Summary of the recommendations for β blocker use in patients with heart failure at the start of the study (1998)
| Indications |
| Patients with symptomatic heart failure from any cause, with depressed left ventricular function (ejection fraction ≤40%), in NYHA class II–III, clinically stable, already on treatment with ACE inhibitor, diuretic, and digitalis |
| Patients more likely to benefit are those with: |
| • History of hypertension |
| • Heart rate >90 beats/min |
| Patients less likely to benefit are those with: |
| • Severe biventricular dysfunction |
| • Systolic blood pressure <100 mm Hg |
| • Heart rate <60 beats/min |
| Uncertain indications |
| Elderly patients (>75 years) |
| NYHA class IV |
| Asymptomatic left ventricular dysfunction |
| Heart failure caused by valvar disease or diastolic dysfunction |
| Comorbidities (diabetes, mild to moderate obstructive pulmonary disease, renal failure, peripheral vascular disease) |
| Contraindications |
| Severe chronic obstructive pulmonary disease |
| First degree AV block (PQ >0.28 seconds) and second degree AV block (Mobitz 2 or advanced) |
| Heart rate <50 beats/min |
| Systolic blood pressure <90 mm Hg |
| ACE, angiotensin converting enzyme; AV, atrioventricular; NYHA, New York Heart Association. |