Beta‐Blocker Use Is Associated With Prevention of Left Ventricular Remodeling in Recovered Dilated Cardiomyopathy

Figures

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  Figure 1. Patient selection. DCM indicates dilated cardiomyopathy; LVAD, left ventricular assist device; and LVEF, left ventricular ejection fraction. *Adjusted for age, sex, duration of heart failure, New York Heart Association functional class (I–II vs III–IV), atrial fibrillation, pacing rhythm, cardiac resynchronization therapy, LVEF, prior LVEF, hypertension, hyperuricemia, mineralocorticoid receptor antagonists, angiotensin‐converting enzyme inhibitor or angiotensin receptor blocker, digitalis, and amiodarone.

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  Figure 2. Primary and secondary outcomes. Primary outcome and increase in LVDD was less frequently observed in the beta‐blocker group both in ITT and per‐protocol analysis (A, B, D, and E). Increase in LVDS was more frequently observed in ITT analysis, but it did not reach a statistical significance in per‐protocol analysis (C and F). ITT indicates intention‐to‐treat analysis; LVDD, left ventricular diastolic diameter; LVDS, left ventricular systolic diameter; LVEF, left ventricular ejection fraction; and OR, odds ratio.

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  Figure 3. Subgroup analysis of the primary outcome. Female patients were more benefited by beta‐blockers. ACEI indicates angiotensin‐converting enzyme inhibitor; AF, atrial fibrillation; ARB, angiotensin receptor blocker; BB, beta‐blocker; CKD, chronic kidney disease; HR, heart rate; OR, odds ratio; and SBP, systolic blood pressure.

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  Figure 4. Changes in the types of heart failure according to beta‐blocker use. Beta‐blocker was associated with lower prevalence of LVEF <40% at follow‐up. LVEF indicates left ventricular ejection fraction.

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  Figure 5. Dose‐response relationship between delta LVEF and dose of beta‐blocker. Beta‐blockers prevented a decrease in LVEF as beta‐blocker dose increased. Solid line represents estimated delta LVEF with the carvedilol dose=0 mg as the reference level and dotted line does 95% CI. LVEF indicates left ventricular ejection fraction.