Improvement of Ventricular-Arterial Coupling in Elderly Patients with Heart Failure After Beta Blocker Therapy: Results from the CIBIS-ELD Trial
ᅟ The interaction between the heart and the arterial system (ventricular-arterial coupling - VA) is an important determinant of cardiovascular performance. Vascular stiffness (Ea) and left ventricular (LV) endsystolic stiffness (Elv) augment with age and in heart failure (HF). Beta blockers (BB) are...
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| creator | Dekleva, Milica Lazic, Jelena Suzic Soldatovic, Ivan Inkrot, Simone Arandjelovic, Aleksandra Waagstein, Finn Gelbrich, Goetz Cvijanovic, Dane Dungen, Hans Dirk |
| description | ᅟ
The interaction between the heart and the arterial system (ventricular-arterial coupling - VA) is an important determinant of cardiovascular performance. Vascular stiffness (Ea) and left ventricular (LV) endsystolic stiffness (Elv) augment with age and in heart failure (HF). Beta blockers (BB) are recommended therapy for patients with HF. However, data about the effects of BB on VA coupling are scarce.
Aims of the Study: To assess
1) changes in VA after BB therapy; 2) interactions between VA and LV functions, 3) predictive factors influencing VA change.
Methods
Eight hundred seventy-seven elderly patients with HF (aged ≥ 65, NYHA ≥ II, LV ejection fraction (LVEF) ≤ 45 %), treated with BB according to the CIBIS-ELD protocol of up-titration, underwent Doppler echocardiography with clinical and laboratory assessment before and after 12 weeks of BB. VA coupling was calculated as Ea/Elv ratio.
Results
Ventriculo-arterial interaction improved after 12 weeks of BB in elderly patients with HF. Values of Ea significantly decreased from 2.73 ± 1.16 to 2.40 ± 1.01,
p
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| doi_str_mv | 10.1007/s10557-015-6590-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1701322976</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3765305831</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-16c01131cc3b50c304fb259dbd64b7d1c4b36153cee3fc5c9a3bb32bd23ca4d73</originalsourceid><addsrcrecordid>eNp1kc9uEzEQxi1ERUPhAbggS1y4mPrfejG3JE1ppEggCFxXtne2cfHuBttblLfgkXGUghASp9Foft83M_oQesHoG0ZpfZkYraqaUFYRVWlK9CM0Y1UtSM0le4xmVHNKBKfqHD1N6Y4WjdZvn6BzXmklqJIz9HPd7-N4Dz0MGY8d_lpq9G4KJpJ5zBC9CXg5Tvvgh1vsB7wKLcRwwB9N9oVN-IfPO3wDJmZ8bXyYIuB5V4R4AdngRRjdt9JsdxDN_vAOf4I0hSLr4tjjvAO8XC_Wn8lqc4W3x2XP0FlnQoLnD_UCfblebZc3ZPPh_Xo53xAnJc-EKUcZE8w5YSvqBJWdLV-1tlXS1i1z0grFKuEAROcqp42wVnDbcuGMbGtxgV6ffMv73ydIuel9chCCGWCcUsNqygTnulYFffUPejdOcSjXHSkqlWKUF4qdKBfHlCJ0zT763sRDw2hzjKs5xdWUuJpjXI0umpcPzpPtof2j-J1PAfgJSGU03EL8a_V_XX8B_mSgTQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1700466102</pqid></control><display><type>article</type><title>Improvement of Ventricular-Arterial Coupling in Elderly Patients with Heart Failure After Beta Blocker Therapy: Results from the CIBIS-ELD Trial</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Dekleva, Milica ; Lazic, Jelena Suzic ; Soldatovic, Ivan ; Inkrot, Simone ; Arandjelovic, Aleksandra ; Waagstein, Finn ; Gelbrich, Goetz ; Cvijanovic, Dane ; Dungen, Hans Dirk</creator><creatorcontrib>Dekleva, Milica ; Lazic, Jelena Suzic ; Soldatovic, Ivan ; Inkrot, Simone ; Arandjelovic, Aleksandra ; Waagstein, Finn ; Gelbrich, Goetz ; Cvijanovic, Dane ; Dungen, Hans Dirk</creatorcontrib><description>ᅟ
The interaction between the heart and the arterial system (ventricular-arterial coupling - VA) is an important determinant of cardiovascular performance. Vascular stiffness (Ea) and left ventricular (LV) endsystolic stiffness (Elv) augment with age and in heart failure (HF). Beta blockers (BB) are recommended therapy for patients with HF. However, data about the effects of BB on VA coupling are scarce.
