Beta-blocker therapy and severe heart failure: myth or reality?
The medical management of heart failure has undergone remarkable progress in the past 10 years. The paradigm shift is toward long-term reparative strategies that help in altering the biologic properties of the failing heart. Together with angiotensin-converting enzyme inhibitors, beta blockers have emerged as standard therapy for heart failure, especially for patients with mild to moderate heart failure. Since most of the clinical trials demonstrating the benefits of betablockers have been done in patients with mild to moderate heart failure, some controversy exists about the utility of beta-blocking agents in patients with advanced heart failure. This review will summarize the rationale and the use of beta blockers, a very challenging therapeutic strategy, in patients with severe heart failure.
Ventura
Hector O
HO
Department of Cardiology, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USA. hventura@ochsner.org
Kalapura
Thomachan
T
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D006333:Heart Failure / Q000188:drug therapy* / Q000378:metabolism; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D009200:Myocardial Contraction / Q000187:drug effects; D032383:Myocytes, Cardiac / Q000187:drug effects; D012720:Severity of Illness Index; D015398:Signal Transduction / Q000187:drug effects; D013268:Stimulation, Chemical
D000319:Adrenergic beta-Antagonists