Improvement of Ventricular-Arterial Coupling in Elderly Patients with Heart Failure After Beta Blocker Therapy:

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Published on: December 11, 2017

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Milica Dekleva1, Jelena Suzic Lazic, Ivan Soldatovic

  • 1University Clinical Centar "Zvezdara", Belgrade, Serbia, dekleva.milica@gmail.com.

Cardiovascular Drugs and Therapy
|May 13, 2015
PubMed

Insights

Beta blockers (BB) improve heart function in elderly patients with heart failure (HF) by optimizing ventricular-arterial (VA) coupling. This therapy enhances cardiovascular performance and is linked to improved left ventricular ejection fraction (LVEF).

Area of Science:

  • Cardiology
  • Cardiovascular Physiology
  • Pharmacology

Background:

  • Ventricular-arterial (VA) coupling is crucial for cardiovascular performance.
  • Vascular stiffness and left ventricular (LV) stiffness increase with age and in heart failure (HF).
  • Beta blockers (BB) are standard HF therapy, but their impact on VA coupling is not well-established.

Purpose of the Study:

  • To evaluate changes in VA coupling following BB therapy in elderly HF patients.
  • To examine the relationship between VA coupling and LV function.
  • To identify predictors of VA coupling alterations during BB treatment.

Main Methods:

  • Eighty-seven elderly HF patients (age ≥ 65, NYHA ≥ II, LVEF ≤ 45%) were enrolled in the CIBIS-ELD protocol.
  • Patients received up-titrated BB therapy for 12 weeks.
  • Doppler echocardiography assessed VA coupling (Ea/Elv ratio), LV function, and clinical parameters before and after treatment.

Main Results:

  • BB therapy significantly improved VA coupling in elderly HF patients, moving it closer to the optimal range (p < 0.001).
  • Vascular stiffness (Ea) decreased, and VA coupling improved similarly in both ischemic and non-ischemic HF.
  • Improved global LV ejection fraction (LVEF) was the strongest predictor of VA coupling improvement (p < 0.001), followed by patient age (p = 0.014).

Conclusions:

  • BB therapy optimizes VA coupling in elderly HF patients, contributing to their beneficial effects.
  • The improvement in VA coupling is associated with enhanced LVEF and cardiac contractility.
  • BBs represent a valuable therapeutic strategy for improving cardiovascular performance in elderly HF patients through VA coupling modulation.
Abstract

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