title: Is there evidence favoring the use of beta-blockers and dobutamine in acute heart failure?
abstract: Several studies have reported the benefits of beta-blockers (BB) for patients presenting with systolic heart failure. however, many patients hospitalized as a result of acute heart failure are already using BB and require dobutamine for arterial hypotension and low cardiac output. Therefore, a decision must be made regarding whether BB should be maintained or even started in such cases. The aim of this study was to establish whether there is evidence supporting the safety andyeffectiveness of BB together with dobutamine for patients presenting with acute decompensated heart failure (ADHF). We conducted a search of the English-language literature in the databases MEDLINE, ISI Web of Science, Virtual Health Library, Cochrane Library and the CAPES Portal of Scientific Journals to identify related studies. Additional literature was obtained through the review of relevant references in the identified articles. The expected outcomes included information on the prognosis (in-hospital and on follow-up mortality, number of days of hospitalization and readmission),yeffectiveness and safety (worsening of symptoms, shock, intolerance) of the concomitant use of these drugs in hospitalized patients with ADHF and low cardiac output. This review included nine studies. however, no randomized clinical trials on this subject were found. Most studies include a low number of patients, and no studies addressing the safety of the concomitant use of these drugs were found. The resulting data suggest that a careful literature review did not supply evidence for the systematic use of BB in patients with low cardiac output syndrome who require dobutamine for inotropic support.
authors.affiliation: Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, BA, Brasil. lcpassos@ufba.br
authors.forename: Luiz Carlos Santana
authors.initials: LC
authors.lastname: Passos
authors.forename: Andréa Cristina Costa
authors.initials: AC
authors.lastname: Barbosa
authors.forename: Márcio Galvão
authors.initials: MG
authors.lastname: Oliveira
authors.forename: Edval Gomes
authors.initials: EG
authors.lastname: Santos
mesh_terms: D000208:Acute Disease; D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D004280:Dobutamine / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans
chemical_list: D000319:Adrenergic beta-Antagonists; D002316:Cardiotonic Agents; D004280:Dobutamine