Impact of Beta-blockers on Physical Function in HFpEF

Exclusion Criteria

• •Alternate Causes of HFpEF Syndrome:
• •1. Severe valvular disease
• •2. Constrictive pericarditis
• •3. High output heart failure
• •4. Infiltrative cardiomyopathy
• •Other compelling indication for beta blocker
• •1. Prior EF \< 50%
• •2. Hypertrophic cardiomyopathy
• •3. Angina symptoms
• •4. Acute coronary syndrome, myocardial infarction or coronary artery bypass surgery in prior 3 year
• •5. History of ventricular tachycardia
• •6. Atrial arrhythmia with hospitalization for rapid ventricular response, prior 1 year
• •7. Sinus tachycardia \> 100 beats per minute (bpm), atrial arrhythmia with ventricular rate \>90 bpm, systolic blood pressure \> 160 mmHg
• •Clinical instability (N-of-1 trials are appropriate for stable conditions only)
• •1. Decompensated HF
• •2. Hospitalized in past 30 days
• •3. Medication changes or procedures in prior 14 days (to prevent confounding from other interventions), at PI discretion
• •Estimated life expectancy \<6 months
• •Moderate-severe dementia or psychiatric disorder precluding informed consent
• •Any condition that, in Principal Investigator's opinion, makes the patient unsuitable for study participation