (HFpEF) remains uncertain.
Purpose of the Study:
- To evaluate the impact of beta-blockers on mortality and hospitalization in patients with HFpEF through a meta-analysis.
Main Methods:
- Systematic literature search of PubMed, Embase, Scopus, and Cochrane databases.
- Meta-analysis of 15 observational studies and 2 randomized controlled trials (RCTs) involving 27,099 patients.
- Random-effects model used to assess outcomes: all-cause mortality and heart failure hospitalization.
Main Results:
- Observational studies indicated beta-blocker use was linked to lower all-cause mortality (RR 0.81) but not heart failure hospitalization (RR 0.79).
- Two RCTs found no significant association between beta-blockers and reduced all-cause mortality (RR 0.94) or heart failure hospitalization (RR 0.90).
- Benefits in observational studies were primarily seen in patients younger than 75 years.
Conclusions:
- Observational data suggest beta-blockers may reduce mortality in HFpEF, but this is not supported by available RCTs.
- Existing RCTs were underpowered and had high loss to follow-up, limiting definitive conclusions.
- Larger, well-designed randomized trials are required to establish the role of beta-blockers in HFpEF management.
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