['Ventricular-arterial (V-A) decoupling decreases myocardial efficiency and is exacerbated by tachycardia that increases static arterial elastance (Ea). We thus investigated the effects of heart rate (HR) reduction on Ea in septic shock patients using the beta-blocker esmolol. We hypothesized that esmolol improves Ea by positively affecting the tone of arterial vessels and their responsiveness to HR-related changes in stroke volume (SV).', 'After at least 24\xa0h of hemodynamic optimization, 45 septic shock patients, with an HR\xa0≥95\xa0bpm and requiring norepinephrine to maintain mean arterial pressure (MAP)\xa0≥65\xa0mmHg, received a titrated esmolol infusion to maintain HR between 80 and 94\xa0bpm. Ea was calculated as MAP/SV. All measurements, including data from right heart catheterization, echocardiography, arterial waveform analysis, and norepinephrine requirements, were obtained at baseline and at 4\xa0h after commencing esmolol.', 'Esmolol reduced HR in all patients and this was associated with a decrease in Ea (2.19\xa0±\xa00.77 vs. 1.72\xa0±\xa00.52\xa0mmHg\xa0l(-1)), arterial dP/dt max (1.08\xa0±\xa00.32 vs. 0.89\xa0±\xa00.29\xa0mmHg\xa0ms(-1)), and a parallel increase in SV (48\xa0±\xa014 vs. 59\xa0±\xa018\xa0ml), all p\xa0<\xa00.05. Cardiac output and ejection fraction remained unchanged, whereas norepinephrine requirements were reduced (0.7\xa0±\xa00.7 to 0.58\xa0±\xa00.5\xa0µg\xa0kg(-1)\xa0min(-1), p\xa0<\xa00.05).'] Is heart rate reduction with esmolol associated with improved arterial elastance in patients with septic shock : a prospective observational study?