A Johns Hopkins study has raised doubts about a long-accepted notion of what’s going on in many cases of heart failure, suggesting that nearly half of patients with the disorder may be getting the wrong treatment for their disease.

A team of Hopkins scientists found that people with so-called nonsystolic heart failure - marked by relatively normal pumping action - do not have a problem with refilling of the heart after the heart contracts and squeezes blood out. During exercise, the heartbeat does not increase as expected, which limits the capability of these patients to pump blood to the body.

Their findings suggest that these patients might be better off without beta blockers that slow down the heart and worsen blood vessel function. Instead, they may benefit from therapies such as pacemakers to speed up the heartbeat or drugs that enhance blood vessel dilation.

The results may also help explain why some people with heart failure and relatively normal pumping ability still have severe fatigue performing the simplest of daily tasks.

Although preliminary, the findings “could dramatically change the way we initially treat patients with this kind of heart failure, because a cornerstone of current therapy is the use of beta blockers that slow down the heartbeat and decrease the strength of contraction,” says lead study investigator and cardiologist Barry Borlaug, M.D.MORE