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β-Blocker Treatment of Chronic Heart Failure

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From Hypertension to Heart Failure

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Abstract

Congestive heart failure is a major public health problem in most Western countries. In the United States, approximately 3 million people suffer from heart failure, 10% of whom are admitted to hospital each year [1]. Although in recent decades considerable advances in medical therapy have been achieved, especially by angiotensin-converting enzyme (ACE) inhibitors [2, 3], the mortality rate of heart failure still remains very high. In patients of New York Heart Association (NYHA) functional class II, there is a mortality rate of about 10% per year [4]. In order to improve this poor prognosis, additional pharmacological interventions to counteract the pathophysiological changes occurring in heart failure are still important.

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References

  1. Smith WM (1985) Epidemiology of congestive heart failure. Am J Cardiol 55: 3 – 8

    Article  Google Scholar 

  2. The CONSENSUS Trial Study Group (1987) Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 316: 1429 – 1435

    Article  Google Scholar 

  3. The SOLVD Investigators (1991) Effects of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 325: 293 – 302

    Article  Google Scholar 

  4. Australia-New Zealand Heart Failure Research Collaborative Group (1995) Effects of Carvedilol, a vasodilator-beta-blocker, in patients with congestive heart failure due to ischemic heart disease. Circulation 92: 212 – 218

    Google Scholar 

  5. Waagstein F, Hjalmarson A, Varnauskas E, Wallentin I (1975) Effect of chronic beta-adrenergic receptor blockade in congestive cardiomyopathy. Br Heart J 37: 1022 – 1036

    Article  PubMed  CAS  Google Scholar 

  6. Swedberg K, Hjalmarson A, Waagstein F, Wallentin I (1979) Prolongation of survival in congestive cardiomyopathy by beta-receptor blockade. Lancet 1: 1374 – 1376

    Article  PubMed  CAS  Google Scholar 

  7. Swedberg K, Hjalmarson A, Waagstein F, Wallentin I (1980) Adverse effects of beta-blocker withdrawal in patients with congestive cardiomyopathy. Br Heart J 44: 134 – 142

    Article  PubMed  CAS  Google Scholar 

  8. Swedberg K, Hjalmarson A, Waagstein F, Wallentin I (1980) Beneficial effects of long-term beta-blockade in congestive cardiomyopathy. Br Heart J 44: 117 – 133

    Article  PubMed  CAS  Google Scholar 

  9. Cohn JN, Levine TB, Olivari MT, Gerberg V, Lura D, Francis GS, Simon AB, Rector T (1984) Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med 311: 819 – 823

    Article  PubMed  CAS  Google Scholar 

  10. Hausdorff WP, Caron MG, Lefkowitz RJ (1990) Turning off the signal: desensitization of β-adrenergic receptor function. FASEB J 4: 2881 – 2889

    PubMed  CAS  Google Scholar 

  11. Bristow MR, Ginsburg R, Minobe W, et al (1982) Decreased catecholamine sensitivity and β-adrenergic receptor density in failing human hearts. N Engl J Med 307: 205 – 211

    Article  PubMed  CAS  Google Scholar 

  12. Böhm M, Gierschik P, Jakobs KH, Pieske B, Schnabel P, Ungerer M, Erdmann E (1990) Increase of Gia in human hearts with dilated but not ischemic cardiomyopathy. Circulation 82: 1249 – 1265

    Article  PubMed  Google Scholar 

  13. Ungerer M, Böhm M, Elce JS, Erdmann E, Lohse MJ (1993) Altered expression of β-adrenergic receptor kinase and β1-adrenergic receptors in the failing human heart. Circulation 87: 454 – 463

    PubMed  CAS  Google Scholar 

  14. Gage J, Rutman H, Lucido D, Le Jemtel TH (1986) Additive effects of Dobutamine and amrinone on myocardial contractility and ventricular performance in patients with severe heart failure. Circulation 74: 367 – 373

