Division of Cardiology, UC-San Francisco, Fresno Medical Education Program, Fresno, CA 93703, USA.
Cardiol Rev. 2009 Nov-Dec;17(6):287-92. doi: 10.1097/CRD.0b013e3181bdf63e.
Systolic dysfunction and heart failure are major public health problems associated with a significant risk of morbidity and mortality. During the past 2 decades, considerable progress has been made in defining the underlying pathophysiology and the appropriate therapies in heart failure. In patients with chronic heart failure (CHF), sustained sympathetic overactivation leads to down-regulation of beta receptors and uncoupling of the receptors from adenylate cyclase. The clear understanding of the pivotal role of sympathetic overactivation in CHF has led to the evaluation of beta- blocker therapy in CHF. A number of large randomized clinical trials have been conducted with a variety of beta-blockers, and although most of them have shown benefit, there have been differing findings with different molecules. beta-blockers are now considered part of the standard therapy for all patients with symptomatic CHF. Despite the strong evidence supporting their use, beta-blockers continue to be underutilized in CHF.
收缩功能障碍和心力衰竭是与较高发病率和死亡率相关的主要公共卫生问题。在过去的 20 年中，在心衰的基础病理生理学和适当治疗方面已经取得了相当大的进展。在慢性心力衰竭（CHF）患者中，持续的交感神经激活导致β受体下调和受体与腺苷酸环化酶解偶联。对交感神经激活在心衰中的关键作用的清晰认识，导致了对 CHF 中β受体阻滞剂治疗的评估。已经进行了许多使用各种β受体阻滞剂的大型随机临床试验，尽管大多数研究都显示出益处，但不同分子的研究结果却不同。β受体阻滞剂现在被认为是所有有症状 CHF 患者标准治疗的一部分。尽管有强有力的证据支持其使用，但β受体阻滞剂在心衰中的应用仍然不足。
