Ivabradine has no Effect on Cardiac Arrhythmias Observed During Dobutamine Infusion: A Comparative Study with β Blocker Therapy

Çavuşoğlu, Yüksel; Mert, Kadir Uğur; Nadir, Aydın; Mutlu, Fezan; Morrad, Bektas; Ulus, Taner

doi:10.1016/j.jacc.2013.08.327

Cited by 2 publications

(1 citation statement)

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“…In the setting of acute decompensated heart failure requiring inotropic support, BBs have shown to reduce the rate of V/I-induced ventricular arrhythmias, lower rates of premature ventricular contractions, ventricular couplets, and total ventricular arrhythmias [ 11 , 12 ]. In a randomized, double-blind, multi-center study by Böhm and colleagues, the investigators showed that in patients with acute heart failure requiring inotropes, BBs on admission and at discharge led to lower 31-day mortality, and thus recommended continuation while in the hospital [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

The Usage of Concomitant Beta-Blockers with Vasopressors and Inotropes in Cardiogenic Shock

Ryu

Hauschild²,

Bahjri³

et al. 2022

Medical Sciences

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Vasopressors and inotropes (Vs/Is) are widely used in the treatment of cardiogenic shock (CS). Despite improvements in hemodynamic variables and end-organ perfusion, these agents have been associated with an increase in mortality, potentially due to the increased risk of tachyarrhythmias—which we hypothesize may be mitigated by beta-blockers (BBs). We conducted a retrospective chart review of patients who received a V/I (dobutamine, milrinone, dopamine, and norepinephrine) for CS. The primary objective was to assess the effect of BB in patients receiving Vs/Is for CS. In our final analysis of 227 patients, those in the BB group were younger, were more likely to have acute coronary syndrome as the reason for admission, had more reduced left ventricular ejection fraction, were more likely to have coronary artery disease and atrial fibrillation as pre-existing co-morbidities, and had a lower rate of in-hospital mortality. Nevertheless, in our multivariable logistic regression analysis, concurrent BB usage with a V/I was not associated with a reduction in in-hospital mortality. Our present study sheds light on the importance and urgency of large, carefully designed clinical studies to optimize inpatient medical therapy, particularly evaluating the combination of V/I and BB, in this high-risk patient population.

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Section: Discussionmentioning

confidence: 99%

The Usage of Concomitant Beta-Blockers with Vasopressors and Inotropes in Cardiogenic Shock

Ryu

Hauschild²,

Bahjri³

et al. 2022

Medical Sciences

View full text Add to dashboard Cite

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The characterization of concomitant beta-blocker usage with vasopressors and inotropes in cardiogenic shock

Ryu

Hauschild

Bahjri

et al. 2022

Preprint

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Purpose: Vasopressors and inotropes (V/I) are widely used in the treatment of cardiogenic shock (CS). Despite improvement of hemodynamic variables and end-organ perfusion, these agents have been associated with increases in mortality, potentially due to the increased risk of tachyarrhythmias—which may be mitigated by beta-blockers (BB). Methods: We conducted a retrospective chart review of patients who received a V/I (dobutamine, milrinone, dopamine, and norepinephrine). The primary objective was to assess for the role of BB in patients receiving V/I for CS. Descriptive statistics in the form of mean and standard deviation were used for quantitative variables, and number and percentage for qualitative variables. The Chi-square test or Fisher's exact tests were used to assess the association of different variables with mortality status. Results: When comparing between those that received BB vs those that did not, the mean HR was significantly higher in those that received BB (90 v 82 bpm, p=0.002). At maximum V/I doses, the SBP was significantly lower in those that received BB (99 vs 111 mmHg, p<0.001). Upon exclusion of those on high doses of V/I, the multivariate logistic regression did not show a difference in mortality between those that received BB vs those that did not (44.4 vs 55.6%, p=0.637).Conclusions: Based on our study, concomitant BB use with a V/I in CS patients was not associated with mortality. Our present study sheds light on the importance and urgency of large, carefully designed clinical studies to optimize inpatient medical therapy in this high-risk patient population.

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Ivabradine has no Effect on Cardiac Arrhythmias Observed During Dobutamine Infusion: A Comparative Study with β Blocker Therapy

Cited by 2 publications

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The Usage of Concomitant Beta-Blockers with Vasopressors and Inotropes in Cardiogenic Shock

The Usage of Concomitant Beta-Blockers with Vasopressors and Inotropes in Cardiogenic Shock

The characterization of concomitant beta-blocker usage with vasopressors and inotropes in cardiogenic shock

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