Heart failureAnalysis of Randomized Controlled Trials on the Effect of Magnitude of Heart Rate Reduction on Clinical Outcomes in Patients With Systolic Chronic Heart Failure Receiving Beta-Blockers
Section snippets
Methods and Results
To begin to evaluate this issue, we performed a regression analysis of all trials of β blockers compared with placebo in patients with systolic CHF that reported mortality outcomes or the surrogate of change in the LVEF, together with absolute HR values and HR change during the course of therapy.
Studies were identified via Medline search, report reference listings, and abstracts of major meetings. Studies had to be ≥2 months in duration. HR values were the last provided, with a minimum duration
Discussion
The present analysis identified a clear relation between change in HR with β blockade and all-cause mortality outcomes. Although this relation may appear to be intuitive, it has thus far not been at all well documented in published medical research.
This finding is of particular significance with regard to β blockade, because it is well known that considerable heterogeneity exists within the class41 and further that individual patients may exhibit widely differing pharmacodynamic responsiveness
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