{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:28:41Z","timestamp":1753878521016,"version":"3.41.2"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T00:00:00Z","timestamp":1700697600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Translational Sci"],"published-print":{"date-parts":[[2024,1]]},"abstract":"Abstract<\/jats:title>Nonselective beta\u2010blockers (NSBBs) may exacerbate ascites by impairing cardiac function. This study evaluated the impact of achieving a heart rate target of 55\u201360 beats per minute (bpm) on ascites\u2010related death and complications from worsening ascites in patients with cirrhosis and diuretic\u2010responsive ascites using NSBBs. A retrospective study was conducted at the Faculty of Medicine Ramathibodi Hospital, Mahidol University (2012\u20132022) and analyzed patients with cirrhosis and diuretic\u2010responsive ascites using NSBBs (propranolol\/carvedilol) for variceal bleeding prophylaxis. The outcomes were incidence of ascites\u2010related death and complications from worsening ascites, comparing the achievable target group (heart rate 55\u201360\u2009bpm) and the unachievable target group (heart rate >60\u2009bpm). A total of 206 patients were included in the study, with a median follow\u2010up time of 20\u2009months. The patients were divided into an achievable target group (n<\/jats:italic>\u2009=\u200975, median heart rate\u2009=\u200958.0\u2009bpm) and an unachievable target group (n<\/jats:italic>\u2009=\u2009131, median heart rate\u2009=\u200973.6\u2009bpm). Propranolol was the most used NSBB (95.1%). The adjusted hazard ratio (HR) for ascites\u2010related death from spontaneous bacterial peritonitis (SBP) or refractory ascites (RA) or hepatorenal syndrome (HRS) or hepatic encephalopathy (HE) showed no difference between the groups (adjusted HR 0.59 [0.23\u20131.54]; p<\/jats:italic>\u2009=\u20090.28). Additionally, no significant difference was found in the incidence of complications between groups, including SBP, RA, HRS, and HE. Achieving a heart rate target of 55\u201360\u2009bpm with NSBBs for variceal bleeding prophylaxis is safe in patients with diuretic\u2010responsive ascites and cirrhosis.<\/jats:p>","DOI":"10.1111\/cts.13681","type":"journal-article","created":{"date-parts":[[2023,11,11]],"date-time":"2023-11-11T07:43:42Z","timestamp":1699688622000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Optimal resting heart rate and ascites\u2010related death in patients with cirrhosis and ascites using nonselective beta\u2010blockers (ORCA)"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5665-9926","authenticated-orcid":false,"given":"Warunee","family":"Mingpun","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Faculty of Pharmacy Mahidol University Bangkok Thailand"},{"name":"Department of Pharmaceutical Care, Faculty of Pharmacy Chiang Mai University Chiang Mai 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