title: Effect of beta blocker therapy on survival of patients with heart failure and preserved systolic function following hospitalization with acute decompensated heart failure.
abstract: BACKGROUND
  The importance of heart failure with preserved ejection fraction is being increasingly recognized. However, there is a paucity of data about effective treatment for this condition. The present study investigated the impact of beta blocker therapy for 3 months before admission on the two-year survival of patients with heart failure and preserved systolic function hospitalized due to decompensated heart failure.
  
  
  METHODS
  We performed a retrospective cohort analysis of 345 consecutive patients with heart failure with preserved systolic function older than 18 years hospitalized due to decompensated heart failure. Two groups of patients were compared: those who received beta blockers within 3 months before admission (BB) and those who did not (NBB). The primary outcome was two year all cause mortality (maximal follow-up available in all subjects). To adjust for a potential misbalance between BB and NBB groups in baseline characteristics, a propensity score for beta blocker therapy was incorporated into the survival model.
  
  
  RESULTS
  154 patients (44.6%) received beta blockers prior to admission. Overall two year mortality rate in the BB group was 50% vs. 62.8% in the NBB group, log-rank test p = 0.016. Beta blockers showed protective effect on two-year survival after adjustment for comorbidities and propensity score (hazard ratio [HR], 0.69; 95% CI 0.47-0.99).
  
  
  CONCLUSIONS
  Therapy with beta blockers may have protective effect on survival of patients with heart failure with preserved systolic function.
authors.affiliation: Department of Cardiology, Tel Aviv University's Sackler Medical School, Rabin Medical Center, Petah Tikva, Israel. romann2@clalit.org.il
authors.forename: Roman
authors.initials: R
authors.lastname: Nevzorov
authors.forename: Avi
authors.initials: A
authors.lastname: Porath
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Henkin
authors.forename: Sergio L
authors.initials: SL
authors.lastname: Kobal
authors.forename: Alan
authors.initials: A
authors.lastname: Jotkowitz
authors.forename: Victor
authors.initials: V
authors.lastname: Novack
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality* / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies; D013318:Stroke Volume; D016019:Survival Analysis; D013599:Systole
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors