Lechat P
Service de Pharmacologie, CHU Pitié-Salpêtrière, Paris.
Therapie. 1994 May-Jun;49(3):219-24.
Several studies have suggested that beta-blockade could provide functional benefit in heart failure, suggesting a deleterious role for the compensatory sympathetic stimulation. Beta-blockade induced benefit could result from either antagonism of any myocardial beta-adrenergic stimulation or on the opposite a paradoxical cardiac beta-adrenergic responsiveness secondary to beta-adrenergic receptor up-regulation. Two recently completed large scale multicentric placebo controlled studies, the MDC trial with metoprolol and CIBIS with bisoprolol, have confirmed that beta-blockade could functionally improve patients with heart failure. The observed survival improvement in non ischemic patients was observed only in the CIBIS trial. Such a result must be confirmed with additional studies.
多项研究表明，β受体阻滞剂可能对心力衰竭具有功能益处，提示代偿性交感神经刺激具有有害作用。β受体阻滞剂带来的益处可能源于对任何心肌β肾上腺素能刺激的拮抗作用，或者相反，是由于β肾上腺素能受体上调继发的矛盾性心脏β肾上腺素能反应性。两项最近完成的大规模多中心安慰剂对照研究，即美托洛尔的MDC试验和比索洛尔的CIBIS试验，证实了β受体阻滞剂可在功能上改善心力衰竭患者。仅在CIBIS试验中观察到非缺血性患者的生存率有所提高。这一结果必须通过更多研究加以证实。
