دورية أكاديمية
Beta‐blockers withdrawal in patients with heart failure with preserved ejection fraction and chronotropic incompetence: Effect on functional capacity rationale and study design of a prospective, randomized, controlled trial (The Preserve‐HR trial)
| العنوان: | Beta‐blockers withdrawal in patients with heart failure with preserved ejection fraction and chronotropic incompetence: Effect on functional capacity rationale and study design of a prospective, randomized, controlled trial (The Preserve‐HR trial) |
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| المؤلفون: | Palau, Patricia, Seller, Julia, Domínguez Mafé, Eloy, Gómez, Inés, Ramón, José María, Sastre, Clara, De la Espriella, Rafael, Santas, Enrique, Miñana, Gema, Chorro, Francisco J., González Juanatey, José Ramón, Nuñez, Julio |
| بيانات النشر: | Wiley |
| سنة النشر: | 2020 |
| المجموعة: | Repositori Universitat Jaume I (Repositorio UJI) |
| مصطلحات موضوعية: | chronotropic incompetence, exercise capacity, heart failure with preserved ejection fraction, quality of life |
| الوصف: | Background: The pathophysiology of heart failure with preserved ejection fraction (HFpEF) is complex and multifactorial. Chronotropic incompetence (ChI) has emerged as a crucial pathophysiological mechanism. Beta‐blockers, drugs with negative chronotropic effects, are commonly used in HFpEF, although current evidence does not support its routine use in these patients. Hypothesis: We postulate beta‐blockers may have deleterious effects in HFpEF and ChI. This work aims to evaluate the short‐term effect of beta‐blockers withdrawal on functional capacity assessed by the maximal oxygen uptake (peakVO2) in patients with HFpEF and ChI. Methods: This is a prospective, crossover, randomized (1:1) and multicenter study. After randomization, the clinical and cardiac rhythm will be continuously registered for 30 days. PeakVO2 is assessed by cardiopulmonary exercise testing (CPET) at 15 and 30 days in both groups. Secondary endpoints include quality of life, cognitive, and safety assessment. Patients with stable HFpEF, functional class New York Heart Association (NYHA) II‐III, chronic treatment with beta‐blockers, and ChI will be enrolled. A sample size estimation [alfa: 0.05, power: 90%, a 20% loss rate, and delta change of mean peakVO2: +1.2 mL/kg/min (SD ± 2.0)] of 52 patients is necessary to test our hypothesis. Results: Patients started enrolling in October 2018. As January 14th, 2020, 28 patients have been enrolled. It is projected to enroll the last patient at the end of July 2020. Conclusions: Optimizing therapy that improves functional capacity remains an unmeet priority in HFpEF. Deprescribing beta‐blockers in patients with HFpEF and ChI seems a plausible intervention to improve functional capacity. This trial is an attempt towards precision medicine in this complex syndrome. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0160-9289 1932-8737 |
| العلاقة: | Clinical Cardiology, 2020; Ministry of Economy and Competitiveness, Instituto Carlos III: PI17/01426; EDRF founds and CIBER Cardiovascular :16/11/00420 and 16/11/00226; Palau, P, Seller, J, Domínguez, E, et al. Beta‐blockers withdrawal in patients with heart failure with preserved ejection fraction and chronotropic incompetence: Effect on functional capacity rationale and study design of a prospective, randomized, controlled trial (The Preserve‐HR trial). Clin Cardiol. 2020; 1– 7. https://doi.org/10.1002/clc.23345Test; http://hdl.handle.net/10234/187409Test; https://doi.org/10.1002/clc.23345Test |
| DOI: | 10.1002/clc.23345 |
| الإتاحة: | https://doi.org/10.1002/clc.23345Test http://hdl.handle.net/10234/187409Test |
| حقوق: | Atribución 4.0 Internacional ; http://creativecommons.org/licenses/by/4.0Test/ ; info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.DB8171AF |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 01609289 19328737 |
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| DOI: | 10.1002/clc.23345 |