Myocardial strain to identify benefit from beta‐blockers in patients with heart failure with reduced ejection fraction

Abstract

Abstract Aims Not all patients with heart failure with reduced ejection fraction (HFrEF) benefit equally from beta‐blockers. Previous studies suggest that myocardial strain that reflects myocardial deformation may have a better prognostic value than the left ventricular ejection fraction. We aimed to evaluate the differential effect of beta‐blockers according to the global longitudinal strain (GLS) in patients with HFrEF. Methods and results Of the 4312 patients in the Strain for Risk Assessment and Therapeutic Strategies in Patients with Acute Heart Failure registry, we included 2126 HFrEF patients whose data on beta‐blocker use and GLS were available. Patients were categorized into two groups: one group of patients had GLS ≥ 10%, and the other group had GLS 0.05). Conclusions Beta‐blocker use appears to be associated with improved survival in patients with HFrEF and GLS < 10%, but this is not the case in patients with GLS ≥ 10%. Therefore, GLS may be used to identify patients who have attenuated benefits from beta‐blockers in HFrEF. Clinical Trial Registration: ClinicalTrials.gov: NCT03513653 (https://clinicaltrials.gov/ct2/show/NCT03513653).

Keywords

• Beta‐blocker
• Heart failure with reduced ejection fraction
• Mortality
• Myocardial strain
• Prognosis