[Advantages of vasodilating beta-blockers in congestive heart failure].
Beta-blockers play a pivotal role in the treatment of chronic systolic heart failure. However, the pharmacological family of beta-blockers is inhomogeneous regarding their pharmacological properties and their clinical effects can differ substantially according to different pharmacological properties. Because of vasodilator effects, the third generation of beta-blockers has additional potential across the cardiovascular diseases, from hypertension to heart failure. Nebivololol has both high selectivity for beta1-adrenergic receptors, no intrinsic sympathetic activity and ability to stimulate endothelial nitric oxide production. Such properties result in specific hemodynamic effects compared with others beta-blockers. Such properties also result in both high tolerability and positive metabolic effects which are crucial in high-risk groups. In the SENIORS trial, nebivolol demonstrated its efficacy and high tolerability in elderly patients with chronic heart failure irrespective of the left ventricular ejection fraction. More clinical trials would be useful to exhibit specific benefits of nebivolol in other high-risk groups of patients.
Logeart
D
D
Hôpital Lariboisière, Service de Cardiologie, INSERM U942, 2 rue Ambroise Paré, 75010 Paris, France. damien.logeart@lrb.aphp.fr
Solal
A Cohen
AC
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*
D000319:Adrenergic beta-Antagonists; D014665:Vasodilator Agents