title: Beta blockers therapy is associated with improved left ventricular systolic function and sustained exercise capacity in elderly patients with heart failure. CIBIS-ELD sub-study.
abstract: BACKGROUND
  Exercise capacity is critical for therapy and prognosis in patients with heart failure (HF). Effect of beta-blockers (BB) on exercise capacity in elderly patients with HF remains unclear.
  
  
  OBJECTIVE
  To assess contribution of BB to functional capacity and left ventricular (LV) function in the elderly with HF.
  
  
  METHODS
  According to the protocol of CIBIS-ELD study group, elderly patients were treated with BB during 12 weeks. In CPET subgroup, an integral part of the CIBIS ELD study group, patients were performed Doppler echocardiography and cardiopulmonary exercise testing (CPET) before BB therapy and after 12 weeks.
  
  
  METHODS
  Randomized patients with HF beta blockers naïve.
  
  
  METHODS
  thirty patients with HF aged over 65 years were included in CPET subgroup, while 847 were incorporated in CIBIS ELD study group.
  
  
  RESULTS
  Heart rate (HR) and systolic blood pressure (SBP) after BB significantly decreased at rest (p<0.001) and during exercise (p<0.05), with sustained level of peak VO2. Observed changes of resting HR and peak HR were closely correlated (p<0.001). Significant improvement of LV ejection fraction after BB was obtained (p=0.003) and symptoms of breathlessness were reduced (p=0.001). Left ventricular diastolic dysfunction at rest significantly contributed to exercise capacity (p=0.019).
  
  
  CONCLUSIONS
  Beta-blockers in elderly patients with HF are related to a significant decrease of HR and SBP, improvement of systolic LV function and sustained exercise tolerance. Resting LV diastolic dysfunction is strongly associated with lower exercise capacity.
authors.affiliation: School of Medicine University of Belgrade, University Clinical Centre Zvezdara Belgrade, Serbia. mildek@sbb.rs
authors.forename: Milica
authors.initials: M
authors.lastname: Dekleva
authors.forename: Hans-Dirk
authors.initials: HD
authors.lastname: Düngen
authors.forename: Götz
authors.initials: G
authors.lastname: Gelbrich
authors.forename: Simone
authors.initials: S
authors.lastname: Incrot
authors.forename: Jelena
authors.initials: J
authors.lastname: Suzic Lazic
authors.forename: Milena
authors.initials: M
authors.lastname: Pavlovic Kleut
authors.forename: Elvis
authors.initials: E
authors.lastname: Tahirovic
authors.forename: Finn
authors.initials: F
authors.lastname: Waagstein
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D000375:Aging / Q000502:physiology; D017298:Bisoprolol / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects; D002227:Carbazoles / Q000008:administration & dosage; D000077261:Carvedilol; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D011412:Propanolamines / Q000008:administration & dosage; D011446:Prospective Studies; D016277:Ventricular Function, Left / Q000187:drug effects* / Q000502:physiology
chemical_list: D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D017298:Bisoprolol