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[Is it necessary to suspend betablockers in decompensated heart failure with low output?]

Marcelo Villaça Lima1, Juliano Novaes Cardoso, Marcelo Eidi Ochiai

  • 1Instituto do Coração, Faculdade de Medicina, USP, São Paulo, SP, Brasil. villacalima@cardiol.br

Arquivos Brasileiros De Cardiologia
|August 20, 2010
PubMed

Insights

Maintaining beta-blockers (BB) with dobutamine in heart failure patients did not worsen outcomes or increase hospital stay. Patients not suspending BB were discharged on higher BB doses, suggesting continued benefit.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Beta-blockers (BB) suspension in decompensated heart failure may increase mortality.
  • Dobutamine (dobuta), a common inotrope, has antagonist actions to BB at the same receptor, potentially hindering compensation during concurrent use.

Purpose of the Study:

  • To evaluate if maintaining BB alongside dobutamine complicates cardiac compensation in heart failure patients.

Main Methods:

  • A study of 44 heart failure patients (LVEF < 45%) requiring inotropics.
  • Patients were divided into three groups: no BB, BB suspended for dobutamine, and BB concomitant with dobutamine.
  • Statistical tests (Student t, Fisher exact, chi-square) were used for comparison (p < 0.05 significant).

Main Results:

  • Mean LVEF was 23.8 ± 6.6%.
  • Dobutamine use was similar across groups (p = 0.35).
  • Concomitant dobutamine and BB did not increase length of stay (20.36 ± 11.04 days vs 28.37 ± 12.76 days, p = NS).
  • Patients not suspending BB received higher doses (35.8 ± 16.8 mg/day vs 23.0 ± 16.7 mg/day, p = 0.004).

Conclusions:

  • Maintaining BB with dobutamine did not worsen outcomes or prolong hospitalization.
  • Patients who continued BB were discharged on higher BB doses, indicating continued therapeutic benefit.
Abstract

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