[Beta-blockers and heart failure].
Several studies have suggested that beta-blockade could provide functional benefit in heart failure, suggesting a deleterious role for the compensatory sympathetic stimulation. Beta-blockade induced benefit could result from either antagonism of any myocardial beta-adrenergic stimulation or on the opposite a paradoxical cardiac beta-adrenergic responsiveness secondary to beta-adrenergic receptor up-regulation. Two recently completed large scale multicentric placebo controlled studies, the MDC trial with metoprolol and CIBIS with bisoprolol, have confirmed that beta-blockade could functionally improve patients with heart failure. The observed survival improvement in non ischemic patients was observed only in the CIBIS trial. Such a result must be confirmed with additional studies.
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Service de Pharmacologie, CHU Pitié-Salpêtrière, Paris.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000818:Animals; D017298:Bisoprolol / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008790:Metoprolol / Q000627:therapeutic use; D015337:Multicenter Studies as Topic; D013564:Sympathetic Nervous System / Q000503:physiopathology
D000319:Adrenergic beta-Antagonists; D008790:Metoprolol; D017298:Bisoprolol
Bêtabloquants et insuffisance cardiaque.