Abstract
The overall goals in the management of heart failure are to prevent or eliminate symptoms, improve quality of life, and prolong survival. Paradoxically, as has been demonstrated with positive inotropic agents such as vesnarinone and flosequinan, chronic heart failure therapy may improve quality of life and reduce symptoms while increasing mortality. As discussed in Chapter 11, several large randomized controlled trials have demonstrated the beneficial effects of angiotensin-converting enzyme (ACE) inhibitors on exercise tolerance, clinical signs and symptoms, neurohormonal stimulation, quality of life, and survival in patients with chronic heart failure.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Cohn JN, Levine TB, Olivari MT, et al.: Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med 1984, 311:819–823.
Francis GS, Benedict C, Johnstone DE, et al.: Comparison of neuroendocrine activation in patients with left ventricular dysfunction with and without congestive heart failure: a substudy of the Studies of Left Ventricular Dysfunction (SOLVD). Circulation 1990, 82: 1724–1729.
Swedberg K, Hjalmarson A, Waagstein F, Wallentin I: Prolongation of survival in congestive cardiomyopathy by beta-receptor blockade. Lancet 1979, 1(8131):1374–1376.
Hjalmarson A, Waagstein F: Use of beta-blockers in the treatment of dilated cardiomyopathy. In Heart Failure: Basic Science and Clinical Aspects. Edited by Gwathmey JK, Briggs GM, Allen PD. New York: Marcel Dekker; 1993: 223–251.
Hall SA, Cigarroa CG, Marcoux L, et al.: Time course of improvement in left ventricular function, mass and geometry in patients with congestive heart failure treated with beta-adrenergic blockade. J Am Coll Cardiol 1995, 25:1154–1161.
Doughty RN, Whalley GA, Gamble G, et al.: Left ventricular remodeling with carvedilol in patients with congestive heart failure due to ischemic heart disease: Australia-New Zealand Heart Failure Research Collaborative Group. J Am Coll Cardiol 1997, 29: 1060–1066.
Packer M, Bristow MR, Cohn JN, et al.: The effect of carvedilol on morbidity and mortality in patients with chronic heart failure: U.S. Carvedilol Heart Failure Study Group. N Engl J Med 1996, 334: 1349–1355.
Heidenreich PA, Lee TT, Massie BM: Effect of beta-blockade on mortality in patients with heart failure: a meta-analysis of randomized clinical trials. J Am Coll Cardiol 1997, 30:27–34.
Bristow MR, Gilbert EM, Abraham WT, et al.: Carvedilol produces dose-related improvements in left ventricular function and survival in subjects with chronic heart failure. Circulation 1996, 94: 2807–2816.
Colucci WS, Packer M, Bristow MR et al.: Carvedilol inhibits clinical progression in patients with mild symptoms of heart failure: US Carvedilol Heart Failure Study Group. Circulation 1996 94:2800–2806.
CIBIS II Investigators and Committees: The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet 1999 353:9–13.
MERIT-HF Study Group: Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet 1999, 353:2001–2007.
Packer M, Coats AJ, Fowler MB, et al.: Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med 2001, 344:1651–1658.
The CAPRICORN Investigators: Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomised trial. Lancet 2001 357:1385–1390.
The Beta-Blocker Evaluation of Survival Trial Investigators: A trial of the beta-blocker bucindolol in patients with advanced chronic heart failure. N Engl J Med 2001, 344:1659–1667.
Yancy CW, Fowler MB, Colucci WS, et al.: Race and the response to adrenergic blockade with carvedilol in patients with chronic heart failure. N Engl J Med 2001, 344:1358–1365.
Shakar SF, Abraham WT, Gilbert EM, et al.: Combined oral positive inotropic and beta-blocker therapy for treatment of refractory class IV heart failure. J Am Coll Cordial 1998, 31:1336–1340.
Swedberg K, Bergh CH, Dickstein K, et al.: The effects of moxonidine, a novel imidazoline, on plasma norepinephrine in patients with congestive heart failure: Moxonidine Investigators. J Am Coll Cardiol 2000, 35: 398–404.
Jones LG, Cleland JG: Meeting report: the LIDO, HOPE, MOXCON, and WASH. studies. Eur J Heart Fail 1999, 1: 425–431.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2002 Springer Science+Business Media New York
About this chapter
Cite this chapter
Givertz, M.M., Colucci, W.S. (2002). β-Blockers. In: Colucci, W.S. (eds) Atlas of Heart Failure. Current Medicine Group, London. https://doi.org/10.1007/978-1-4615-6490-4_12
Download citation
DOI: https://doi.org/10.1007/978-1-4615-6490-4_12
Publisher Name: Current Medicine Group, London
Print ISBN: 978-1-4615-6492-8
Online ISBN: 978-1-4615-6490-4
eBook Packages: Springer Book Archive