In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to HFA Silver & Gold Members, Fellows of the ESC and Young combined Members

Impact of beta blockers therapy on right ventricular function in heart failure patients with reduced ejection fraction a prospective evaluation

Session Poster Session 3

Speaker Remi Galves

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Pharmacotherapy
  • Session type : Poster Session

Authors : R Galves (Saint Etienne,FR), R Pierrard (Saint Etienne,FR), K Isaaz (Saint Etienne,FR), A Da Costa (Saint Etienne,FR)

R Galves1 , R Pierrard1 , K Isaaz1 , A Da Costa1 , 1CHU Saint Etienne Hopital Nord, Cardiology - Saint Etienne - France ,


Background.ß-Blocker Therapy has been shown to improve mortality and reduce hospitalizations in patients with heart failure (HF) with reduced ejection fraction (HFrEF). Although the physiological action mechanisms of ß-Blocker Therapy are well described, its effects on rigth ventricular (RV) function have not been prospectively well studied. Objective. The aim of this prospective study was to: (1) evaluate if ß-Blocker Therapy impacts RV remodellingbased on echo parameters; (2) sought the echo predictive factors of ß-Blocker therapy response.Methods. From september 2017 to September 2018, HF patients were prospectively enrolled using CIBIS criteria: Class II, III, or IV HF; left ventricular ejection fraction (LVEF) of 40% or less; hospitalized for HF within the previous 12 months. Echo evaluation was performed before initiating ß-Blocker therapy and 3 months after optimal dose adjustment. Based on previous studies, patients with (absolute) improvement in LVEF =5% were considered significant ß-Blocker therapy responders. Results. Forty patients completing the study were characterized by age: 70±10 years; gender: 10 women; cardiomyopathy aetiology: idiopathic in 24 and ischaemic in 16; NYHA Class: II in 22 and III in 10; LVEF: 32±5%; NTProBNP: 2665±2400pg/ml.The final population comprised 32 pts (79%), given that 8 pts (21%) were excluded: 2 did not tolerate ß-Blocker therapy, 1 was lost of follow-up, 5 did not pursue the protocol. Under ß-Blocker therapy, several echo parameters significantly improved: LVEF from 31.7±9to 40.5±9 (p<0.0001); LV end-diastolic volume (EDV) from 154±54 to 143±45 ml (p=0.06); LV end-systolic volume (ESV) from 107±49 to 88±37 ml (p=0.0006); LV ES from 46±11to 64±13 ml (p=0.008); LV end-diastolic diameter (EDD) (57±9 to 54±6 mm; p=0.04); LV end-systolic diameter (ESD) (48±10 to 44±7 mm; p=0.007); right ventricular systolic pressure (RV SP) from 39±10 to 32±8 (p=0.0001). Significant modifications were observed in terms of RV echo parameters: right ventricular size decreased (30±4 vs. 27±5; p=0.03) and right ventricular systolic function improved significantly based on the tricuspid annular plane systolic excursion (TAPSE) (16.5±4 vs. 19±4 mm; .0006); DTI-derived tricuspid lateral annular systolic velocity wave (S’)(10±2 vs. 11.3±3 cm/s; p=0.03); RIMP (Tei index) (0.5±.1 vs. 0.46±.1; p=0.04) (Table II). RV 2D FAC (fractional area change) was not significantly different despite a clear improvement tendency (35±6 vs. 37±4 %; p=0.1). No significant modifications were observed concerning LV diastolic parameters. ß-Blocker echo responders (n=23/32; 72%) exhibited the same left and right echo parameters. No echo variables predicted the ß-Blocker response. Conclusions. In HFrEFpatients, ß-Blocker therapy significantly improves significantly LV and RV systolic remodelling. Accordingly, ß-Blocker therapy could be used as soon as possible in HFrEF patients associated with right ventricular dysfunction in order to limit RV remodelling.

The free consultation period for this content is over.

It is now only available year-round to HFA Silver & Gold Members, Fellows of the ESC and Young combined Members

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are