[Beta blockers and cardiac decompensation]

It has been demonstrated that beta blockers are able to modify the course of the disease, through the reduction of hemodynamic in stabilization and mortality cases. The success of these drugs in the treatment of chronic heart failure is related to the sympathoadrenergic activation and to renin-angiothensin-aldosteron system. Various molecules are available at the moment. Recent research has been done on third generation beta blockers (carvedilol, nebivolol, bucindolol). These drugs have shown to possess some peculiar characteristics, in particular the ability of reducing the number of side effects which may be seen while using beta blockers of the first generations. Although it is currently difficult to give general informations based only on the pharmacologic profile, the choice of the type of drug to use in the single patient with chronic heart failure should be made considering the adequacy of the pharmacologic characteristics in each specific situation.