Current patterns of beta-blocker prescription in cardiac amyloidosis: an Italian nationwide survey.
Autor: | Tini G; Department of Internal Medicine, University of Genova, Viale Benedetto XV, 10, Genova, 16132, Italy.; Cardiology, Clinical and Molecular Medicine Department, Sapienza University of Rome, Rome, Italy., Cappelli F; Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy., Biagini E; Cardiology Unit, St. Orsola Hospital, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Musumeci B; Cardiology, Clinical and Molecular Medicine Department, Sapienza University of Rome, Rome, Italy., Merlo M; Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy., Crotti L; Department of Cardiovascular, Neural and Metabolic Sciences, University of Milano-Bicocca, Istituto Auxologico Italiano, IRCCS, Milan, Italy., Cameli M; Department of Medical Biotechnologies, Section of Cardiology, University of Siena, Siena, Italy., Di Bella G; Rare Cardiac Disease Center, Cardiology Unit, University of Messina, Messina, Italy., Cipriani A; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy., Marzo F; Cardiology Unit, Infermi Hospital, Rimini, Italy., Guerra F; Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital 'Ospedali Riuniti Umberto I -Lancisi - Salesi', Ancona, Italy., Forleo C; Cardiology Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, University Hospital Policlinico Consorziale, Bari, Italy., Gagliardi C; Cardiology Unit, St. Orsola Hospital, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Zampieri M; Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy., Carigi S; Cardiology Unit, Infermi Hospital, Rimini, Italy., Vianello PF; Department of Internal Medicine, University of Genova, Viale Benedetto XV, 10, Genova, 16132, Italy., Mandoli GE; Department of Medical Biotechnologies, Section of Cardiology, University of Siena, Siena, Italy., Ciliberti G; Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital 'Ospedali Riuniti Umberto I -Lancisi - Salesi', Ancona, Italy., Lichelli L; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy., Mariani D; Department of Cardiovascular, Neural and Metabolic Sciences, University of Milano-Bicocca, Istituto Auxologico Italiano, IRCCS, Milan, Italy., Porcari A; Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy., Russo D; Cardiology, Clinical and Molecular Medicine Department, Sapienza University of Rome, Rome, Italy., Licordari R; Rare Cardiac Disease Center, Cardiology Unit, University of Messina, Messina, Italy., Ponziani A; Cardiology Unit, St. Orsola Hospital, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Porto I; Department of Internal Medicine, University of Genova, Viale Benedetto XV, 10, Genova, 16132, Italy.; Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino - IRCCS Italian Cardiovascular Network, Genova, Italy., Perfetto F; Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy., Autore C; Cardiology, Clinical and Molecular Medicine Department, Sapienza University of Rome, Rome, Italy., Rapezzi C; University Cardiological Center, University of Ferrara, Ferrara, Italy.; Maria Cecilia Hospital, GVM Care & Research, Ravenna, Italy., Sinagra G; Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy., Canepa M; Department of Internal Medicine, University of Genova, Viale Benedetto XV, 10, Genova, 16132, Italy.; Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino - IRCCS Italian Cardiovascular Network, Genova, Italy. |
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Jazyk: | angličtina |
Zdroj: | ESC heart failure [ESC Heart Fail] 2021 Aug; Vol. 8 (4), pp. 3369-3374. Date of Electronic Publication: 2021 May 14. |
DOI: | 10.1002/ehf2.13411 |
Abstrakt: | Aims: The use of beta-blocker therapy in cardiac amyloidosis (CA) is debated. We aimed at describing patterns of beta-blocker prescription through a nationwide survey. Methods and Results: From 11 referral centres, we retrospectively collected data of CA patients with a first evaluation after 2016 (n = 642). Clinical characteristics at first and last evaluation were collected, with a focus on medical therapy. For patients in whom beta-blocker therapy was started, stopped, or continued between first and last evaluation, the main reason for beta-blocker management was requested. Median age of study population was 77 years; 81% were men. Arterial hypertension was found in 58% of patients, atrial fibrillation (AF) in 57%, and coronary artery disease in 16%. Left ventricular ejection fraction was preserved in 62% of cases, and 74% of patients had advanced diastolic dysfunction. Out of the 250 CA patients on beta-blockers at last evaluation, 215 (33%) were already taking this therapy at first evaluation, while 35 (5%) were started it, in both cases primarily because of high-rate AF. One-hundred-nineteen patients (19%) who were on beta-blocker at first evaluation had this therapy withdrawn, mainly because of intolerance in the presence of heart failure with advanced diastolic dysfunction. The remaining 273 patients (43%) had never received beta-blocker therapy. Beta-blockers usage was similar between CA aetiologies. Patients taking vs. not taking beta-blockers differed only for a greater prevalence of arterial hypertension, coronary artery disease, AF, and non-restrictive filling pattern (P < 0.01 for all) in the former group. Conclusions: Beta-blockers prescription is not infrequent in CA. Such therapy may be tolerated in the presence of co-morbidities for which beta-blockers are routinely used and in the absence of advanced diastolic dysfunction. (© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.) |
Databáze: | MEDLINE |
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