[Treatment of cardiac insufficiency by beta-blockaders. A review of the literature and discussion].
The use of beta-blockers in the treatment of heart failure at first seems paradoxical because of their negative inotropic effect. Nonetheless, clinical studies performed over the last ten or so years in patients with dilated cardiomyopathy or ischemic heart failure indicate functional improvement and a tendency to reduced mortality. These preliminary studies were carried out with a limited number of patients and were sometimes by nature methodologically imperfect. They have since been succeeded by large, randomized, prospective studies also based on solid experimental arguments concerning the supposed mechanisms of action of beta-blockers. The themes of these studies include: protection against the cardiotoxicity of catecholamines, up-regulation, reduction in myocardial energy requirements and in heart rate, improved diastolic function and compliance, inhibition of vasoconstriction induced by catecholamines, and antiarrhythmic action.
Hermida
J S
JS
Service de Cardiologie A, Hôpital Sud, Amiens.
Jarry
G
G
Bertrand
S
S
Guillaumont
M P
MP
Rey
J L
JL
Bernasconi
P
P
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D001341:Autonomic Nervous System / Q000503:physiopathology; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D015854:Up-Regulation
D000319:Adrenergic beta-Antagonists
Traitement de l'insuffisance cardiaque par les bêtabloquants. Revue de la littérature et discussion.