Analysis of influencing factors for bronchospasm in patients with chronic heart failure during metoprolol treatment

Wang Xuwei; Cheng Kang; Yao Jingwen

doi:10.3760/j.issn.1673-4777.2026.04.002

Abstract：Objective To analyze the influencing factors for bronchospasm in patients with chronic heart failure(CHF)during metoprolol treatment.Methods A total of 284 CHF patients treated with metoprolol who were admitted to the Affiliated Hospital of Jiangsu University from January 2022 to December 2024 were enrolled as research subjects.According to the occurrence of bronchospasm during treatment,the patients were divided into the bronchospasm group and the non-bronchospasm group,and the clinical data of the patients were collected.Univariate and multivariate Logistic regression analyses were used to screen the independent influencing factors of bronchospasm.A visual nomogram was constructed by R software,and the discrimination ability,calibration and clinical validity of the visual nomogram were evaluated by receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis.Results A total of 284 CHF patients treated with metoprolol were included in this study,and 43 patients developed bronchospasm during treatment,with an incidence rate of 15.1％(43/284).There were statistically significant differences in age,smoking status,history of asthma,complicated chronic obstructive pulmonary disease(COPD),forced expiratory volume in the first second/forced vital capacity(FEV1/FVC)ratio and brain natriuretic peptide(BNP)level between the bronchospasm group and the non-bronchospasm group(all P＜0.05).Multivariate Logistic regression analysis showed that age(odds ratio=1.114,95％confidence interval:1.054-1.178,P＜0.001),smoking(odds ratio=2.839,95％confidence interval:1.266-6.362,P=0.011),history of asthma(odds ratio=3.631,95％confidence interval:1.228-10.737,P=0.020),compli-cated COPD(odds ratio=5.008,95％confidence interval:2.095-11.968,P＜0.001)and BNP level(odds ratio=1.011,95％confidence interval:1.005-1.017,P＜0.001)were independent risk factors for bronchos-pasm in CHF patients during metoprolol treatment,while FEV1/FVC ratio(odds ratio=0.926,95％confidence interval:0.889-0.965,P＜0.001)was an independent protective factor.The area under the curve of the constructed visual nomogram was 0.860(95％confidence interval:0.797-0.923).The calibration curve had a high coincidence with the ideal diagonal line(Hosmer-Lemeshow testx2=7.243,P=0.511),and the decision curve showed a high net benefit value in the threshold probability range of 0-98％.Conclusion Age,smoking,history of asthma,complicated COPD,FEV1/FVC ratio and BNP level are independent influencing factors for bronchospasm in CHF patients during metoprolol treatment.The visual nomogram constructed in this study has good clinical practicability,which can provide a reference for early identification of high-risk patients and optimiza-tion of medication management.