Effects of beta blockers on left ventricular diastolic function: the importance of optimal heart rate reduction

Abstract

Left ventricular (LV) diastolic dysfunction is an important cause of heart failure in hypertensive heart disease.The aim of this study is to establish the effects of beta blockers on LV diastolic function and long axis motion in patients with arterial hypertension.

Methods — Sixty patients (aged 55 ± 8 y) with mild-to-moderate arterial hypertension were treated with beta blockers for 12 weeks. Clinical and echocardiographic assessment was done prior to and after the treatment. Doppler transmitral flow velocity recording was used to evaluate left ventricular diastolic function. Left ventricular long axis function was analysed using digitized M-mode tracings of mitral annulus motion.

Results — Therapy with beta blockers resulted in an increase in the transmitral early to late diastolic velocity ratio (from 0.90 ± 0.22 m/s to 1.00 ± 0.26 m/s, P < 0.05), and systolic amplitude of mitral annulus motion (from 7.9 ± 1.5 mm to 8.4 ± 1.6 mm, P < 0.05). The changes in left ventricular diastolic function and mitral annulus motion parameters were related to changes in heart rate. When the heart rate was reduced to 57-68 bpm, left ventricular diastolic and long axis functions improved.

Conclusion — Beta blockers can improve left ventricular diastolic and long axis function when a significant heart rate reduction is achieved in patients with mild-to-moderate arterial hypertension.

Key Words:

• beta blockers
• arterial hypertension
• diastolic function
• heart rate