Beta-blocker treatment in heart failure. Role of heart rate reduction.
The potential therapeutic effect of beta-blocker treatment in chronic heart failure is still actively being investigated through large scale clinical trials. The underlying cardioprotective mechanism relies upon protection against the deleterious consequences of cardiac sympathetic stimulation. Heart rate reduction induced by beta-blocker treatment may importantly contribute to such benefit especially by improving myocardial energetic balance and by inducing a less negative force-frequency relationship. Results from clinical trials such as CIBIS suggest that prognosis in chronic heart failure may partly depend on left ventricular function improvement, but additional data are needed to more precisely define the relationships between heart rate reduction, left ventricular function improvement, and survival.
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Pharmacology Department, Pitié-Salpétrière Hospital, Paris, France.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D017298:Bisoprolol / Q000627:therapeutic use; D002303:Cardiac Output, Low / Q000188:drug therapy*; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D013564:Sympathetic Nervous System / Q000502:physiology; D016277:Ventricular Function, Left / Q000187:drug effects
D000319:Adrenergic beta-Antagonists; D017298:Bisoprolol