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.