Rodríguez Moreno C, Durán Parrondo C, Donado Budiño E G, García Reboredo M, Tato Herrero F, Tarragó Bofarull J, Lado Lado F, Rodríguez López I
Servicio de Farmacología Clínica, Hospital Clínico Universitario, Vidán s/n, 15706 Santiago de Compostela.
An Med Interna. 2002 Jul;19(7):368-74.
The rationale for betablocker use in heart failure, based on neurohormonal physiology, has been established over the past 20 years. Recent trials have shown the unequivocal benefits of betablockers in patients with chronic systolic heart failure. The benefits include improve survival (35%) reduced need for hospitalization and improve of left ventricular function. However, betablockers may also make a patient with heart failure worse, especially when treatment begins and there is reluctance to use betablockade therapy. Complications can generally be avoided by starting with extremely low doses and increasing the dose very slowly. Despite this, further questions remain regarding the use of these agents in cardiac failure, including the role in the progression of the disease, the selection of individual betablocker, and the use in very severe disease or very old patients.
基于神经激素生理学，β受体阻滞剂用于心力衰竭的理论依据在过去20年中已确立。近期试验表明，β受体阻滞剂对慢性收缩性心力衰竭患者有明确益处。这些益处包括提高生存率（35%）、减少住院需求以及改善左心室功能。然而，β受体阻滞剂也可能使心力衰竭患者病情恶化，尤其是在治疗开始时且患者不愿接受β受体阻滞剂治疗时。一般可通过极低剂量起始并非常缓慢地增加剂量来避免并发症。尽管如此，关于这些药物在心力衰竭中的应用仍存在进一步的问题，包括在疾病进展中的作用、个别β受体阻滞剂的选择以及在非常严重的疾病或高龄患者中的应用。
