Ortigosa Aso J, Silva Melchor L, García A, de Artaza Andrade M
Servicio de Cardiología, Clínica Puerta de Hierro, Madrid.
Rev Esp Cardiol. 1997 May;50(5):304-7.
The evidence supporting the use of beta-adrenergic blockers in the treatment of heart failure secondary to systolic dysfunction is reviewed. Up to date, seven controlled trials of carvedilol in patients with heart failure have been published. It has been concluded that the use of the non-selective, third generation beta-adrenergic blockers, with alpha-adrenergic (vasodilator) and antioxidant properties, carvedilol, is only justified in patients with mild or moderate heart failure without contraindications to beta-adrenergic blockers. There are not data to support the use of carvedilol in patients with severe or unstable heart failure. It seems logical to wait for the results of the ongoing trials (BEST Trial, CIBIS II Trial, COMET Trial, and MERIT Trial) to more precisely define the role that beta-adrenergic blockers should play in the treatment of patients with heart failure. The information presently available suggests that carvedilol should be considered a therapeutic agent for the prevention of progressive clinical heart failure rather than for the treatment of refractory heart failure.
本文综述了支持使用β-肾上腺素能阻滞剂治疗收缩功能障碍继发心力衰竭的证据。迄今为止，已发表了七项关于卡维地洛治疗心力衰竭患者的对照试验。得出的结论是，具有α-肾上腺素能（血管舒张）和抗氧化特性的非选择性第三代β-肾上腺素能阻滞剂卡维地洛，仅适用于轻度或中度心力衰竭且无β-肾上腺素能阻滞剂禁忌证的患者。尚无数据支持在重度或不稳定心力衰竭患者中使用卡维地洛。等待正在进行的试验（BEST试验、CIBIS II试验、COMET试验和MERIT试验）结果，以便更精确地确定β-肾上腺素能阻滞剂在心力衰竭患者治疗中应发挥的作用，这似乎是合乎逻辑的。目前可得的信息表明，卡维地洛应被视为预防进行性临床心力衰竭的治疗药物，而非用于治疗难治性心力衰竭。