    Article  PubMed  CAS  Google Scholar 

  15. Schwartz A, Lindenmayer GE, Harigaya S (1968) Respiratory control and calcium transport in heart mitochondria from the cardiomyopathic hamster. Trans N Y Acad Sci 30 (Suppl 2): 951

    PubMed  CAS  Google Scholar 

  16. Feldman MD, Alderman JD, Aroesty JM, et al (1988) Depression of systolic and diastolic myocardial reserve during atrial pacing tachycardia in patients with dilated cardiomyopathy. J Clin Invest 82: 1661 – 1669

    Article  PubMed  CAS  Google Scholar 

  17. Schwinger RHG, Böhm M, Müller-Ehmsen J, et al (1993) Effect of inotropic stimulation on the negative force-frequency-relationship in the failing human heart. Circulation 88: 2267 – 2276

    PubMed  CAS  Google Scholar 

  18. Eichhorn EJ, Bedotto JB, Malloy CR, et al (1990) Effects of ß-adrenergic receptor blockade on myocardial function and energetics in congestive heart failure. Circulation 82: 473 – 483

    Article  PubMed  CAS  Google Scholar 

  19. Andersson B, Hamm C, Persson S, et al (1994) Improved exercise hemodynamic status in dilated cardiomyopathy after beta-blockade treatment. J Am Coll Cardiol 23: 1397 – 1404

    Article  PubMed  CAS  Google Scholar 

  20. Ferro G, Duilio C, Spinelli L, et al (1991) Effects of beta-blockade on the relation between heart rate and ventricular diastolic perfusion time during exercise in systemic hypertension. Am J Cardiol 68: 1101 – 1103

    Article  PubMed  CAS  Google Scholar 

  21. Nicholas G, Oakley C, Pouleur H, et al (1990) Xamoterol in severe heart failure. Lancet 336: 1 – 6

    Article  Google Scholar 

  22. Gilbert EM, Anderson JL, Deitchman D, et al (1990) Long-term betablocker vasodilator therapy improves cardiac function in idiopathic dilated cardiomyopathy: a double-blind, randomized study of bucindolol versus placebo. Am J Med 88: 223 – 229

    Article  PubMed  CAS  Google Scholar 

  23. Gilbert EM, Abraham WT, Olsen S, et al (1996) Comparative hemodynamic, left ventricular functional and antiadrenergic effects of chronic treatment with metoprolol versus carvedilol in the failing heart. Circulation 94: 2817 – 2825

    PubMed  CAS  Google Scholar 

  24. Imperato-McGinley J, Gautier T, Ehlers K, et al (1987) Reversibility of catecholamine-induced dilated cardiomyopathy in a child with pheochromocytoma. N Engl J Med 316: 793 – 797

    Article  PubMed  CAS  Google Scholar 

  25. Cruickshank JM, Neil-Dwyer G, Degaute JP, et al (1987) Reduction of stress/catecholamine-induced cardiac necrosis by betal-selective blockade. Lancet 1: 585 – 589

    Article  Google Scholar 

  26. Gilbert EM, Olsen SL, Renlund DG, Bristow MR (1993) Beta-adrenergic receptor regulation and left ventricular function in idiopathic dilated cardiomyopathy. Am J Cardiol 71: 23C – 29C

    Article  PubMed  CAS  Google Scholar 

  27. Sigmund M, Jakob H, Becker H (1996) Effects of metoprolol on myocardial β-adrenoceptors and Gia-proteins in patients with congestive heart failure. Eur J Clin Pharmacol 51: 127 – 132

    Article  PubMed  CAS  Google Scholar 

  28. Yoshikawa T, Port JD, Asaro K, et al (1996) Cardiac adrenergic receptor effects of carvedilol. Eur Heart J 17 (Suppl. B): 8 – 16

    PubMed  CAS  Google Scholar 

  29. Whyte K, Jones CR, Howie CA, et al (1987) Haemodynamic metabolic and lymphocyte beta2-adrenoceptor changes following chronic beta-adrenoceptor antagonism. Eur J Clin Pharmacol 32: 237 – 243

