[Prediction of intolerance to beta blocker therapy in chronic heart failure patients using BNP].
Beta-blocker therapy is actually recommended as first line therapy for systolic heart failure. However, beta-blocker have a low prescription rate comparatively to ACEI. Beta-blocker potential side effects as bradycardia, hypotension and especially acute decompensation could explain this under prescription. Clinical data could easily identify high-risk patients for hypotension or bradycardia but not high-risk patients for induced decompensation linked to beta-blocker therapy. BNP could identify these patients with a high sensitivity. Patients with BNP above 1000 pg/ml had a 40% risk of acute decompensation after introduction or increase of beta-blocker therapy. As a conclusion, clinicians must be very cautious for introducing or increasing Carvedilol therapy in patients with high BNP levels.
Hery
E
E
Service de cardiologie, centre hospitalier R. Dubos, 95300 Pontoise, France.
Jourdain
P
P
Funck
F
F
Bellorini
M
M
Loiret
J
J
Thebault
B
B
Guillard
N
N
El Hallak
A
A
Desnos
M
M
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D000368:Aged; D002227:Carbazoles / Q000009:adverse effects* / Q000627:therapeutic use; D000077261:Carvedilol; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D011412:Propanolamines / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D020097:Natriuretic Peptide, Brain