Heart failure treatment profile at the beta blockers era.
OBJECTIVE
The inhibition of the rennin-angiotensin-aldosterone system (RAAS) and sympathetic autonomous nervous system has increased the perspective of survival in these patients, as well as allowing the improvement of the quality of life. The aim of this study was to evaluate the reality of the treatment employed and its impact on the disease in patients followed at a specialized heart failure (HF) outpatient clinic.


METHODS
A sample of 96 patients followed at the HF and Transplant Outpatient Clinic of Heart Institute of the University of São Paulo School of Medicine (InCor -HCFMUSP) were evaluated. The data were collected during the ambulatory consultation from the medical files and through physical examination. Patients were randomly selected for the study.


RESULTS
Most of the patients were Functional Class II (42.3%) and evolution stage C (94.9%). The medical prescription given to the patients was quite similar to the one recommended by the directives. Approximately 95% of them received RAAS inhibitors (ACE inhibitor--enalapril and captopril--or angiotensin receptor antagonist--losartan), whereas 85% of the patients additionally received beta blockers (carvedilol). The mean dose prescribed was also similar to the one used in large studies and reached more than 60% of the maximum dose for each medication. The hemodynamic data show that patients were stable, despite the intensity of the dysfunction and ventricular remodeling observed in these patients.


CONCLUSIONS
Patients with HF followed by a specialized medical team receive a medical prescription that is closer to the recommended one. These patients, despite the marked characteristics of disease severity, achieve hemodynamic and clinical stability with an adequate therapeutic optimization.
Silva
Christiano Pereira
CP
Unidade de Insuficiência Cardíaca e Transplante, Instituto do Coraçúo, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. chrispsilva@cardiol.br
Bacal
Fernando
F
Pires
Philippe Vieira
PV
Mangini
Sandrigo
S
Issa
Victor Sarli
VS
Moreira
Silvia Ferreira Ayub
SF
Chizzola
Paulo Roberto
PR
Souza
Germano Emílio Conceição
GE
Guimarães
Guilherme Veiga
GV
Bocchi
Edimar Alcides
EA
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D002216:Captopril / Q000008:administration & dosage; D002227:Carbazoles / Q000008:administration & dosage*; D000077261:Carvedilol; D004359:Drug Therapy, Combination; D004656:Enalapril / Q000008:administration & dosage; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D019808:Losartan / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011412:Propanolamines / Q000008:administration & dosage*; D012720:Severity of Illness Index
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D004656:Enalapril; D002216:Captopril; D019808:Losartan