Abstract
The left-ventricular (LV) functional, hemodynamic, and antiadrenergic effects of metoprolol, bucindolol, and carvedilol have been compared in three concurrent placebo-controlled clinical trials in patients with symptomatic idiopathic dilated cardiomyopathy. All three drugs were well tolerated, all produced at least moderate degrees of β-blockade as assessed by reduction in exercise heart rate, and all increased the left-ventricular ejection fraction. Compared with the β_1-selective, second-generation compound metoprolol, the third-generation compounds bucindolol and carvedilol lowered indices of adrenergic activity and tended to improve LV function to a greater extent. In patients with chronic heart failure there may be important therapeutic response differences between second- and third-generation beta-blocking agents.
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Bristow, M.R., Abraham, W.T., Yoshikawa, T. et al. Second- and Third-Generation Beta-Blocking Drugs in Chronic Heart Failure. Cardiovasc Drugs Ther 11 (Suppl 1), 291–296 (1997). https://doi.org/10.1023/A:1007748131847
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DOI: https://doi.org/10.1023/A:1007748131847