    Article  PubMed  CAS  Google Scholar 

  30. Hall SA, Cigarroa CG, Marcoux L, et al (1995) 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 25: 1154 – 6131

    Article  PubMed  CAS  Google Scholar 

  31. Kukin ML, Kalman J, Mannino M, et al (1996) Combined alpha-betablockade (doxazosin and metoprolol) compared with beta-blockade alone in chronic congestive heart failure. Am J Cardiol 77: 486 – 491

    Article  PubMed  CAS  Google Scholar 

  32. Yue TL, Cheng H-J, Lysko PG, et al (1992) Carvedilol, a new vasodilator and beta-adrenoceptor antagonist, is an antioxidant and free radical scavenger. J Pharmacol Exp Ther 263: 92 – 98

    PubMed  CAS  Google Scholar 

  33. Yue T-L, Liu T, Feuerstein G (1992) Carvedilol, a new vasodilator and beta-adrenoceptor antagonist, inhibits oxygen radical mediated lipid per-oxidation in swine ventricular membranes. Pharmacol Communications 1: 27 – 35

    CAS  Google Scholar 

  34. Bolli R (1990) Mechanisms of myocardial stunning. Circulation 82: 723–738

    Article  PubMed  CAS  Google Scholar 

  35. Belch JJF, Bridges AB, Scott N, Chopra M (1991) Oxygen free radicals in congestive heart failure. Br Heart J 65: 245 – 248

    Article  PubMed  CAS  Google Scholar 

  36. Sung C-P, Arleth AJ, Ohlstein EH (1993) Carvedilol inhibits vascular smooth muscle cell proliferation. J Cardiovasc Pharmacol 21: 221 – 227

    Article  PubMed  CAS  Google Scholar 

  37. Ohlstein EH, Douglas SA, Sung C-P, et al (1993) Carvedilol, a cardiovascular drug, prevents vascular smooth muscle cell proliferation, migration and neointimal formation following vascular injury. Proc Natl Acad Sci U S A 90: 6189 – 6193

    Article  PubMed  CAS  Google Scholar 

  38. Cleland JGF, Bristow MR, Erdmann E, Remme WJ, Swedberg K, Waagstein F (1996) Beta-blocking agents in heart failure - should they be used and how? Eur Heart J 17: 1629 – 1639

    PubMed  CAS  Google Scholar 

  39. Waagstein F, Bristow MR, Swedberg K, et al (1993) Beneficial effects of metoprolol in idiopathic dilated cardiomyopathy. Lancet 342: 1441 – 1446

    Article  PubMed  CAS  Google Scholar 

  40. Fisher ML, Gottlieb SS, Plotnick G, et al (1994) Beneficial effects of metoprolol in heart failure associated with coronary artery disease: a randomized trial. J Am Coll Cardiol 23: 943 – 950

    Article  PubMed  CAS  Google Scholar 

  41. CIBIS Investigators and Committees (1994) A randomized trial of β-blockade in heart failure. The Cardiac Insufficiency Bisoprolol Study (CIBIS). Circulation 90: 1765 – 1773

    Google Scholar 

  42. Woodley SL, Gilbert EM, Anderson JL, et al (1991) β-blockade with bucindolol in heart failure caused by ischemic versus idiopathic dilated cardiomyopathy. Circulation 84: 2426 – 2441

    PubMed  CAS  Google Scholar 

  43. Bristow MR, O’Connel JB, Gilbert EM, et al (1994) Dose-response of chronic β-blocker treatment in heart failure from either idiopathic dilated or ischemic cardiomyopathy. Circulation 89: 1632 – 1642

    PubMed  CAS  Google Scholar 

  44. Packer M, Bristow MR, Cohn JN, et al. for the US carvedilol study group (1996) The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med 334: 1349 – 1355

    Google Scholar 

  45. Australia-New Zealand Heart Failure Research Collaborative Group (1997) Randomized, placebo-controlled trial of carvedilol in patients with congestive heart failure due to ischemic heart disease. Lancet 349: 375 – 380

