Effects of β-blocker therapy on electrocardiographic and echocardiographic characteristics of left ventricular
Jin Li1, Jennifer Franke, Regina Pribe-Wolferts
1Department of Cardiology, University Hospital of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
Insights
Beta-blocker therapy reduced left ventricular (LV) mass in patients with left ventricular noncompaction (LVNC) cardiomyopathy. Further studies are needed to confirm these findings in LVNC patients.
Area of Science:
- Cardiology
- Internal Medicine
- Pharmacology
Background:
- Left ventricular noncompaction (LVNC) is a rare cardiomyopathy characterized by excessive LV hypertrabeculation.
- LVNC is associated with heart failure, arrhythmias, and thromboembolic events, but its features are not fully understood.
- Late recognition of LVNC as a clinical entity necessitates further characterization.
Purpose of the Study:
- To describe echocardiographic and electrophysiologic characteristics of LVNC patients.
- To assess the impact of chronic beta-blocker treatment on LVNC.
- To evaluate clinical outcomes in LVNC patients under beta-blocker therapy.
Main Methods:
- Retrospective analysis of 20 LVNC patients with reduced LV ejection fraction and increased LV mass.
- Echocardiographic and electrocardiographic assessments.
- Comparison of LV mass changes in patients receiving beta-blockers versus those not treated.
Main Results:
- Patients on beta-blocker therapy (n=17) showed a significant reduction in LV mass over 13 months (p=0.007).
- Patients not on beta-blockers (n=3) exhibited an increase in LV mass (p=0.023).
- No significant changes in LVEF or ECG parameters were observed with beta-blocker treatment; no major adverse events occurred.
Conclusions:
- Chronic beta-blocker treatment may lead to a reduction in LV mass in patients with LVNC.
- The findings suggest a potential therapeutic role for beta-blockers in managing LVNC.
- Prospective, controlled studies are required to validate these observations and establish treatment guidelines.
Abstract:
Left ventricular noncompaction (LVNC) is a cardiomyopathy with hypertrabeculation of the LV, often complicated by heart failure, arrhythmia and thromboembolic events. The features of LVNC are still incompletely characterized due to its late recognition as clinically relevant condition. The aims of this study were to describe echocardiographic and electrophysiologic characteristics of LVNC patients and to assess the effects of chronic β-blocker treatment. Study patients (n = 20; 42.5 [36.3; 52.5] years; 12 men) exhibited reduced LV ejection fraction (median LVEF = 32 %) and an increased LV mass of 210 g. Sinus rhythm was present in 19 patients, whereas one patient was in atrial fibrillation. Baseline heart rate was 77.5 beats per minute. Left bundle branch block was detected in five cases. In a subgroup of patients receiving β-blocker therapy (n = 17), LV mass was reduced from 226 [178; 306] g to 220 [169; 254] g (p = 0.007) at 13 ± 6 months follow-up. By contrast, a subgroup of three patients that were not treated with an anti-β-adrenergic agent showed LV mass increase from 180 [169; 197] g to 199 [185; 213] g (p = 0.023). LVEF and electrocardiographic parameters were not significantly modulated during chronic β-blocker treatment. There was no sustained symptomatic ventricular tachyarrhythmia, thromboembolic event or death in either group. In conclusion, this study reveals reduction of LV mass among LVNC patients during β-blocker therapy. Effects of β-blocker treatment in LVNC require validation in prospective controlled studies.
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