Abstract
Congestive heart failure is a common clinical syndrome, the incidence of which apperars to be increasing. Over recent years there have been considerable advances in the understanding of both the pathophysiology and management of heart failure. However, despite these advances, morbidity and mortality remain high and heart failure is still a major public health problem. In New Zealand there are about 8000 admissions of about 5000 patients each year with heart failure, or the equivalent of 330 hospital beds being occcupied all year, every year by patients with heart failure [1]. Management of heart failure accounts for about 1.5% to 2% of total health budgets in Western countries [1,2].
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References
Doughty R, Yee T, Sharpe N, MacMahon S (1995) Hospital admissions and deaths due to congestive heart failure in New Zealand 1988-91. NZ Med J 108:473–475
McMurray J, Hart W, Rhodes G (1993) An evaluation of the cost of heart failure to the National Health Service in the UK. Br J Med Econ 6:99–110
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
The SOLVD Investigators (1991) Effect of enalapril on survival in patients with reduced left ventricular ejection fraction and congestive heart failure. N Engl J Med 325:293–302
Packer M, Carver JR, Rodeheffer RJ, Ivanhoe RJ, Di Bianco R, Zeldis SM, et al for the PROMISE Study Research Group (1991) Effect of oral milrinone on mortality in severe heart failure. N Engl J Med 325:1468–1475
Doughty RN, MacMahon S, Sharpe N (1994) ²-blockers in heart failure: promising or proved? J Am Coll Cardiol 23:814–821
Packer M (1992) The neurohormonal hypothesis: a theory to explain the mechanism of disease progression in heart failure. J Am Coll Cardiol 20:248–254.
Szakacs JE, Cannon A (1958) Norepinephrine myocarditis. Am J Clin Pathol 30:425–435
Bigger JT. (1987) Why patients with congestive heart failure die: arrhythmias and sudden cardiac death. Circulation 75 [Suppl IV] IV28–IV35
Mancia G (1990) Sympathetic activation in congestive heart failure. Eur Heart J 11 [Suppl A]:3–11
Waagstein F, Hjalmarson A, Varnauskas E, Wallentin I (1975) Effect of chronic β-adrenergic receptor blockade in congestive cardiomyopathy. Br Heart J 37:1022–1036
Swedberg K, Hjalmarson A, Waagstein F, Wallentin I (1980) Beneficial effects of longterm β-blockade in congestive cardiomyopathy. Br Heart J 44:117–133
Swedberg K, Hjalmarson A, Waagstein F, Wallentin I (1979) Prolongation of survival in congestive cardiomyopathy by β-receptor blockade. Lancet 1:1374–1376
Ikram H, Fitzpatrick D (1981) Double-blind trial of chronic oral β-blockade in congestive cardiomyopathy. Lancet 2:490–492
Currie PJ, Kelly MJ, McKenzie A, Harper RN, Lim YL, Federman J et al (1984) Oral β-adrenergic blockade with metoprolol in chronic severe dilated cardiomyopathy. J Am Coll Cardiol 3:203–209
Anderson JL, Lutz JR, Gilbert EM, Sorensen SG, Yanowitz FG, Menlove RL et al (1985) A randomised trial of low-dose β-blockade therapy for idiopathic dilated cardiomyopathy. Am J Cardiol 55:471–475
Engelmeier RS, O’Connell JB, Walsh R, Rand N, Scanlon PJ, Gunnar RM (1985) Improvement in symptoms and exercise tolerance by metoprolol in patients with dilated cardiomyopathy: a double-blind, randomised, placebo-controlled trial. Circulation 72:536–546
Sano H, Kawabata N, Yonezawa K, Hirayama H, Sakuma I, Yasuda H (1989) Metoprolol was more effective than captopril for dilated cardiomyopathy in Japanese patients Circulation 80 [Suppl II]:II–118 (abstr)
Leung WH, Lau CP, Wong CK, Chen CH, Tai YT, Lim SP (1990) Improvement in exercise performance and haemodynamics by labetalol in patients with idiopathic dilated cardiomyopathy. Am Heart J 119:884–890
Pollock SG, Lystash J, Tedesco C, Craddock G, Smucker ML (1990) Usefulness of bucindolol in congestive heart failure. Am J Cardiol 66:603–607
Gilbert EM, Anderson JL, Deitchman D, Yanowitz FG, O’Connell JB, Renlund DG et al. (1990) Long-term β-blocker vasodilator therapy improves cardiac function in idiopathic dilated cardiomyopathy: a double-blind, randomized study of bucindolol versus placebo. Am J Med 88:223–229
Woodley SL, Gilbert EM, Anderson JL, O’Connell JB, Deitchman D, Yanowitz FG, et al. (1991) β-blocker with bucindolol in heart failure caused by ischaemic versus idiopathic dilated cardiomyopathy. Circulation 84:2426–2441
Paolisso G, Gambardella, Marrazzo G, Varza M, Teasuro P, Varricchio M, et al. (1992) Metabolic and cardiovascular benefits deriving from β-adrenergic blockade in chronic congestive heart failure. Am Heart J 123:103–110
Waagstein F, Bristow MR, Swedberg K, Camerini F, Fowler MB, Silver MA et al. for the Metoprolol in Dilated Cardiomyopathy (MDC) Trial Study Group (1993) Beneficial effects of metoprolol in idiopathic dilated cardiomyopathy. Lancet 342:1441–1446
Wisenbaugh T, Katz I, Davis J, Essop R, Skulargis J, Middlemost S et al. (1993) Longterm (3 month) effects of a new β-blocker (nebivolol) on cardiac performance in dilated cardiomyopathy. J Am Coll Cardiol 21:1094–1100
Fisher ML, Gottlieb SS Plotnick GD, Greenberg NL, Patten RD, Bennett SK, et al. (1994) Beneficial effects of metoprolol in heart failure associated with coronary artery disease: a randomised trial. J Am Coll Cardiol 23:943–950
Bristow MR, O’Connell JB, Gilbert EM, French WJ, Leatherman G, Kantrowitz NE, et al. for the Bucindolol Investigators (1994) Dose-response of chronic β-blocker treatment in heart failure from either idiopathic dilated cardiomyopathy or ischemic cardiomyopathy. Circulation 89:1632–1642
Eichorn EJ, Heesch CM, Barnett JH, Alvarez LG, Fass SM, Grayburn PA et al. (1994) Effect of metoprolol on myocardial function and energetics in patients with nonischemic dilated cardiomyopathy: a randomised, double-blind, placebo-controlled study. J Am Coll Cardiol 24:1314–1320
Metra M, Nardi M, Giubbini R, Dei Cas L. (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
CIBIS Investigators and Committees (1994) A Randomized Trial of β-Blockade in Heart Failure. The Cardiac Insufficiency Bisoprolol Study (CIBIS). Circulation 90:1765–1773.
