title: Effects of β-adrenergic blockade on left ventricular remodeling among Hispanics and African Americans with chronic heart failure.
abstract: BACKGROUND
  Although β-blockers (BBs) have been shown to improve cardiac function, there is individual and ethnic variation in BB clinical response. We examined the effects of BBs on left ventricular remodeling among African Americans (AAs), Hispanics, and Caucasians with systolic heart failure.
  
  
  OBJECTIVE
  There is ethnic variability in the effects of BBs on cardiac remodeling.
  
  
  METHODS
  There were 185 AAs, 159 Hispanics, and 74 Caucasians selected with ejection fraction ≤ 40% from any etiology. Change in left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimensions (LVEDD), and degree of mitral regurgitation (MR) in response to 1 year of BBs was evaluated retrospectively.
  
  
  RESULTS
  Overall, there was a significant improvement in LVEF, LVEDD, and degree of MR in AAs and Caucasians after 1 year of BBs (P < 0.001 vs baseline). Compared with other races, Hispanics (%) had no significant improvement in LVEDD and degree of MR, and had fewer patients with reverse remodeling: LVEF (42.77%), LVEDD (5.03%), and MR (16.35%). In multivariable analysis, Hispanic and AA race were important predictors of LVEF and LVEDD (P < 0.01) but not MR response.
  
  
  CONCLUSIONS
  Although most patients demonstrated improvement of LVEF, there seems to be ethnic variability in the effects of BBs on cardiac remodeling. Degree of MR and LVEDD failed to show improvement among Hispanics.
authors.affiliation: Department of Medicine, Division of Cardiology Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York.
authors.forename: Iosif
authors.initials: I
authors.lastname: Kelesidis
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Varughese
authors.forename: Patrick
authors.initials: P
authors.lastname: Hourani
authors.forename: Ronald
authors.initials: R
authors.lastname: Zolty
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001741:Black or African American; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology / Q000503:physiopathology; D006630:Hispanic or Latino; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000188:drug therapy / Q000208:ethnology / Q000503:physiopathology; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D016277:Ventricular Function, Left / Q000187:drug effects*; D020257:Ventricular Remodeling / Q000187:drug effects*; D044465:White People
chemical_list: D000319:Adrenergic beta-Antagonists
references.citation: J Am Coll Cardiol. 2009 Apr 7;53(14):1167-75
references.pmid: 19341856
references.citation: Nat Med. 2003 Oct;9(10):1300-5
references.pmid: 14502278
references.citation: J Card Fail. 2000 Sep;6(3):183-6
references.pmid: 10997742
references.citation: Diabetes Care. 1991 Jul;14(7):628-38
references.pmid: 1914812
references.citation: Am J Cardiol. 2004 May 6;93(9A):43B-8B
references.pmid: 15144937
references.citation: J Health Care Poor Underserved. 2002 Nov;13(4):477-503
references.pmid: 12407964
references.citation: Heart. 2003 Mar;89(3):293-8
references.pmid: 12591834
references.citation: Am J Cardiol. 2005 Oct 1;96(7):956-63
references.pmid: 16188524
references.citation: Circ Heart Fail. 2012 Mar 1;5(2):167-75
references.pmid: 22414939
references.citation: Circulation. 1991 Dec;84(6):2426-41
references.pmid: 1683602
references.citation: N Engl J Med. 1999 Feb 25;340(8):609-16
references.pmid: 10029645
references.citation: Circulation. 1996 Dec 1;94(11):2807-16
references.pmid: 8941106
references.citation: J Am Coll Cardiol. 1994 Dec;24(7):1678-87
references.pmid: 7963115
references.citation: N Engl J Med. 1996 May 23;334(21):1349-55
references.pmid: 8614419
references.citation: Circulation. 1994 Apr;89(4):1632-42
references.pmid: 7908610
references.citation: J Am Coll Cardiol. 2003 May 7;41(9):1529-38
references.pmid: 12742294
references.citation: Circulation. 1996 Dec 1;94(11):2817-25
references.pmid: 8941107
references.citation: Curr Control Trials Cardiovasc Med. 2001;2(1):20-23
references.pmid: 11806769
references.citation: N Engl J Med. 1996 Nov 21;335(21):1597-9
references.pmid: 8900095
references.citation: J Card Fail. 1999 Sep;5(3):178-87
references.pmid: 10496190
references.citation: Circulation. 2005 Mar 15;111(10):1313-20
references.pmid: 15769774
references.citation: Ethn Dis. 2007 Summer;17(3):568-73
references.pmid: 17985515
references.citation: Circulation. 2000 Aug 1;102(5):546-51
references.pmid: 10920067
references.citation: Am J Cardiol. 1999 Apr 15;83(8):1201-5
references.pmid: 10215284
references.citation: Clin Pharmacol Ther. 2005 Sep;78(3):221-31
references.pmid: 16153393
references.citation: Pharmacogenet Genomics. 2005 Apr;15(4):227-34
references.pmid: 15864115
references.citation: N Engl J Med. 2001 May 31;344(22):1651-8
references.pmid: 11386263
references.citation: Am J Public Health. 2005 Dec;95(12):2161-8
references.pmid: 16257940
references.citation: J Am Coll Cardiol. 1999 Nov 1;34(5):1522-8
references.pmid: 10551702
references.citation: J Am Coll Cardiol. 2010 Jan 19;55(3):234-42
references.pmid: 20117402
references.citation: Congest Heart Fail. 2010 Jul-Aug;16(4):175-80
references.pmid: 20662871
references.citation: N Engl J Med. 2001 May 31;344(22):1659-67
references.pmid: 11386264
references.citation: J Am Coll Cardiol. 1997 Apr;29(5):1060-6
references.pmid: 9120160
references.citation: Am J Epidemiol. 2008 Apr 15;167(8):962-9
references.pmid: 18283034
references.citation: Lancet. 2001 May 5;357(9266):1385-90
references.pmid: 11356434
references.citation: Heart. 2005 Nov;91(11):1471-2
references.pmid: 16230448
references.citation: Am J Epidemiol. 2003 Dec 1;158(11):1048-57
references.pmid: 14630600
references.citation: Heart Fail Rev. 2010 May;15(3):187-96
references.pmid: 18437562
references.citation: Proc Natl Acad Sci U S A. 2006 Jul 25;103(30):11288-93
references.pmid: 16844790
references.citation: Clin Cardiol. 2012 Aug;35(8):505-11
references.pmid: 22488122
references.citation: J Am Coll Cardiol. 2011 Mar 29;57(13):1468-76
references.pmid: 21435516