{"id":"12b01b4f99c5","type":"article","url":"https://hartvaat.nl/2021/11/23/betablokkerstaken-en-functionele-capaciteit-bij-hfpef/","title":"Bètablokkerstaken en functionele capaciteit bij HFpEF","title_en":"Effect of β-Blocker Withdrawal on Functional Capacity in Heart Failure and Preserved Ejection Fraction.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2021.08.073","source_url":"https://doi.org/10.1016/j.jacc.2021.08.073","authors":["Patricia Palau","Julia Seller","Eloy Domínguez","Clara Sastre","Jose María Ramón","Rafael de La Espriella","Enrique Santas","Gema Miñana","Vicent Bodí","Juan Sanchis","Alfonso Valle","F Javier Chorro","Pau Llácer","Antoni Bayés-Genís","Julio Núñez"],"significance":6,"published":"2021-11-23","source_date":"2021-11-23","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/betablokkers-cardiale-indicaties/"],"congress":"","summary_en":"This study showed that beta-blocker withdrawal in HFpEF patients improves chronotropic response and functional capacity, providing evidence that beta-blockers may be counterproductive in preserved ejection fraction heart failure.","created":"2026-07-03T10:29:30Z","updated":"2026-07-03T13:28:37Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar het effect van bètablokker-onttrekking op functionele capaciteit bij HFpEF.","abstract_original":"BACKGROUND: Chronotropic incompetence has shown to be associated with a decrease in exercise capacity in heart failure with preserved ejection fraction (HFpEF), yet β-blockers are commonly used in HFpEF despite the lack of robust evidence. OBJECTIVES: This study aimed to evaluate the effect of β-blocker withdrawal on peak oxygen consumption (peak Vo2) in patients with HFpEF and chronotropic incompetence. METHODS: This is a multicenter, randomized, investigator-blinded, crossover clinical trial consisting of 2 treatment periods of 2 weeks separated by a washout period of 2 weeks. Patients with stable HFpEF, New York Heart Association functional classes II and III, previous treatment with β-blockers, and chronotropic incompetence were first randomized to withdrawing from (arm A: n = 26) versus continuing (arm B: n = 26) β-blocker treatment and were then crossed over to receive the opposite intervention. Changes in peak Vo2 and percentage of predicted peak Vo2 (peak Vo2%) measured at the end of the trial were the primary outcome measures. To account for the paired-data nature of this crossover trial, linear mixed regression analysis was used. RESULTS: The mean age was 72.6 ± 13.1 years, and most of the patients were women (59.6%) in New York Heart Association functional class II (66.7%). The mean peakVo2 and peak Vo2% were 12.4 ± 2.9 mL/kg/min, and 72.4 ± 17.8%, respectively. No significant baseline differences were found across treatment arms. Peak Vo2 and peak Vo2% increased significantly after β-blocker withdrawal (14.3 vs 12.2 mL/kg/min [Δ +2.1 mL/kg/min]; P < 0.001 and 81.1 vs 69.4% [Δ +11.7%]; P < 0.001, respectively). CONCLUSIONS: β-blocker withdrawal improved maximal functional capacity in patients with HFpEF and chronotropic incompetence. β-blocker use in HFpEF deserves profound re-evaluation. (β-blockers Withdrawal in Patients With HFpEF and Chronotropic Incompetence: Effect on Functional Capacity [PRESERVE-HR]; NCT03871803; 2017-005077-39)."}