Related Experiment Video

Updated: Jun 20, 2026

Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR
07:24

Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR

Published on: April 8, 2013

Survival among patients with left ventricular systolic dysfunction treated with atenolol

John R Kapoor1, Paul A Heidenreich

  • 1Stanford University, Palo Alto, CA, USA. jkapoor@stanford.edu

Congestive Heart Failure (Greenwich, Conn.)
|September 16, 2009
PubMed

Insights

Atenolol and carvedilol showed lower unadjusted mortality in heart failure patients compared to metoprolol tartrate. After adjustments, atenolol demonstrated a comparable and potentially lower risk of death, suggesting its utility in heart failure treatment.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Metoprolol succinate, carvedilol, and bisoprolol are approved for heart failure treatment.
  • Metoprolol tartrate is considered inferior, and atenolol has not been extensively studied in this context.

Purpose of the Study:

  • To compare all-cause mortality in patients with left ventricular dysfunction treated with atenolol, carvedilol, or metoprolol tartrate.
  • To evaluate the potential utility of atenolol in heart failure management.

Main Methods:

  • Retrospective analysis of 974 patients with left ventricular function ≤40%.
  • Comparison of unadjusted and propensity-adjusted all-cause mortality rates at 6 months across treatment groups (atenolol, carvedilol, metoprolol tartrate).

Main Results:

  • Unadjusted 6-month mortality was lower for atenolol (3.2%) and carvedilol (4.2%) versus metoprolol tartrate (7.5%).
  • After propensity adjustment, atenolol treatment was associated with a significantly lower risk of death compared to metoprolol tartrate.
  • Outcomes for atenolol were comparable to those treated with carvedilol.

Conclusions:

  • Atenolol may be a viable treatment option for patients with heart failure and reduced ejection fraction.
  • Further randomized trials are needed to directly compare atenolol with established beta-blockers like carvedilol in heart failure.

Related Concept Videos

Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...