Aims of the Study: To assess
1) changes in VA after BB therapy; 2) interactions between VA and LV functions, 3) predictive factors influencing VA change.
Methods
Eight hundred seventy-seven elderly patients with HF (aged ≥ 65, NYHA ≥ II, LV ejection fraction (LVEF) ≤ 45 %), treated with BB according to the CIBIS-ELD protocol of up-titration, underwent Doppler echocardiography with clinical and laboratory assessment before and after 12 weeks of BB. VA coupling was calculated as Ea/Elv ratio.
Results
Ventriculo-arterial interaction improved after 12 weeks of BB in elderly patients with HF. Values of Ea significantly decreased from 2.73 ± 1.16 to 2.40 ± 1.01,
p
< 0.001, resulting in a VA level close to the optimal range i.e. from 1.70 ± 1.05 (1.46) to 1.50 ± 0.94 (1.29),
p
< 0.001. A similar degree of VA change was found in the patients with ischemic and non-ischemic HF after the treatment. Improvement in the clinical stage of HF closely correlated with VA coupling change after BB (
p
= 0.006). The strongest predictor of VA coupling alteration during BB was the improvement in global LVEF (
p
< 0.001) followed by the age of patients (
p
= 0.014).
Conclusions
The beneficial effect of BB in elderly patients with HF was achieved by optimizing VA coupling close to recommended range, associated with an improvement in LVEF and contractility.</description><identifier>ISSN: 0920-3206</identifier><identifier>EISSN: 1573-7241</identifier><identifier>DOI: 10.1007/s10557-015-6590-9</identifier><identifier>PMID: 25963064</identifier><identifier>CODEN: CDTHET</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adrenergic beta-Antagonists - pharmacology ; Adrenergic beta-Antagonists - therapeutic use ; Aged ; Arteries - drug effects ; Bisoprolol - pharmacology ; Bisoprolol - therapeutic use ; Cardiology ; Double-Blind Method ; Echocardiography, Doppler - drug effects ; Female ; Heart Failure - drug therapy ; Heart Failure - physiopathology ; Humans ; Male ; Medicine ; Medicine & Public Health ; Original Article ; Stroke Volume - drug effects ; Ventricular Function, Left - drug effects ; Ventricular Function, Left - physiology</subject><ispartof>Cardiovascular drugs and therapy, 2015-06, Vol.29 (3), p.287-294</ispartof><rights>Springer Science+Business Media New York 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-16c01131cc3b50c304fb259dbd64b7d1c4b36153cee3fc5c9a3bb32bd23ca4d73</citedby><cites>FETCH-LOGICAL-c442t-16c01131cc3b50c304fb259dbd64b7d1c4b36153cee3fc5c9a3bb32bd23ca4d73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10557-015-6590-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10557-015-6590-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25963064$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dekleva, Milica</creatorcontrib><creatorcontrib>Lazic, Jelena Suzic</creatorcontrib><creatorcontrib>Soldatovic, Ivan</creatorcontrib><creatorcontrib>Inkrot, Simone</creatorcontrib><creatorcontrib>Arandjelovic, Aleksandra</creatorcontrib><creatorcontrib>Waagstein, Finn</creatorcontrib><creatorcontrib>Gelbrich, Goetz</creatorcontrib><creatorcontrib>Cvijanovic, Dane</creatorcontrib><creatorcontrib>Dungen, Hans Dirk</creatorcontrib><title>Improvement of Ventricular-Arterial Coupling in Elderly Patients with Heart Failure After Beta Blocker Therapy: Results from the CIBIS-ELD Trial</title><title>Cardiovascular drugs and therapy</title><addtitle>Cardiovasc Drugs Ther</addtitle><addtitle>Cardiovasc Drugs Ther</addtitle><description>ᅟ
The interaction between the heart and the arterial system (ventricular-arterial coupling - VA) is an important determinant of cardiovascular performance. Vascular stiffness (Ea) and left ventricular (LV) endsystolic stiffness (Elv) augment with age and in heart failure (HF). Beta blockers (BB) are recommended therapy for patients with HF. However, data about the effects of BB on VA coupling are scarce.
Aims of the Study: To assess
1) changes in VA after BB therapy; 2) interactions between VA and LV functions, 3) predictive factors influencing VA change.
