Heart Failure with Preserved Ejection Fraction (HFpEF)

According to the American and European heart failure guidelines, HFpEF is defined as a condition with LVEF >=50% and accompanying signs and symptoms of heart failure, along with elevated left ventricular filling pressures, such as increased natriuretic peptide levels and hemodynamic measurements. It imposes a financial burden, affects healthcare system resource allocation, and is linked to higher morbidity and mortality rates.

Beta-blockers and HFpEF

According to a recently published meta-analysis, Current Problems in Cardiology, beta-blockers can decrease all-cause mortality in individuals with heart failure with preserved ejection fraction (HFpEF). However, they did not affect cardiovascular mortality or rehospitalization.

Beta-blockers are commonly used to treat heart failure with reduced ejection fraction, but the same may not apply to HFpEF. This study aimed to evaluate beta-blockers' impact on mortality and rehospitalization in HFpEF patients through a systematic review and meta-analysis. The primary outcomes were all-cause and cardiovascular mortality, all-cause and heart failure-related rehospitalization, and a composite of these endpoints.

Key Results from the Study

• Out of the 13,189 records, 16 full-text records met the inclusion criteria and were analyzed.
• 27,188 patients were recruited, with a mean age of 62 – 84 years old, predominantly female, with HFpEF.
• 63.4% of patients received a beta-blocker, while 36.6% did not.
• There was a significant reduction in all-cause mortality by 19% with an odds ratio of 0.81, whereas rehospitalization for heart failure (OR 1.13) or its composite with all-cause mortality (OR 1.01) was similar between the beta-blocker and control groups.

In conclusion, based on observational studies, beta-blockers can potentially reduce all-cause mortality in patients with HFpEF. Nevertheless, rehospitalization for heart failure or its composite with all-cause mortality remains unchanged. Further investigations are warranted to clarify this uncertainty.

Reference

Kaddoura, R., Madurasinghe, V., Chapra, A., Abushanab, D., Al‐Badriyeh, D., & Patel, A. (2024). Beta-blocker therapy in heart failure with preserved ejection fraction (B-HFpEF): a systematic review and meta-analysis. Current Problems in Cardiology, 102376. https://doi.org/10.1016/j.cpcardiol.2024.102376