Beta-blockers and heart failure with mildly reduced and preserved ejection fraction. A personalized approach beyond the heart failure syndrome phenotypes is needed
This article relates to:
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Beta-blocker use and outcomes in patients with heart failure and mildly reduced and preserved ejection fraction
- Shingo Matsumoto,
- Alasdair D. Henderson,
- Li Shen,
- Toru Kondo,
- Mingming Yang,
- Ross T. Campbell,
- Inder S. Anand,
- Rudolf A. de Boer,
- Akshay S. Desai,
- Carolyn S.P. Lam,
- Aldo P. Maggioni,
- Felipe A. Martinez,
- Milton Packer,
- Margaret M. Redfield,
- Jean L. Rouleau,
- Dirk J. Van Veldhuisen,
- Muthiah Vaduganathan,
- Faiez Zannad,
- Michael R. Zile,
- Pardeep S. Jhund,
- Scott D. Solomon,
- John J.V. McMurray,
- Volume 27Issue 1European Journal of Heart Failure
- pages: 124-139
- First Published online: August 31, 2024
Corresponding Author
José Ramón González-Juanatey
Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain
Centro de Investigación Biomédica en Red-Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
Servicio de Cardiología, Complejo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
Corresponding author. Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Choupana s/n, PC 15706, Santiago de Compostela, A Coruña, Spain. Email: [email protected]
Search for more papers by this authorOscar Otero-García
Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain
Centro de Investigación Biomédica en Red-Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
Servicio de Cardiología, Complejo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
Search for more papers by this authorMichael Böhm
Klinik für Innere Medizin III - Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
Search for more papers by this authorCorresponding Author
José Ramón González-Juanatey
Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain
Centro de Investigación Biomédica en Red-Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
Servicio de Cardiología, Complejo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
Corresponding author. Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Choupana s/n, PC 15706, Santiago de Compostela, A Coruña, Spain. Email: [email protected]
Search for more papers by this authorOscar Otero-García
Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain
Centro de Investigación Biomédica en Red-Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
Servicio de Cardiología, Complejo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
Search for more papers by this authorMichael Böhm
Klinik für Innere Medizin III - Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
Search for more papers by this authorThe opinions expressed in this article are not necessarily those of the Editors of the European Journal of Heart Failure or of the European Society of Cardiology. doi: 10.1002/ejhf.3383.

References
- 1Packer M. A reclassification of heart failure based on recognition of heart failure with normal to supernormal ejection fraction, a clinically common form of cardiac contracture, with distinctive pathophysiological and therapeutic features. Eur J Heart Fail 2023; 25: 669–672. https://doi.org/10.1002/ejhf.2849
- 2Khan MS, Shahid I, Fonarow GC, Greene SJ. Classifying heart failure based on ejection fraction: Imperfect but enduring. Eur J Heart Fail 2022; 24: 1154–1157. https://doi.org/10.1002/ejhf.2470
- 3Uijl A, Savarese G, Vaartjes I, Dahlström U, Brugts JJ, Linssen GCM, et al. Identification of distinct phenotypic clusters in heart failure with preserved ejection fraction. Eur J Heart Fail 2021; 23: 973–982. https://doi.org/10.1002/ejhf.2169
- 4McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2022; 24: 4–131. https://doi.org/10.1002/ejhf.2333
- 5Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA Guideline for the management of heart failure: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2022; 145: e895–e1032. https://doi.org/10.1161/CIR.0000000000001063
- 6Cleland JGF, Bunting KV, Flather MD, Altman DG, Holmes J, Coats AJS, et al.; Beta-blockers in Heart Failure Collaborative Group. Beta-blockers for heart failure with reduced, mid-range, and preserved ejection fraction: An individual patient-level analysis of double-blind randomized trials. Eur Heart J 2018; 39: 26–35. https://doi.org/10.1093/eurheartj/ehx564
- 7Yndigegn T, Lindahl B, Mars K, Alfredsson J, Benatar J, Brandin L, et al.; REDUCE-AMI Investigators. Beta-blockers after myocardial infarction and preserved ejection fraction. N Engl J Med 2024; 390: 1372–1381. https://doi.org/10.1056/NEJMoa2401479
- 8Arnold SV, Silverman DN, Gosch K, Nassif ME, Infeld M, Litwin S, et al. Beta-blocker use and heart failure outcomes in mildly reduced and preserved ejection fraction. JACC Heart Fail 2023; 11: 893–900. https://doi.org/10.1016/j.jchf.2023.03.017
- 9Anker SD, Usman MS, Anker MS, Butler J, Böhm M, Abraham WT, et al. Patient phenotype profiling in heart failure with preserved ejection fraction to guide therapeutic decision making. A scientific statement of the Heart Failure Association, the European Heart Rhythm Association of the European Society of Cardiology, and the European Society of Hypertension. Eur J Heart Fail 2023; 25: 936–955. https://doi.org/10.1002/ejhf.2894
- 10Peikert A, Bart BA, Vaduganathan M, Claggett BL, Kulac IJ, Kosiborod MN, et al. Contemporary use and implications of beta-blockers in patients with HFmrEF or HFpEF: The DELIVER trial. JACC Heart Fail 2024; 12: 631–644. https://doi.org/10.1016/j.jchf.2023.09.007
- 11Kaddoura R, Madurasinghe V, Chapra A, Abushanab D, Al-Badriyeh D, Patel A. Beta-blocker therapy in heart failure with preserved ejection fraction (B-HFpEF): A systematic review and meta-analysis. Curr Probl Cardiol 2024; 49:102376. https://doi.org/10.1016/j.cpcardiol.2024.102376
- 12Matsumoto S, Henderson AD, Shen L, Kondo T, Yang M, Campbell RT, et al. Beta-blocker use and outcomes in patients with heart failure and mildly reduced and preserved ejection fraction. Eur J Heart Fail 2025; 27: 124–139. https://doi.org/10.1002/ejhf.3383
- 13Musse M, Lau JD, Yum B, Pinheiro LC, Curtis H, Anderson T, et al. Physician perspectives on the use of beta blockers in heart failure with preserved ejection fraction. Am J Cardiol 2023; 193: 70–74. https://doi.org/10.1016/j.amjcard.2023.01.050