Author/Editor		Ružič-Medvešček, Nadja
Title		Beta-adrenoreceptors blocking drugs in chronic heart failure
Type		članek
Source		In: Štiblar-Martinčič D, Petrovič D, editors. Cardiovascular diseases. Proceedings of the 32nd memorial meeting devoted to professor Janez Plečnik, International symposium in memory of professor Rene Favaloro; 2001 Dec 6-8; Ljubljana. Ljubljana: Medical faculty,
Publication year		2001
Volume		str. 125-30
Language		eng
Abstract		Because beta-blockers were known to depress cardiac function, the use of these drugs was considered to be contraindicated in patients with compromised left ventricular functions and signs of chronic heart failure. Several neurohormonal systems, including the sympathetic nervous system, are activated in heart failure and contribute to the progression of the disorder. During the past decade, trials have demonstrated that the addition of a beta-blocker to conventional therapy is associated with a consistent improvement in hemodynamic and clinical status of the patients with heart failure due to reduced left ventricular systolic function. Long-term treatment produces significant benefits on symptoms and functional capacity and favorable affects on cardiac performance and structure. In addition, the results of large-scale trials have shown that beta-blockers favorably influence the natural history of heart failure. Treatment with carvedilol, bisoprolol and metoprolol has been associated with the reduction in the risk of clinical deterioration and a decrease in the frequency of worsening heart failure requiring hospitalisation. The most important finding has been that beta-blockers produce substantial reduction in the mortality rate of patients with heart failure. The initiation of therapy with beta-blockers should be very cautious, with tiny doses, but target doses could and should be achieved in most patients.
Descriptors		HEART FAILURE, CONGESTIVE VENTRICULAR DYSFUNCTION, LEFT ADRENERGIC BETA-ANTAGONISTS