    Article  Google Scholar 

  46. Waagstein F, Caidahl K, Wallentin I, et al (1989) Long-term beta-blockade in dilated cardiomyopathy: effects of short-and long-term metoprolol treatment followed by withdrawal and readministration of metoprolol. Circulation 80: 551 – 563

    Article  PubMed  CAS  Google Scholar 

  47. Lahiri A, Rodrigues EA, Al-Khawaja I, et al (1987) Effect of a new vasodilating beta-blocking drug, carvedilol, on left ventricular function in stable angina-pectoris. Am J Cardiol 59: 769 – 774

    Article  PubMed  CAS  Google Scholar 

  48. Awan NA, Needham KE, Evenson MK, et al (1981) Therapeutic application of prazosin in chronic refractory congestive heart failure: tolerance and “tachyphylaxis” in perspective. Am J Med 71: 153 – 160

    Article  PubMed  CAS  Google Scholar 

  49. Metra M, Nardi M, Giubbini R (1994) Effects of short-and long-term carvedilol administration on rest and exercise hemodynamic variables, exercise capacity and clinical conditions in patients with idiopathic dilated cardiomyopathy. J Am Coll Cardiol 24: 1678 – 1687

    Article  PubMed  CAS  Google Scholar 

  50. Doughty RN, Whalley GA, Gamble G, et al. on behalf of the Australia-New Zealand Heart Failure Research Collaborative Group (1997) Left ventricular remodeling with carvedilol in patients with congestive heart failure due to ischemic heart disease. J Am Coll Cardiol 29: 1060 – 1066

    Google Scholar 

  51. Gaudron P, Eilles C, Kugler I, Ertl G (1993) Progressive left ventricular dysfunction and remodeling after myocardial infarction. Potential mechanisms and early predictors. Circulation 87: 755–763

    PubMed  CAS  Google Scholar 

  52. Hammermeister KE, De Rouen TA, Dodge HAT (1979) Variables predictive of survival in patients with coronary disease: selection by univariate and multivariate analyses from the clinical, electrocardiographic, exercise, arteriographic and quantitative angiographic evaluations. Circulation 59: 421 – 430

    PubMed  CAS  Google Scholar 

  53. White HD, Norris RM, Brown MA, Brandt PWT, Whitlock RML, Wild CJ (1987) Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation 76: 44 – 51

    Article  PubMed  CAS  Google Scholar 

  54. Sharpe N, Murphy J, Smith H, Hannan S (1988) Treatment of patients with symptomless left ventricular dysfunction after myocardial infarction. Lancet: 255 – 259

    Google Scholar 

  55. Sutton MSJ, Pfeffer MA, Plappert T, et al (1994) Quantitative two-dimensional echocardiographic measurements are major predictors of adverse cardiovascular events after acute myocardial infarction. Circulation 89: 68 – 75

    Google Scholar 

  56. Cohn JN (1994) Vasodilators in heart failure: conclusions from V-HeFT II and rationale for V-HeFT III. Drugs 47 (Suppl 4): 47 – 58

    Article  PubMed  Google Scholar 

  57. Hash TW, Prisant LM (1997) ß-blocker use in systolic heart failure and dilated cardiomyopathy. J Am Coll Cardiol 37: 7 – 19

    CAS  Google Scholar 

  58. Swedberg K (1994) Exercise testing in heart failure: a critical review. Drugs 47 (Suppl 4): 14 – 24

    Article  PubMed  Google Scholar 

  59. Heilbrunn SM, Shah P, Bristow MR, et al (1989) Increased ß-receptor density and improved hemodynamic response to catecholamine stimulation during long-term metoprolol therapy in heart failure from dilated cardiomyopathy. Circulation 79: 483 – 490

    Article  PubMed  CAS  Google Scholar 

  60. Böhm M, Deutsch HJ, Hartmann D, La Rosée K, Stäblein A (1997) Improvement of postreceptor events by metoprolol treatment in patients with chronic heart failure. J Am Coll Cardiol 30: 992 – 996