Methods
Eight hundred seventy-seven elderly patients with HF (aged ≥ 65, NYHA ≥ II, LV ejection fraction (LVEF) ≤ 45 %), treated with BB according to the CIBIS-ELD protocol of up-titration, underwent Doppler echocardiography with clinical and laboratory assessment before and after 12 weeks of BB. VA coupling was calculated as Ea/Elv ratio.
Results
Ventriculo-arterial interaction improved after 12 weeks of BB in elderly patients with HF. Values of Ea significantly decreased from 2.73 ± 1.16 to 2.40 ± 1.01,
p
< 0.001, resulting in a VA level close to the optimal range i.e. from 1.70 ± 1.05 (1.46) to 1.50 ± 0.94 (1.29),
p
< 0.001. A similar degree of VA change was found in the patients with ischemic and non-ischemic HF after the treatment. Improvement in the clinical stage of HF closely correlated with VA coupling change after BB (
p
= 0.006). The strongest predictor of VA coupling alteration during BB was the improvement in global LVEF (
p
< 0.001) followed by the age of patients (
p
= 0.014).
Conclusions
The beneficial effect of BB in elderly patients with HF was achieved by optimizing VA coupling close to recommended range, associated with an improvement in LVEF and contractility.</description><subject>Adrenergic beta-Antagonists - pharmacology</subject><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Aged</subject><subject>Arteries - drug effects</subject><subject>Bisoprolol - pharmacology</subject><subject>Bisoprolol - therapeutic use</subject><subject>Cardiology</subject><subject>Double-Blind Method</subject><subject>Echocardiography, Doppler - drug effects</subject><subject>Female</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Failure - physiopathology</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Stroke Volume - drug effects</subject><subject>Ventricular Function, Left - drug effects</subject><subject>Ventricular Function, Left - physiology</subject><issn>0920-3206</issn><issn>1573-7241</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kc9uEzEQxi1ERUPhAbggS1y4mPrfejG3JE1ppEggCFxXtne2cfHuBttblLfgkXGUghASp9Foft83M_oQesHoG0ZpfZkYraqaUFYRVWlK9CM0Y1UtSM0le4xmVHNKBKfqHD1N6Y4WjdZvn6BzXmklqJIz9HPd7-N4Dz0MGY8d_lpq9G4KJpJ5zBC9CXg5Tvvgh1vsB7wKLcRwwB9N9oVN-IfPO3wDJmZ8bXyYIuB5V4R4AdngRRjdt9JsdxDN_vAOf4I0hSLr4tjjvAO8XC_Wn8lqc4W3x2XP0FlnQoLnD_UCfblebZc3ZPPh_Xo53xAnJc-EKUcZE8w5YSvqBJWdLV-1tlXS1i1z0grFKuEAROcqp42wVnDbcuGMbGtxgV6ffMv73ydIuel9chCCGWCcUsNqygTnulYFffUPejdOcSjXHSkqlWKUF4qdKBfHlCJ0zT763sRDw2hzjKs5xdWUuJpjXI0umpcPzpPtof2j-J1PAfgJSGU03EL8a_V_XX8B_mSgTQ</recordid><startdate>20150601</startdate><enddate>20150601</enddate><creator>Dekleva, Milica</creator><creator>Lazic, Jelena Suzic</creator><creator>Soldatovic, Ivan</creator><creator>Inkrot, Simone</creator><creator>Arandjelovic, Aleksandra</creator><creator>Waagstein, Finn</creator><creator>Gelbrich, Goetz</creator><creator>Cvijanovic, Dane</creator><creator>Dungen, Hans Dirk</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20150601</creationdate><title>Improvement of Ventricular-Arterial Coupling in Elderly Patients with Heart Failure After Beta Blocker Therapy: Results from the CIBIS-ELD Trial</title><author>Dekleva, Milica ; Lazic, Jelena Suzic ; Soldatovic, Ivan ; Inkrot, Simone ; Arandjelovic, Aleksandra ; Waagstein, Finn ; Gelbrich, Goetz ; Cvijanovic, Dane ; Dungen, Hans Dirk</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-16c01131cc3b50c304fb259dbd64b7d1c4b36153cee3fc5c9a3bb32bd23ca4d73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adrenergic beta-Antagonists - pharmacology</topic><topic>Adrenergic beta-Antagonists - therapeutic use</topic><topic>Aged</topic><topic>Arteries - drug effects</topic><topic>Bisoprolol - pharmacology</topic><topic>Bisoprolol - therapeutic use</topic><topic>Cardiology</topic><topic>Double-Blind Method</topic><topic>Echocardiography, Doppler - drug effects</topic><topic>Female</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Failure - physiopathology</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Stroke Volume - drug effects</topic><topic>Ventricular Function, Left - drug