β-blocker in Heart failure with reduced ejection fraction: A review
Journal Title: Nepalese Heart Journal - Year 2013, Vol 10, Issue 1
Abstract
Heart failure, a major public health problem is associated with high mortality, poor quality of life, and frequent hospitalization. It is a complex syndrome characterized by neurohumoral activation. Activation of sympathetic nervous system plays an important role in its pathogenesis. Randomized trials have show that β-blockers reduce mortality, hospitalization and improves quality of life. One of the three β-blockers (i.e., bisoprolol, carvedilol, and sustained-release metoprolol succinate) is recommended for all patients with current or prior symptoms of Heart Failure, unless contraindicated, to reduce morbidity and mortality. β-blockers are underused in patients with heart failure. If a patient is considered suitable for β-blocker therapy, a careful initiation and gradual increases of β-blocker dose are crucial to avoid clinical deterioration. Initiating the Angiotensin Conventing Enzyme inhibitor first is traditional but studies have proven similar safety with a β-blocker-first strategy. Emerging evidence suggests that the order of initial ACEI or β-blocker therapy may not matter.
Authors and Affiliations
Chandra Mani Adhikari| Department of cardiology, Shahid Gangalal National Heart Centre,Kathmandu,Nepal
Keywords
Related Articles
- EP ID EP15729
- DOI http://dx.doi.org/10.3126/njh.v10i1.9746
- Views 398
- Downloads 18
Observational Study of Pulmonary Embolism Patients in Shahid Gangalal National Heart Centre
Pulmonary thromboembolism (PE) is a relatively common cardiovascular emergency, with a signifcant mortality and morbidity often precipitated by deep venous thrombosis (DVT).It is considered as the third most common cardi...
The Clinical and Electrophysiological Features in Patients with Wolff- Parkinson- White Syndrome
Background and Aims: Wolff-Parkinson-White Syndrome is a congenital anomaly with delta wave in electrocardiogram representing an accessory conducting pathway. The aim of the present study was to evaluate the characterist...
Anesthetic Management of Traumatic Rupture of Aorta and Diaphragm at Shahid Gangalal National Heart Centre
Traumatic transaction thoracic aorta and rupture diaphragm carries high mortality rate. It needs specialized centre which is able to handle such case and prompt intervention. Even with maximum effort, only 5 to 7% of th...
Patterns of Valvular Involvement in Rheumatic Heart Disease patients taking Benzathine Penicillin at Shahid Gangalal National Heart Centre, Kathmandu, Nepal
Background and Aims: Acute rheumatic fever and rheumatic heart disease constitute an important public health problem in the developing countries. The disease results from an abnormal autoimmune response to a group A st...
Current Scenario of Heart Diseases in Nepal: At a glance
Background Cardiovascular disease no more remains as a disease of developed countries. It is affectng developing countries as well. In additon, developing countries have big challenge to deal with these because of lac...