Pharmacological left ventricular reverse remodeling in elderly patients receiving optimal therapy for chronic heart failure

Giovanni Cioffi, Luigi Tarantini, Stefania De Feo, Giovanni Pulignano, Donatella Del Sindaco, Carlo Stefenelli, Cristina Opasich

Research output: Contribution to journalArticle

Abstract

Background and aims: In recent years, reversal of established left ventricular (LV) dilatation has been increasingly recognized in middle-aged patients with dilated cardiomyopathy receiving angiotensin-converting enzyme (ACE) inhibitors and/or beta-blockers. We performed this prospective study to evaluate whether optimized therapy for heart failure also induces LV reverse remodeling in older patients. Methods: One hundred and twenty-four patients aged >70 years with LV ejection fraction 25% from baseline to final evaluation. LV reverse remodeling was recognized in 32 patients (26%). Compared to the subjects who did not improve LV geometry, those with reverse remodeling had, at baseline, higher arterial blood pressure, lower serum creatinine levels, shorter duration of symptoms of heart failure, more frequently received beta-blocker therapy and had predominantly nonischemic aetiology. The variables associated with the development of reverse remodeling in the multivariate analysis were shorter duration of symptoms of heart failure (Odds ratio: 7.7; CI: 2.5-23.3, p=0.0001) and beta-blocker therapy (Odds ratio: 6.0; CI: 1.6-23.3, p=0.01). Conclusions: LV reverse remodeling takes place in elderly as well as in younger heart failure patients. A significant proportion of elderly patients undergoes this favourable process which occurs prevalently in patients receiving beta-blocker therapy with a short history of cardiac disease.

Original languageEnglish
Pages (from-to)1040-1048
Number of pages9
JournalEuropean Journal of Heart Failure
Volume7
Issue number6
DOIs
Publication statusPublished - Oct 2005

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Keywords

  • Chronic heart failure
  • Dilated cardiomyopathy
  • Elderly population
  • Left ventricular reverse remodeling
  • Left ventricular systolic dysfunction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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