β-blockers in heart failure: recently completed and ongoing clinical trials

Abstract

β-blockers have emerged as an important therapy in patients with symptomatic left ventricular systolic dysfunction. Early studies demonstrated that β-blocker therapy improved left ventricular function, reduced neurohumoral activity and reduced heart failure symptoms in these patients. While none of these small studies demonstrated a significant benefit in terms of overall survival, several meta-analyses suggested that β-blocker therapy could, in fact, reduce mortality in patients with left ventricular systolic dysfunction and mild to moderate heart failure symptoms (New York Heart Association class II or III). Three large, recently completed, trials have confirmed the benefit of β-blockade in these patients. This report reviews some of the initial clinical studies of β-blockade in heart failure, examines the findings of the three large multicentre trials and other relevant research. Finally, ongoing trials designed to assess the relative efficacy of different β-blockers and evaluate the utility of β-blockade in specific subsets of patients with heart failure are discussed.

• β-blocker
• clinical trial
• heart failure
• mortality
• prognosis