Interv Akut Kardiol. 2009;8(6):322-324

Beta blockers in the treatment of acute heart failure

Tomáš Janota

III. interní klinika VFN a 1. LF UK, Praha

Beta blockers boast a number of advantageous effects. Substantial is a deceleration of heart rate, leading to the decrease in metabolic

demands of the myocardium, improvement of left ventricle filling, as well as improvement in the subendocardial blood flow. They

also decrease arterial blood pressure, have antiarrhythmic effects and in long term use in chronic heart failure lead to an increase in

left ventricle ejection fraction. Beta blockers can also improve myocardial function in acute heart failure. It is nowadays a standard

practice to continue chronic beta blocker medication in acute exacerbation of chronic heart failure when possible. In newly manifested

more severe heart failure or in those not yet started on beta blocker therapy, its initiation can lead to major improvement especially

in those with significant tachycardia. Short-acting or very short-acting drugs are recommended for the initiation, as well as the whole

duration of treatment in acute heart failure, allowing for safe trial of efficacy and tolerance. It is important to use only high selective

beta-1-blockers. The positive effect of beta blockers initiated after the acute phase of heart failure has been documented in large trials,

however, there is increasing evidence from case studies and experimental work that initiation of beta blockers during the acute phase

of heart failure has benefits, too.

Keywords: acute heart failure, treatment, beta blockers

Published: December 12, 2009  Show citation