Document Detail

Expanding role of beta-blockade in the management of chronic heart failure.
MedLine Citation:
PMID:  12680475     Owner:  NLM     Status:  MEDLINE    
Although recent advances have been made in the treatment of heart failure, this disease continues to result in significant morbidity and mortality. Among the negative effects associated with progression of heart failure are decline in myocardial reserve, decreased exercise tolerance, decreased contractile function, and altered cardiac gene expression. Guidelines recommend neurohormonal antagonists for treatment and stress the importance of angiotensin-converting enzyme inhibition and beta-blockade in reversing the cardiac remodeling process. beta-Blockade slows or reverses the adverse effects resulting from chronic adrenergic stimulation. Traditionally, beta-blockers were reserved for mild-to-moderate heart failure, based on evidence from large, randomized clinical trials showing their positive effects on myocardial function and clinical outcomes. More recently, clinical data reveal that the agents can be expanded to patients with severe heart failure and those with left ventricular systolic dysfunction after myocardial infarction. Individual beta-blocking agents vary in their pharmacology and dosing requirements. These variations may influence treatment decisions and affect clinical measurements of left ventricular function and ventricular remodeling.
J Herbert Patterson; Jo E Rodgers
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Pharmacotherapy     Volume:  23     ISSN:  0277-0008     ISO Abbreviation:  Pharmacotherapy     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-04-08     Completed Date:  2003-07-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8111305     Medline TA:  Pharmacotherapy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  451-9     Citation Subset:  IM    
School of Pharmacy, University of North Carolina, CB #7360 Beard Hall, Chapel Hill, NC 27599-7360, USA.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use*
Chronic Disease
Disease Management
Heart Failure / drug therapy*,  physiopathology
Ventricular Dysfunction, Left / drug therapy,  physiopathology
Reg. No./Substance:
0/Adrenergic beta-Antagonists

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