Usefulness of Beta-Blocker Therapy and Outcomes in Patients With Pulmonary Arterial Hypertension

So, Petsy Pui-Sze; Davies, Ross A.; Chandy, George; Stewart, Duncan J.; Beanlands, Rob; Haddad, Haissam; Pugliese, Carolyn; Mielniczuk, Lisa

doi:10.1016/j.amjcard.2012.01.368

Cited by 69 publications

(45 citation statements)

References 20 publications

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“…Our findings suggest no significant difference in the severity functional NYHA class on follow-up with or without BB use. This correlates with the data published by SO et al [15], although our β-blocker cohort had a shorter 6MWD at baseline.…”

Section: Figuresupporting

confidence: 82%

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Outcomes of β-blocker use in pulmonary arterial hypertension: a propensity-matched analysis

et al. 2015

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The utility and safety of β-blockers in pulmonary hypertension is controversial. Anecdotal reports suggest that β-blockers may be harmful in these patients. The aim of our study was to evaluate outcomes of β-blocker use in pulmonary hypertension.We reviewed patients from our pulmonary hypertension registry between 2000 and 2011. Patients who continued to use β-blockers were compared to those who never used β-blockers for all-cause mortality, time to clinical worsening events, defined as death, lung transplantation and hospitalisation due to pulmonary hypertension. We also evaluated the effect of β-blockers on 6-min walking distance and New York Heart Association (NYHA) functional class.133 patients used β-blockers and 375 patients never used β-blockers. Mean±SD age was 57±16 years and the median follow-up period was 78 months. Propensity-matched analysis showed that the adjusted odds ratio (95% CI) for mortality with β-blocker use was 1.13 (0.69-1.82) and for clinical worsening events was 0.96 (0.55-1.68). No significant difference was noted in probability of survival and time to clinical worsening events. Patients on β-blockers walked a shorter distance on follow-up 6 min walk test; follow-up NYHA class was similar between groups.Pulmonary hypertension patients receiving β-blockers had a similar survival and time to clinical worsening events compared to patients not receiving them. Functional outcomes were similar, although β-blocker use was associated with a tendency towards shorter walking distance. @ERSpublications β-blocker use does not affect survival, symptom worsening or functional capacity in pulmonary hypertension

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Section: Figuresupporting

confidence: 82%

“…More recently, a small prospective nonrandomised study described no harmful effects of β-blocker use in all categories of PAH patients [15]. The study found that the use of β-blockers did not increase odds of death, clinical worsening or hospitalisations for worsening of pulmonary hypertension by univariate or multivariate analysis.…”

Section: Discussionmentioning

confidence: 92%

Outcomes of β-blocker use in pulmonary arterial hypertension: a propensity-matched analysis

et al. 2015

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“…for treatment of arrhythmias. In these studies, second-generation β-blockers (mainly metoprolol) did not appear to exert detrimental effects in PAH patients even if beneficial effects of β-blockers were not specifically studied [13,14]. Thus, discrepancies remain in the current literature regarding the second-generation of β-blockers effects and benefits; although detrimental effects seem not to be present as it was with the use of the first generation β-blockers.…”

Section: To the Editormentioning

confidence: 54%

β-blockers in pulmonary arterial hypertension: generation might matter

Malenfant

Perros

2016

Eur Respir J

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“…There are studies reporting that discontinuing propranolol has favorable effects in 10 patients with portopulmonary hypertension (197). Nevertheless, new data has shown that these drugs can be used safely in right HF and may prevent remodeling that may form in the right heart (198,199). However, more trials are required about this subject.…”

Section: Do Beta-blockers or Digoxin Affect Ph Associated With Left Hmentioning

confidence: 99%

“…However, there are very few trials that are conducted regarding the effect of treatments in right HF targeting these systems. For example, So et al demonstrated that BB use did not cause any side effects in patients with PAH (199). The results of ongoing trials with bisoprolol and carvedilol in patients with PAH are expected to have an answer on this issue (209).…”

Section: Do Beta-blockers or Digoxin Affect Ph Associated With Left Hmentioning

confidence: 99%

Practical approaches for the treatment of chronic heart failure: Frequently asked questions, overlooked points and controversial issues in current clinical practice

Çavuşoğlu

Altay²,

Ekmekçi³

et al. 2015

Anatol J Cardiol

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Practical approaches for the treatment of chronic heart failure:Frequently asked questions, overlooked points and controversial issues in current clinical practiceHeart failure (HF) is a progressive disorder associated with impaired quality of life, high morbidity, mortality and frequent hospitalization and affects millions of people from all around the world. Despite further improvements in HF therapy, mortality and morbidity remains to be very high. The life-long treatment, frequent hospitalization, and sophisticated and very expensive device therapies for HF also leads a substantial economic burden on the health care system. Therefore, implementation of evidence-based guideline-recommended therapy is very important to overcome its worse clinical outcomes. However, HF therapy is a long process that has many drawbacks and sometimes HF guidelines cannot answers to every question which rises in everyday clinical practice. In this paper, commonly encountered questions, overlooked points, controversial issues, management strategies in grey zone and problems arising during follow up of a HF patient in real life clinical practice have been addressed in the form of expert opinions based on the available data in the literature. (Anatol J Cardiol 2015: 15 Suppl 2; 1-60)

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Usefulness of Beta-Blocker Therapy and Outcomes in Patients With Pulmonary Arterial Hypertension

Cited by 69 publications

References 20 publications

Outcomes of β-blocker use in pulmonary arterial hypertension: a propensity-matched analysis

Outcomes of β-blocker use in pulmonary arterial hypertension: a propensity-matched analysis

β-blockers in pulmonary arterial hypertension: generation might matter

Practical approaches for the treatment of chronic heart failure: Frequently asked questions, overlooked points and controversial issues in current clinical practice

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