title: Initiation and use of beta-blockers in class IV heart failure.
abstract: Treatment of patients with heart failure caused by left ventricular systolic dysfunction using b-adrenergic receptor antagonists (or b-blockers) results in improvements in symptoms, hemodynamics, left ventricular remodeling, morbidity, and mortality. Most patients studied in prospective, randomized placebo-controlled trials have had New York Heart Association (NYHA) functional class II or III symptoms. The efficacy of b-blockers in treating NYHA class IV patients is not as well-established. This review summarizes the published experience regarding the use of b-blockers in patients with advanced heart failure. Although treatment requires considerable care, the data support attempts at initiation of b-blockers in this group of patients.
authors.affiliation: Division of Cardiology 4A100, University of Utah Health Sciences Center, 30 North 1900 East, Salt Lake City, UT 84132, USA.
authors.forename: Feras M
authors.initials: FM
authors.lastname: Bader
authors.forename: John F
authors.initials: JF
authors.lastname: MacGregor
authors.forename: Edward M
authors.initials: EM
authors.lastname: Gilbert
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000145:classification / Q000188:drug therapy* / Q000209:etiology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D018487:Ventricular Dysfunction, Left / Q000150:complications
chemical_list: D000319:Adrenergic beta-Antagonists; D010726:Phosphodiesterase Inhibitors