ß-Blocker Therapy has been shown to improve mortality and reduce hospitalizations in patients with heart failure (HF) with reduced ejection fraction (HFrEF). Its effects on right ventricular (RV) function have not been prospectively well studied. Objective. The aim of this prospective study was to:

– evaluate if ß-Blocker Therapy impacts RV remodelling based on echo parameters;

– sought the echo predictive factors of ß-Blocker therapy response.

From September 2017 to September 2018, HF patients were prospectively enrolled using CIBIS criteria: Class II, III, or IV HF; left ventricular ejection fraction (LVEF) <40%; hospitalized for HF within the previous 12 months. Echo evaluation was performed before initiating ß-Blocker therapy and 3 months after optimal dose adjustment. Patients with improvement in LVEF ≥5% were considered significant ß-Blocker therapy responders.

Forty patients completing the study. The final population comprised 32 pts (79%): 2 did not tolerate ß-Blocker therapy, 1 was lost of follow-up, 5 did not pursue the protocol. Several echo parameters significantly improved: LVEF from 31.7±9 to 40.5±9 (P<0.0001); LV end-diastolic volume from 154±54 to 143±45ml (P=0.06); LV end-systolic volume from 107±49 to 88±37ml (P=0.0006); LV ES from 46±11 to 64±13ml (P=0.008), right ventricular size decreased (30±4 vs. 27±5; P=0.03), right ventricular systolic function improved significantly based on the tricuspid annular plane systolic excursion (16.5±4 vs. 19±4mm; .0006); tricuspid lateral annular systolic velocity wave (10±2 vs. 11.3±3cm/s; P=0.03); and Tei index (0.5±.1 vs. 0.46±.1; P=0.04). ß-Blocker echo responders (n=23/32; 72%) exhibited the same left and right echo parameters. No echo variables predicted the ß-Blocker response (Fig. 1).

In HFrEF patients, ß-Blocker therapy significantly improves LV and RV systolic remodelling.