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Protective effect of beta-blockers on worsening of renal function in heart failure patients with sympathetic overactivation

Session Poster session 5

Speaker Ryuichi Ushijima

Congress : ESC Congress 2016

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure - Pathophysiology and Mechanisms
  • Session type : Poster Session
  • FP Number : P4580

Authors : R Ushijima (Toyama,JP), S Joho (Toyama,JP), T Akabane (Toyama,JP), T Hirai (Toyama,JP), K Kinugawa (Toyama,JP)

Authors:
R. Ushijima1 , S. Joho1 , T. Akabane1 , T. Hirai1 , K. Kinugawa1 , 1University of Toyama - Toyama - Japan ,

Citation:
European Heart Journal ( 2016 ) 37 ( Abstract Supplement ), 917

Background: β-blockers might preserve renal function in patients with chronic heart failure (HF). However, the effect of central sympathetic activity on renal function in patients taking β-blockers is unclear.

Purpose: The aim of this study is to evaluate the interactive effect of β-blockers and central sympathetic activity on worsening of renal function (WRF) in patients with HF.

Methods: We determined resting muscle sympathetic nerve activity (MSNA) and serum creatinine level in 105 patients with HF (ejection fraction <0.45). Serum creatinine level was determined at baseline and 3, 6 and 12 months after measurement of MSNA. WRF was defined as an absolute increase in serum creatinine level ≥0.3mg/dL.

Results: During the follow-up period, WRF was observed in 15 patients. MSNA was significantly higher in patients with WRF than in those without WRF. Multivariate logistic regression analysis revealed that MSNA and non-use of β-blockers were independent risk factors of WRF. In higher MSNA patients (66 ≥ bursts/100beats), prevalence of WRF was lower in patients with β-blockers than in those without β-blockers.

Conclusion: Sympathetic overactivation predicts WRF in patients with HF. β-blockers might be necessary to prevent WRF in HF patients with sympathetic overactivation.

Predictors of WRF within 12 months
Logistic regression analysesUnivariateMultivariateOdds ratio (95% CI)
Sex0.5362
Age0.1954
Apnoea hypopnoea index0.6029
Body mass index0.05260.9003
Specific activity scale0.00010.4575
Mean blood pressure0.01520.2050
Heart rate0.2305
Burst incidence0.00010.01261.07 (1.01–1.15)
(1 burst/100 beats increase)
Ejection fraction0.00320.0934
Haemoglobin0.00860.2001
Creatinine0.5094
BNP0.128
RAS-Inhibitors0.04990.0911
Beta-blockers0.00760.03870.17 (0.02–0.91)
Frosemide dose0.00250.3004
Pimobendan0.08670.1522
WRF free survival


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