beta-Adrenergic receptor blockers and heart failure risk after myocardial infarction: a critical review.

Remodeling after myocardial infarction is a complex biological process that leads to progressive left ventricular dilation and clinical heart failure. Multiple influences, including autonomic imbalance with sympathetic activation, contribute to the process. This article reviews clinical data in favor of early- and long-term use of beta-adrenergic receptor blockers in patients after myocardial infarction. Areas of uncertainty, such as the selection of dose and duration of therapy, current guidelines, and patterns of underuse of therapy with this important class of drugs are outlined and highlighted.