Olsen SL, Gilbert EM, Renlund DG, Taylor EO, Yanowitz FD, Bristow MR (1995) Carvedilol improves left ventricular function and symptoms in chronic heart failure: a double-blind randomised study. J Am Coll Cardiol 25:1225–1231
Krum H, Sackner-Bernstein JD, Goldsmith RL, et al. (1995) Double-blind, placebo controlled study of the long-term efficacy of carvedilol in patients with severe chronic heart failure. Circulation 92:1499–1506
Australia New Zealand Heart Failure Research Collaborative Group (1997) Effects of carvedilol in patients with congestive heart failure due to ischemic heart disease: final results from the Australia New Zealand Heart Failure Research Collaborative Group trial. Lancet 349:375–380
Packer M, Bristow MR, Cohn JN, Colucci WS, Fowler MB, Shusterman NH, for the US Carvedilol Heart Failure Study Group (1996) The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med 334:1349–1355.
Australia New Zealand Heart Failure Research Collaborative Group (1995) Effects of carvedilol, a vasodilator β-blocker in patients with congestive heart failure due to ischemic heart disease. Circulation 92:212–218
Sweeney ME, Fletcher BJ, Fletcher GF (1989) Exercise testing and training with β-adrenergic blockade: role of drug washout period in “unmasking ” a training effect. Am Heart J 118:941–948
Lipkin DP, Scriven AJ, Crake T (1986) Six minute walk test for assessing exercise capacity in chronic heart failure. Br Med J 92:653–655
Franciosa JA, Park M, Levine TB (1981) Lack of correlation between exercise capacity and indexes of resting left ventricular performance in heart failure. Am J Cardiol 47:33–39
Clark A, Coats A (1994) Mechanisms of exercise intolerance in cardiac failure: abnormalities of skeletal muscle and pulmonary function. Curr Opin Cardiol 9:305–314
Drexler H (1995) Changes in the peripheral circulation in heart failure. Curr Opin Cardiol 10:268–273
Doughty RN, Whalley GA, Gamble G, MacManon S, Sharpe N on behalf of 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
Cohn JN, Fowler MB, Bristow MR, Colucci WS, Gilbert EM, Kinal V et al. for the Carvedilol Study Group (1996) Effect of carvedilol in severe chronic heart failure J Am Coll Cardiol 27 [Suppl A]: 169A (abstr)
Bristow MR, Gilbert EM, Abraham W, Adams KF, Fowler MB, Hershberger RE et al. for the MOCHA Investigators (1996) Carvedilol produces dose-related improvements in left ventricular function and survival in subjects with chronic heart failure. Circulation 94:2807–2816
Packer M, Colucci WS, Sackner-Bernstein O, Liang CS, Goldscher DA, Freeman I 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
Colucci WS, Packer M, Bristow MR, Gilbert EM, Cohn JN, Fowler MB et al. (1996) Carvedilol inhibits clinical progression in patients with mild symptoms of heart failure. Circulation 94:2800–2806
Cleland JGF, Swedberg K (1996) Carvedilol for heart failure, with care. Lancet 347:1199–1200
Pfeffer MA, Stevenson LW (1996) β-adrenergic blockers and survival in heart failure. N Engl J Med 334:1396–1397
Doughty RN, Rodgers A, Sharpe N, MacManon S (1997) Effects of β-blocker therapy on mortality in patients with heart failure. A systematic overview of randomised controlled trials. Eur Heart J 18:560–565
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Dougthy, R., Sharpe, N. (1998). The Role of β-Blockers in the Management of Heart Failure: Results of Controlled Trials. In: Camerini, F., Gavazzi, A., De Maria, R. (eds) Advances in Cardiomyopathies. Springer, Milano. https://doi.org/10.1007/978-88-470-2155-6_29
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DOI: https://doi.org/10.1007/978-88-470-2155-6_29
Publisher Name: Springer, Milano
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