Related Experiment Video
Updated: Jun 13, 2025
04:05
Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis
Published on: June 30, 2023
1.7K
Beta-Blocker Usage in Patients With Heart Failure With Reduced Ejection Fraction During Acute Decompensated Heart
Matthew T Brennan1, Khaled M Harmouch2, Jawad Basit3
1Wayne State University School of Medicine, Detroit, MI.
Ochsner Journal
|September 16, 2024
Summary
Beta-blockers improve outcomes for patients with heart failure with reduced ejection fraction. Guideline-directed use, including initiation in stable patients, reduces mortality and rehospitalization in acute decompensated heart failure.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Acute decompensated heart failure leads to over 1 million US hospitalizations annually.
- Beta-blockers are crucial for heart failure with reduced ejection fraction, yet their use during hospitalization is suboptimal.
- Evidence review and guideline analysis were performed to clarify beta-blocker prescribing in this setting.
Purpose of the Study:
- To analyze existing evidence and guidelines on beta-blocker use in acute decompensated heart failure.
- To determine optimal conditions for initiating or continuing beta-blocker therapy in hospitalized patients.
- To provide a decision-making framework for clinicians.
Main Methods:
- PubMed search (2004-2024) for "beta blockers" and "acute decompensated heart failure."
- Inclusion of studies on beta-blocker use in heart failure with reduced ejection fraction.
- Compilation of professional society recommendations for beta-blocker management.
Main Results:
- Maintaining beta-blocker therapy in patients with heart failure with reduced ejection fraction lowers mortality and rehospitalization rates.
- Withdrawing beta-blockers increases in-hospital and short-term mortality.
- A guideline-based flowchart was developed to guide clinical decisions.
Conclusions:
- Guideline-directed beta-blocker therapy improves outcomes for patients with heart failure with reduced ejection fraction.
- Initiating low-dose beta-blockers in hemodynamically stable patients is recommended.
- The developed flowchart aids physicians in optimizing beta-blocker use for better patient results.
Related Concept Videos
01:22Heart Failure Drugs: β-Blockers
321
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,...
321
01:27Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers
543
β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in...
543
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
398
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...
398
01:22Heart Failure Drugs: Diuretics
350
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
350
01:31Adrenergic Antagonists: ɑ and β-Receptor Blockers
420
Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is...
420
01:28Antihypertensive Drugs: Types of β-Blockers
603
β receptors are classified into three subclasses: β1, β2, and β3. β1 receptors are primarily located in the heart and kidneys. When they get activated, they increase heart rate, contractility, and renin release. This process enhances blood pressure and aids in stress management. In contrast, β2 receptors are situated mainly in the lungs, blood vessels, and skeletal muscles. Upon activation, they trigger smooth muscle relaxation, causing bronchodilation and...
603