ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Intensive Care Cardiovascular Medicine
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1665466
Efficacy and Safety of Short-Acting β-Blockers in Patients with Sepsis-Associated Cardiac Dysfunction: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Provisionally accepted
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Background: The role of ultra-rapid β-blockers in sepsis-associated cardiac dysfunction remains controversial, with conflicting evidence regarding mortality benefits and safety concerns in hemodynamically unstable patients. Methods: This study retrieved relevant reports on randomized controlled trials of ultra-rapid β-blockers conducted for adult patients with sepsis-associated cardiac dysfunction, up to and including the date of May 30, 2025, from the databases of PubMed, Web of Science, Cochrane Library and Embase. Primary outcomes were 28-day mortality and adverse events; secondary outcomes included heart rate control and mean arterial pressure (MAP) at 48 hours. Random-effects models calculated risk ratios (RR) or standardized mean differences (SMD) with 95% confidence intervals (CI). Heterogeneity was assessed using I² statistics. Results: Eight studies reported 28-day mortality, showing no significant reduction with ultra-rapid β-blockers (RR, 0.84, 95% CI: 0.67–1.06; P = 0.15; I² = 54%). Safety data from four studies indicated no increased adverse events (RR, 1.04, 95% CI: 0.82–1.33; P = 0.72; I² = 0%). Paradoxically, ultra-rapid β-blockers were associated with worse heart rate control (RR, 1.51, 95% CI: 1.00–2.29; P = 0.05). MAP at 48 hours showed no intergroup difference (SMD, −0.85, 95% CI: −2.24–0.54). Conclusion: ultra-rapid β-blockers demonstrate an acceptable safety profile without compromising hemodynamic stability but fail to reduce 28-day mortality in sepsis-associated cardiac dysfunction patients. The inferior heart rate control suggests potential physiological incompatibility in this population. Precision targeting based on adrenergic activity and cardiac phenotyping warrants investigation.
Keywords: ultra-rapid β-blockers, Sepsis, Cardiac dysfunction, Healing efficacy, Safety
Received: 14 Jul 2025; Accepted: 28 Aug 2025.
Copyright: © 2025 Zheng, Wang, Xie, Guo, Chen, He and Yao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Min'an ' Zheng, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
Guoyan Yao, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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