CHICAGO — Treatment with a β-blocker may enhance survival in patients with severe aortic regurgitation, based on a retrospective review of 756 patients from one center.
Conventional wisdom has counseled against treating aortic-regurgitation patients with a β-adrenergic receptor antagonist, out of concern that a slowed heart rate will increase the duration of diastole, which is when regurgitation occurs, Dr. Unnati Sampat and her associates said in a poster presented at the annual meeting of the American College of Cardiology.
Despite this, of the 756 patients with severe aortic regurgitation seen at Loma Linda (Calif.) University Medical Center during 1993–2007, 47% were treated with a β-blocker. The contrarian rationale for β-blocker treatment is that because aortic regurgitation produces neuroendocrine activation similar to heart failure, treatment with a β-blocker may be beneficial.
The average age of all the regurgitation patients was 61 years, and 59% were men.
During a mean follow-up of 4.5 years, treatment with a β-blocker was associated with better survival. After the first year of follow-up, survival was 90% in the patients on a β-blocker, compared with a 75% survival rate among the other patients. By the end of 5 years of follow-up, 70% of patients on β-blockers were still alive, compared with 55% of patients not on a β-blocker.
In a multivariate analysis that controlled for demographics, comorbidities, and baseline treatments, treatment with a β-blocker cut the risk of death in regurgitation by about 25%, a statistically significant effect, reported Dr. Sampat, a cardiology researcher at Loma Linda, and her associates.