effects</topic><topic>Ventricular Function, Left - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dekleva, Milica</creatorcontrib><creatorcontrib>Lazic, Jelena Suzic</creatorcontrib><creatorcontrib>Soldatovic, Ivan</creatorcontrib><creatorcontrib>Inkrot, Simone</creatorcontrib><creatorcontrib>Arandjelovic, Aleksandra</creatorcontrib><creatorcontrib>Waagstein, Finn</creatorcontrib><creatorcontrib>Gelbrich, Goetz</creatorcontrib><creatorcontrib>Cvijanovic, Dane</creatorcontrib><creatorcontrib>Dungen, Hans Dirk</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Cardiovascular drugs and therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dekleva, Milica</au><au>Lazic, Jelena Suzic</au><au>Soldatovic, Ivan</au><au>Inkrot, Simone</au><au>Arandjelovic, Aleksandra</au><au>Waagstein, Finn</au><au>Gelbrich, Goetz</au><au>Cvijanovic, Dane</au><au>Dungen, Hans Dirk</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improvement of Ventricular-Arterial Coupling in Elderly Patients with Heart Failure After Beta Blocker Therapy: Results from the CIBIS-ELD Trial</atitle><jtitle>Cardiovascular drugs and therapy</jtitle><stitle>Cardiovasc Drugs Ther</stitle><addtitle>Cardiovasc Drugs Ther</addtitle><date>2015-06-01</date><risdate>2015</risdate><volume>29</volume><issue>3</issue><spage>287</spage><epage>294</epage><pages>287-294</pages><issn>0920-3206</issn><eissn>1573-7241</eissn><coden>CDTHET</coden><abstract>ᅟ
The interaction between the heart and the arterial system (ventricular-arterial coupling - VA) is an important determinant of cardiovascular performance. Vascular stiffness (Ea) and left ventricular (LV) endsystolic stiffness (Elv) augment with age and in heart failure (HF). Beta blockers (BB) are recommended therapy for patients with HF. However, data about the effects of BB on VA coupling are scarce.
Aims of the Study: To assess
1) changes in VA after BB therapy; 2) interactions between VA and LV functions, 3) predictive factors influencing VA change.
Methods
Eight hundred seventy-seven elderly patients with HF (aged ≥ 65, NYHA ≥ II, LV ejection fraction (LVEF) ≤ 45 %), treated with BB according to the CIBIS-ELD protocol of up-titration, underwent Doppler echocardiography with clinical and laboratory assessment before and after 12 weeks of BB. VA coupling was calculated as Ea/Elv ratio.
Results
Ventriculo-arterial interaction improved after 12 weeks of BB in elderly patients with HF. Values of Ea significantly decreased from 2.73 ± 1.16 to 2.40 ± 1.01,
p
< 0.001, resulting in a VA level close to the optimal range i.e. from 1.70 ± 1.05 (1.46) to 1.50 ± 0.94 (1.29),
p
< 0.001. A similar degree of VA change was found in the patients with ischemic and non-ischemic HF after the treatment. Improvement in the clinical stage of HF closely correlated with VA coupling change after BB (
p
= 0.006). The strongest predictor of VA coupling alteration during BB was the improvement in global LVEF (
p
< 0.001) followed by the age of patients (
p
= 0.014).
Conclusions
The beneficial effect of BB in elderly patients with HF was achieved by optimizing VA coupling close to recommended range, associated with an improvement in LVEF and contractility.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>25963064</pmid><doi>10.1007/s10557-015-6590-9</doi><tpages>8</tpages></addata></record> |
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| subjects | Adrenergic beta-Antagonists - pharmacology Adrenergic beta-Antagonists - therapeutic use Aged Arteries - drug effects Bisoprolol - pharmacology Bisoprolol - therapeutic use Cardiology Double-Blind Method Echocardiography, Doppler - drug effects Female Heart Failure - drug therapy Heart Failure - physiopathology Humans Male Medicine Medicine & Public Health Original Article Stroke Volume - drug effects Ventricular Function, Left - drug effects Ventricular Function, Left - physiology |
| title | Improvement of Ventricular-Arterial Coupling in Elderly Patients with Heart Failure After Beta Blocker Therapy: Results from the CIBIS-ELD Trial |
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