title: Long-term functional and clinical follow-up of patients with heart failure with recovered left ventricular ejection fraction after β-blocker therapy.
abstract: BACKGROUND
  Some patients with left ventricular systolic dysfunction (LVSD) have a dramatic improvement in left ventricular ejection fraction (LVEF) after β-blockade. No study has analyzed the long-term echocardiographic and clinical follow-up of this subgroup of patients.
  
  
  RESULTS
  We included in this analysis 174 consecutive patients with LVSD who had an LVEF≥45% after β-blockade. We performed a long-term echocardiographic follow-up (median 7.7 [4-9.9] years) and clinical follow-up (median 9.2 [7.2-10.8] years). LVEF improved from 33±8% to 54±6% after β-blockade (P<0.0001). At the last echocardiographic evaluation, 26% of the patients had an LVEF<45% (mean±SD: 34±6%), whereas 74% still had an LVEF≥45% (mean±SD: 54±6%). Independent predictors of LVEF deterioration were a low LVEF, a high left ventricular end-diastolic diameter and a low heart rate after β-blockade, and the presence of a complete left bundle-branch block. In the overall study population, survival rates were 90% at 5 years and 75% at 10 years. Cardiovascular death rate was 9%, noncardiovascular death rate was 11%, and unknown death rate was 3%. Patients with subsequent LVEF deterioration had a higher cardiovascular mortality compared with patients with sustained recovered LVEF (22% versus 4%).
  
  
  CONCLUSIONS
  The long-term survival of patients with LVSD and with near-normal LVEF after β-blockade is good. However, a quarter of these patients may experience a subsequent degradation of LVEF. These patients are at higher risk of cardiovascular mortality.
authors.affiliation: From the Service de Cardiologie, Pôle Cardio-Vasculaire et Pulmonaire (P.d.G., M.F., A.D.P., C.G., N.L., C.B.) and Service des Explorations Fonctionnelles Cardio-vasculaires, Pôle Imagerie et Explorations Fonctionnelles (A.D.P.), Centre Hospitalier Régional et Universitaire de Lille, France; Inserm U744, Institut Pasteur de Lille, France (P.d.G., M.F., N.L., C.B.); and Faculté de Médecine de Lille, Université de Lille, France (N.L., C.B.). pascal.degroote@chru-lille.fr.
authors.forename: Pascal
authors.initials: P
authors.lastname: de Groote
authors.affiliation: From the Service de Cardiologie, Pôle Cardio-Vasculaire et Pulmonaire (P.d.G., M.F., A.D.P., C.G., N.L., C.B.) and Service des Explorations Fonctionnelles Cardio-vasculaires, Pôle Imagerie et Explorations Fonctionnelles (A.D.P.), Centre Hospitalier Régional et Universitaire de Lille, France; Inserm U744, Institut Pasteur de Lille, France (P.d.G., M.F., N.L., C.B.); and Faculté de Médecine de Lille, Université de Lille, France (N.L., C.B.).
authors.forename: Marie
authors.initials: M
authors.lastname: Fertin
authors.affiliation: From the Service de Cardiologie, Pôle Cardio-Vasculaire et Pulmonaire (P.d.G., M.F., A.D.P., C.G., N.L., C.B.) and Service des Explorations Fonctionnelles Cardio-vasculaires, Pôle Imagerie et Explorations Fonctionnelles (A.D.P.), Centre Hospitalier Régional et Universitaire de Lille, France; Inserm U744, Institut Pasteur de Lille, France (P.d.G., M.F., N.L., C.B.); and Faculté de Médecine de Lille, Université de Lille, France (N.L., C.B.).
authors.forename: Anju
authors.initials: A
authors.lastname: Duva Pentiah
authors.affiliation: From the Service de Cardiologie, Pôle Cardio-Vasculaire et Pulmonaire (P.d.G., M.F., A.D.P., C.G., N.L., C.B.) and Service des Explorations Fonctionnelles Cardio-vasculaires, Pôle Imagerie et Explorations Fonctionnelles (A.D.P.), Centre Hospitalier Régional et Universitaire de Lille, France; Inserm U744, Institut Pasteur de Lille, France (P.d.G., M.F., N.L., C.B.); and Faculté de Médecine de Lille, Université de Lille, France (N.L., C.B.).
authors.forename: Céline
authors.initials: C
authors.lastname: Goéminne
authors.affiliation: From the Service de Cardiologie, Pôle Cardio-Vasculaire et Pulmonaire (P.d.G., M.F., A.D.P., C.G., N.L., C.B.) and Service des Explorations Fonctionnelles Cardio-vasculaires, Pôle Imagerie et Explorations Fonctionnelles (A.D.P.), Centre Hospitalier Régional et Universitaire de Lille, France; Inserm U744, Institut Pasteur de Lille, France (P.d.G., M.F., N.L., C.B.); and Faculté de Médecine de Lille, Université de Lille, France (N.L., C.B.).
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lamblin
authors.affiliation: From the Service de Cardiologie, Pôle Cardio-Vasculaire et Pulmonaire (P.d.G., M.F., A.D.P., C.G., N.L., C.B.) and Service des Explorations Fonctionnelles Cardio-vasculaires, Pôle Imagerie et Explorations Fonctionnelles (A.D.P.), Centre Hospitalier Régional et Universitaire de Lille, France; Inserm U744, Institut Pasteur de Lille, France (P.d.G., M.F., N.L., C.B.); and Faculté de Médecine de Lille, Université de Lille, France (N.L., C.B.).
authors.forename: Christophe
authors.initials: C
authors.lastname: Bauters
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D015897:Comorbidity; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology*; D015996:Survival Rate; D013599:Systole / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*
chemical_list: D000319:Adrenergic beta-Antagonists
keywords: adrenergic beta-antagonists; heart failure, systolic; prognosis; ventricular dysfunction, left