    Article  PubMed  Google Scholar 

  61. White M, Yanowitz F, Gilbert EM, et al (1995) Role of β-adrenergic receptor downregulation in the peak exercise response in patients with heart failure due to idiopathic dilative cardiomyopathy. Am J Cardiol 76: 1271 – 1276

    Article  PubMed  CAS  Google Scholar 

  62. Packer M, Arver JR, Rodeheffer RJ, et al. for the PROMISE Study Research Group (1991) Effect of oral milrinone on mortality in severe chronic heart failure. N Engl J Med 325: 1468 – 1475

    Google Scholar 

  63. The Digitalis Investigation Group (DIG) (1997) The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med 336: 525 – 533

    Article  Google Scholar 

  64. Lipicky RJ, Packer M (1993) Role of surrogate end points in the evaluation of drugs for heart failure. J Am Coll Cardiol 22 (Suppl A): 179A–184A

    Article  PubMed  CAS  Google Scholar 

  65. Colucci WS, Packer M, Bristow MR, et al (1996) Carvedilol inhibits clinical progression in patients with mild symptoms of heart failure. Circulation 94: 2800 – 2806

    PubMed  CAS  Google Scholar 

  66. Bristow MR, Gilbert EM, Abraham WT, Adams KF, Fowler MB, Hershberger RE, Kubo SH, Narahara KA, Ingersoll H, Krueger S, Young S, Shusterman N (1996) Carvedilol produces dose-related improvements in left ventricular function and survival in subjects with chronic heart failure. MOCHA Investigators [comment]. Circulation 94: 2807–2816

    PubMed  CAS  Google Scholar 

  67. Packer M, Colucci WS, Sackner-Bernstein JD, Liang CS et al. for the PRECISE Study Group (1996) Double-blind, placebo controlled study of the effects of carvedilol in patients with moderate to severe heart failure: the PRECISE trial. Circulation 94: 2793 – 2799

    Google Scholar 

  68. Cohn J, Fowler MB, Bristow MR, et al (1997) Safety and efficacy of carvedilol in severe chronic heart failure. J Card Failure 3: 173 – 179

    Article  CAS  Google Scholar 

  69. Pfeffer MA, Stevenson LW (1996) β-adrenergic blockers and survival in heart failure. N Engl J Med 334: 1396 – 1397

    Google Scholar 

  70. Parmershwar J, Shackel MM, Richardson A, Poole-Wilson PA, Sutton GC (1992) Prevalence of heart failure in three general practices in northwest London. Br J Gen Pract 42: 287 – 289

    Google Scholar 

  71. Sutton GC (1990) Epidemiologic aspects of heart failure. Am Heart J 120: 1538 – 1540

    Article  PubMed  CAS  Google Scholar 

  72. Marwood JF, Stokes GS (1986) Studies on the vasodilator actions of bucindolol in the rat. Clin Exp Pharmacol Physiol 13: 59 – 68

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. C. Maack
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  2. M. Böhm
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Editors and Affiliations

  1. Klinik III für Innere Medizin der Universität Köln, Josef-Stelzmann-Straße 9, 50924, Köln, Germany

    Michael Böhm

  2. Cornell Medical Center, The New York Hospital, 526 East 68th Street, New York, NY, 10021, USA

    John H. Laragh

  3. Abteilung Innere Medizin III, Med. Universitätsklinik und Poliklinik, Hugstetterstraße 55, 79106, Freiburg, Germany

    Manfred Zehender

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Maack, C., Böhm, M. (1998). β-Blocker Treatment of Chronic Heart Failure. In: Böhm, M., Laragh, J.H., Zehender, M. (eds) From Hypertension to Heart Failure. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60300-6_10

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  • DOI: https://doi.org/10.1007/978-3-642-60300-6_10

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-63542-0

  • Online ISBN: 978-3-642-60300-6

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