Key result
Beta-blocker use in older HFpEF linked to lower resting heart rate but no peak exercise benefit.
Why the study?
Differences in oxygen uptake and heart rate during exercise and recovery in older HFpEF patients with and without β-blocker treatment were not well characterized.
Does beta-blocker therapy alter heart rate and oxygen uptake during exercise and recovery in older patients with HFpEF?
Observational (n=174)
Does beta-blocker therapy alter heart rate and oxygen uptake during exercise and recovery in older patients with HFpEF?
Beta-blockers lower resting and submaximal heart rates in older HFpEF patients but do not significantly affect peak heart rate, heart rate reserve, or oxygen uptake during exercise.
Answers are grounded in this paper and cite their sources.
Reassures against chronotropic concerns limiting exercise in older HFpEF; leaves open effects on clinical outcomes.
Purpose: The study aimed to investigate the differences in oxygen uptake ( JOURNAL/jcprh/04.03/01273116-202005000-00007/7FSM1/v/2023-09-11T074857Z/r/image-gif o 2 ) and heart rate (HR) (at rest, submaximal exercise, peak exercise, and recovery) in patients with heart failure with preserved ejection fraction (HFpEF) with β-blockers (BB) or without BB treatment (NBB) and to analyze the relationship between HR reserve (HR resv ) and peak JOURNAL/jcprh/04.03/01273116-202005000-00007/7FSM1/v/2023-09-11T074857Z/r/image-gif o 2 ( JOURNAL/jcprh/04.03/01273116-202005000-00007/7FSM1/v/2023-09-11T074857Z/r/image-gif o 2peak ) in BB and NBB. Methods: A total of 174 HFpEF patients (>65 yr; BB, n = 59; NBB, n = 115) were assessed with a cardiopulmonary exercise test to peak exertion using an incremental protocol. After 5 min of supine rest, HR and JOURNAL/jcprh/04.03/01273116-202005000-00007/7FSM1/v/2023-09-11T074857Z/r/image-gif o 2 (HR rest , JOURNAL/jcprh/04.03/01273116-202005000-00007/7FSM1/v/2023-09-11T074857Z/r/image-gif o 2rest ) at submaximal exercise (HR submax , JOURNAL/jcprh/04.03/01273116-202005000-00007/7FSM1/v/2023-09-11T074857Z/r/image-gif o 2submax ), at peak exercise (HR peak , JOURNAL/jcprh/04.03/01273116-202005000-00007/7FSM1/v/2023-09-11T074857Z/r/image-gif o 2peak ), at 1 min of passive recovery (HR rec1 ), HR resv (HR peak − HR rest ), and HR recovery (HR recov = HR peak − HR rec1 ) were evaluated. Results: Analysis showed that HR rest (66.0 ± 12.2 vs 69.7 ± 10.6 bpm), HR submax (91.7 ± 16.2 vs 98.6 ± 15.2 bpm), and HR rec1 (102.9 ± 18.9 vs 109.4 ± 16.9 bpm) were significantly lower ( P ≤ .05) in BB than in NBB, respectively. However, there were no significant differences ( P > .05) between the BB and the NBB for HR peak , HR resv , HR recov , JOURNAL/jcprh/04.03/01273116-202005000-00007/7FSM1/v/2023-09-11T074857Z/r/image-gif o 2rest , JOURNAL/jcprh/04.03/01273116-202005000-00007/7FSM1/v/2023-09-11T074857Z/r/image-gif o 2submax , and JOURNAL/jcprh/04.03/01273116-202005000-00007/7FSM1/v/2023-09-11T074857Z/r/image-gif o 2peak . A significant relationship was found between HR resv and JOURNAL/jcprh/04.03/01273116-202005000-00007/7FSM1/v/2023-09-11T074857Z/r/image-gif o 2peak values in both groups (BB, r = 0.52; NBB, r = 0.49, P < .001). Conclusions: The nonsignificant differences in HR peak , HR resv , HR recov , or JOURNAL/jcprh/04.03/01273116-202005000-00007/7FSM1/v/2023-09-11T074857Z/r/image-gif o 2 values between BB and NBB HFpEF patients, along with significant correlation between HR resv and JOURNAL/jcprh/04.03/01273116-202005000-00007/7FSM1/v/2023-09-11T074857Z/r/image-gif o 2peak , suggest that these measures may have equal utility in prognostic and functional assessment as well as clinical applications, including the prescription of exercise, in elderly HFpEF patients.
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Maldonado‐Martín et al. (2020) conducted an observational in Heart failure with preserved ejection fraction (HFpEF) (n=174). β-blockers vs. No β-blocker treatment was evaluated on Heart rate at rest (bpm) (p=≤.05). In older patients with HFpEF, β-blocker use was associated with lower resting heart rate (66.0 vs 69.7 bpm, P≤.05) but no significant differences in peak heart rate or peak oxygen uptake.
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