Stopping beta-blockers in heart failure with preserved ejection fraction

Effect of Beta-blocker Discontinuation on Functional Capacity and Cardiac Hemodynamics in Patients With Heart Failure With Preserved Ejection Fraction

This pilot will try stopping beta-blockers for about 4 weeks in people with HFpEF to see if symptoms, walking distance, and heart function change.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 30 (estimated)
• Ages: 50 Years to 80 Years
• Sex: All
• Sponsor: UConn Health (other)
• Locations: 1 site (Farmington, Connecticut)
• Trial ID: NCT05174351 on ClinicalTrials.gov

What this trial studies

This is a prospective pilot enrolling 30 stable HFpEF patients who are currently taking a beta-blocker, with two visits about 4 weeks apart. At the first (clinic) visit the team documents baseline status, then beta-blockers are stopped and patients return about 4 weeks later for a research visit with questionnaires, a limited echocardiogram, and a 6-minute walk test. The goal is to measure changes from baseline to 4 weeks after withdrawal; there is no long-term follow-up beyond the second visit. Patients with beta-blockers prescribed for other cardiac conditions, recent HF hospitalization, or high resting heart rate are excluded for safety.

Who should consider this trial

Good fit: Adults age 50–80 with HFpEF (EF ≥50%) and grade 2–3 diastolic dysfunction who are on chronic loop diuretics and a beta-blocker and have NYHA class II–III symptoms or BNP ≥100 are ideal candidates.

Not a fit: Patients whose beta-blocker is prescribed for other cardiac conditions such as atrial fibrillation or coronary artery disease, those with heart rate >100 bpm, recent HF hospitalization, or who cannot attend the study visits are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, the study could show that stopping beta-blockers improves symptoms, exercise tolerance, or heart function for some people with HFpEF and help avoid unnecessary medication.

How similar studies have performed: This specific approach is relatively novel in HFpEF with only limited prior pilot data, so there is sparse evidence to date supporting broad success.

Eligibility criteria

Inclusion Criteria:

* Stable HFpEF patients with NYHA Class II-III or elevated BNP ≥100
* N=30 (Target: 30).
* Age: 50 \~ 80 years.
* ECHO evidence of EF ≥50% and Grade 2 or 3 diastolic dysfunction.
* Chronic loop diuretic use
* Currently on beta-blocker

Exclusion Criteria:

* Beta blocker was prescribed for treating other cardiac conditions such as atrial fibrillation or coronary artery disease.
* Heart rate \> 100 bpm
* Recent hospitalization due to HF within 3 months
* Non-English speaker

Where this trial is running

Farmington, Connecticut

• UConn Health / John Dempsey Hospital — Farmington, Connecticut, United States (RECRUITING)

Study contacts

• Principal investigator: Kai Chen, MD,PhD — UConn Health
• Study coordinator: Kai Chen, MD,PhD

Conditions: Heart Failure With Preserved Ejection Fraction, HFpEF, Beta-blocker, echocardiogram, 6MWT