Beta-Blockers in Severe Heart Failure

Journal of Clinical and Basic Cardiology 2002; 5 (2): 155-158

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Keywords: Betablocker,  Herzinsuffizienz,  beta-blocker,  heart failure

Beta-blockers have been demonstrated to have a significant benefit in the treatment of heart failure. Nevertheless there is a reluctance to use these agents because of their potential adverse effects in patients with severe heart failure. Analysis of the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) trial, and the sub-group analysis of the Metoprolol CR/XL Randomized Intervention Trial in Chronic Heart Failure (MERIT-HF) in patients with severe heart failure, in NYHA Class III/IV with left ventricular ejection fraction below 25 % showed a significant survival benefit. In addition the frequency of withdrawal for any reason and for increase in heart failure symptoms were less frequent than in the placebo group. These observations indicate that beta-blockers are safe and effective when administered to patients with severe heart failure who are stable on angiotensin converting enzyme inhibitors.