Evidence map›Paper›PMID 41136226›Full record

SynthesisOpen heart2025

Beta blockers and hypertrophic obstructive cardiomyopathy: a systematic review and meta-analysis.

Alexander James Smith, Amy Magaret Munro Cromie, Libby Bowles, Thomas Anderson, Jay Panchal, Ben Walters

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Open heart, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Alexander James SmithUniversity Hospital Coventry, Coventry, Warwickshire, UK 12.alexanderjsmith@gmail.com.ORCID http://orcid.org/0009-0007-1528-3532
Amy Magaret Munro CromieGeorge Eliot Hospital NHS Trust, Nuneaton, UK.ORCID http://orcid.org/0009-0006-1354-7779
Libby BowlesChesterfield Royal Hospital NHS Foundation Trust, Chesterfield, England, UK.ORCID http://orcid.org/0009-0002-5728-2582
Thomas AndersonUniversity Hospital Coventry, Coventry, Warwickshire, UK.ORCID http://orcid.org/0009-0006-3465-3626
Jay PanchalKettering General Hospital NHS Foundation Trust, Kettering, UK.ORCID http://orcid.org/0000-0003-2394-3231
Ben WaltersDoncaster and Bassetlaw Hospitals NHS Foundation Trust, Doncaster, UK.ORCID http://orcid.org/0000-0002-5208-6446

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSince the 1960s, beta blockers have been used to treat hypertrophic obstructive cardiomyopathy (HOCM), a genetic disorder causing abnormal heart muscle thickening. This systematic review evaluates their efficacy across clinical outcomes.

methodsRegistered on PROSPERO (CRD42022344255), searches were performed in June 2022 and updated in September 2025 across MEDLINE, Embase, CINAHL and PubMed. Two reviewers independently screened studies. Meta-analysis was undertaken when ≥3 comparable datasets were available; otherwise, narrative synthesis was used.

results21 studies including 775 adults met inclusion criteria. Beta blockers significantly reduced left ventricular outflow tract (LVOT) gradient (Standardised mean difference (SMD) -1.57; 95% CI -2.07 to -1.07) and heart rate (SMD -1.19; 95% CI -2.24 to -0.14). Sensitivity analyses confirmed the robustness of the LVOT effect, while heart rate effects remained heterogeneous. Improvements in New York Heart Association class, exercise tolerance and symptom burden were consistently reported, although data were subjective and small in scale. Mortality evidence was limited to two retrospective cohorts with divergent findings.

conclusionsBeta blockers provide consistent haemodynamic and symptomatic benefits in HOCM, but most evidence derives from small, older studies with high risk of bias and limited survival data. Contemporary, adequately powered randomised controlled trials are required to define optimal agent selection, dosing and long-term outcomes. PROSPERO REGISTRATION NUMBER: CRD42022344255.

Indexed as

Adrenergic beta-AntagonistsCardiomyopathy, HypertrophicVentricular Function, LeftHeart RateHumansTreatment OutcomeAdrenergic beta-AntagonistsCardiomyopathy, HypertrophicMeta-AnalysisPharmacology, ClinicalSystematic Reviews as Topic

Identifiers

PMID41136226
PMCPMC12557796

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.