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Updated: Aug 16, 2026

The Intra-Aortic Balloon Pump
Published on: February 5, 2021
Initiation and use of beta-blockers in class IV heart failure
Feras M Bader1, John F MacGregor, Edward M Gilbert
1Division of Cardiology 4A100, University of Utah Health Sciences Center, 30 North 1900 East, Salt Lake City, UT 84132, USA.
Abstract:
Treatment of patients with heart failure caused by left ventricular systolic dysfunction using b-adrenergic receptor antagonists (or b-blockers) results in improvements in symptoms, hemodynamics, left ventricular remodeling, morbidity, and mortality. Most patients studied in prospective, randomized placebo-controlled trials have had New York Heart Association (NYHA) functional class II or III symptoms. The efficacy of b-blockers in treating NYHA class IV patients is not as well-established. This review summarizes the published experience regarding the use of b-blockers in patients with advanced heart failure. Although treatment requires considerable care, the data support attempts at initiation of b-blockers in this group of patients.
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