Interest of β-blockers in patients with right ventricular systemic dysfunction.
BACKGROUND
β-blockers improve the prognosis of patients with cardiac failure due to left ventricular systolic dysfunction. The aim of this study was to assess the efficacy of β-blockers in patients with dysfunctional systemic right ventricle.


METHODS
Fourteen patients with systemic right ventricle following a Mustard or a Senning operation for the transposition of the great arteries, or congenitally corrected transposition were included in the study. All had a decreased systemic right ventricular ejection fraction despite having standard cardiac failure therapy. Quality of life, New York Heart Association class, aerobic capacity, and systemic right ventricular function were assessed before treatment with β-blockers and at the end of the follow-up period, mean of 12.8 months with a range from 3 to 36 months.


RESULTS
Change in New York Heart Association class was significant (p = 0.016). Quality of life improved significantly throughout the study from a median grade 2 with a range from 1 to 3 to a median grade 1 with a range from 1 to 2 (p = 0.008). Systemic right ventricular ejection fraction assessed by radionuclide ventriculography improved significantly from a median of 41% (range: 29-53%) to 49% (range: 29-62%; p = 0.031). However, the change in thee ejection fraction assessed by magnetic resonance imaging was not significant from a median of 29% (range: 12-47%) to 32% (range: 22-63%; p = 0.063).


CONCLUSIONS
In patients with cardiac failure due to systemic right ventricular dysfunction, β-blockers improve New York Heart Association class, quality of life, and systemic right ventricular ejection fraction assessed by radionuclide ventriculography.
Department of Paediatric Cardiology and Congenital Heart Disease, Cardiology Hospital, University of Lille, France.
Rachid
R
Bouallal
François
F
Godart
Charles
C
Francart
Adélaïde
A
Richard
Claude
C
Foucher-Hossein
Christophe
C
Lions
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D017298:Bisoprolol / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D013318:Stroke Volume; D014188:Transposition of Great Vessels / Q000601:surgery; D018497:Ventricular Dysfunction, Right / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D055815:Young Adult
D000319:Adrenergic beta-Antagonists; D017298:Bisoprolol