β-blocker therapy in patients after aortic valve replacement for aortic regurgitation

Background: β-blocker therapy for dilated or ischemic cardiomyopathy is now an accepted and effective treatment. However, little is known about its efficacy in patients with postoperative impaired left ventricular function. This retrospective study was designed to assess the effects of β-blocker therapy in patients after aortic valve replacement (AVR) for aortic regurgitation (AR). Methods: A total of 59 patients who underwent AVR for chronic AR were assigned to four groups. Twelve patients were treated with both ACE inhibitors and β-blockers, 12 patients with only ACE inhibitors, eight patients with only β-blockers, and 27 patients without β-blockers or ACE inhibitors. A postoperative echocardiographic study was performed one year after surgery. Results: The heart rate was significantly reduced in patients with β-blockers despite the use of ACE inhibitors after surgery. Postoperative left ventricular volume was more significantly decreased in β patients than in non-β patients despite the use of ACE inhibitors. There were also significant reductions in left ventricular mass index in ACE+β patients compared to ACE+non-β patients. However, there were no significant differences in NYHA functional class and survival rate between β patients and non-β patients. Conclusions: β-blocker therapy may improve cardiac performance by reducing cardiac volume and mass in patients with impaired LV function after AVR for AR.