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Review Article

IJMDC. 2023; 7(4): 687-694


β-blocker dose, heart rate reduction, and death in patients with heart f ailure: a systematic review

Maram Alomari, Abdullah Alyahia, Nuha Al Otaibi, Naif Al Ruais, Norah Alzayed, Dhaifallah Alotaibi.




Abstract

Background: In individuals with systolic chronic Heart failure (HF), β-blockers enhance cardiac function and increase survival. The precise processes driving these advantages are unclear, though. It is uncertain if there is a direct link between clinical results with these medications and heart rate (HR) decrease. According to recommendations, β-blockers should be administered to individuals with HF at effective dosages in clinical studies. It is unknown if the advantages of β-blockade are dose-related, even though the disadvantages are.
Aim: To investigate the survival benefits of β-blockade in HF and its association with the level of HR reduction or the β-blocker dose.
Methods: This is an updated systematic review of studies discussing the survival benefits of β-blockade in HF and its association with the level of HR reduction or the β-blocker dose between 2020 and 2022. The PubMed and Google Scholar databases were used to explore studies regarding our subject. The keywords included “β-blocker Dose, Heart Rate Reduction, Death, Patients, and Heart Failure,” and were used in various combinations. The inclusion criteria were original studies that reported the survival benefits of β-blockade in HF and its association with the level of HR reduction or the β-blocker dose and full-text articles.
Results: Though 240 articles were obtained, only 8 of them met the inclusion criteria. The studies included more than 120,348 patients: 4 prospective studies, 1 case series, 1 multicenter, a randomized clinical trial, and 2 observational cohort studies.
Conclusion: Oral β-blocker therapy was independently associated with a lower risk of poor in-hospital outcomes in sore throat speech therapy (ST)-elevation myocardial infarction patients with Killip class II or III HF. In individuals with chronic or acute coronary syndrome, an HR of 70 bpm was related to poorer clinical indicators and prognosis. β-blocker therapy was independently associated with a lower risk of all-cause death. In HF patients with reduced ejection fraction with advanced chronic kidney disease, using β-blockers was linked to decreased morbidity and death rates. Moreover, HF patients who receive medical treatment with βb can reverse exercise oscillatory ventilation.

Key words: β-blocker dose, heart rate reduction, death, patients, and heart failure.






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