[Beta-blockers and new drugs for cardiac failure]

Intensive investigations are currently performed in the treatment of cardiac failure, based on the hypothesis of the potentially deleterious effects of compensatory neurohormonal mechanisms. Administration of beta-adrenergic blockers at progressively increasing doses appears well tolerated in most cases, improves left ventricular function and symptoms, and reduces the frequency of hospitalisations for heart failure worsening in patients already receiving a background treatment combining diuretics and an angiotensin converting enzyme inhibitor. Survival improvement remains to be established by the ongoing large scale multicentric trials of beta-blockers. Other therapeutic strategies are investigated, mainly inhibition of angiotensin II and endothelin effects by specific antagonists.