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Heart 1999;81:453-454; doi:10.1136/hrt.81.5.453
Copyright © 1999 BMJ Publishing Group Ltd & British Cardiovascular Society
Heart 1999;81:453-454 ( May )

Editorial

Introducing new treatments in clinical practice: the Italian approach to beta  blockers in heart failure

The first 150 words of the full text of this article appear below.

Congestive heart failure (CHF) is a growing public health problem, having a significant impact on the health care system.1-3 Recently beta  adrenergic antagonists, considered in the past a potential cause of worsening heart failure, have emerged as a promising approach in the treatment of patients with CHF, reducing sympathetic activity and its deleterious consequences.4 Several randomised clinical trials have tested the effects of carvedilol, metoprolol, and bisoprolol in patients with heart failure with different causes and severity. The results of these trials have shown that beta  blockers can have a favourable role in improving left ventricular function, reducing symptoms and the need for hospitalisation, delaying clinical progression of the disease, and, as a logical consequence, reducing mortality.5-8

However, clinical experience shows that treatment with beta  blockers is delicate to manage and potentially harmful in inexperienced hands. A short epidemiological study conducted in Italy in 1994 showed that beta  blockers were used in only 4% . . . [Full text of this article]
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This article has been cited by other articles:

  • Maggioni, A P, Sinagra, G, Opasich, C, Geraci, E, Gorini, M, Gronda, E, Lucci, D, Tognoni, G, Balli, E, Tavazzi, L (2003). Treatment of chronic heart failure with {beta} adrenergic blockade beyond controlled clinical trials: the BRING-UP experience. Heart 89: 299-305 [Abstract] [Full Text]  
  • Senni, M., Gavazzi, A. (2001). How patients with heart failure are managed in Italy. Eur J Heart Fail 3: 257-260 [Abstract] [Full Text]  
  • Maggioni, A. P. (2001). HEART FAILURE: Treatment strategies for heart failure: {beta} blockers and antiarrhythmics. Heart 85: 97-103 [Full Text]  
  • Tognoni, G. (2000). Parallel realities of guidelines and practice. Eur Heart J 21: 1819-1821  
  • Tavazzi, L. (2000). Ventricular pacing: a promising new therapeutic strategy in heart failure. For whom?. Eur Heart J 21: 1211-1214  
  • Davies, C.H., Bashir, Y. (1999). Beta-blockers for heart failure-time to think the unthinkable?. QJM 92: 673-678 [Full Text]  
  • SLEIGHT, P. (1999). A Napoleonic future for cardiology?. Heart 81: 455-455 [Full Text]  

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