BETA-BLOCKERS IN HEART-FAILURE

Beta-blocker therapy for heart failure has gained popularity as a resu lt of recent growing evidence that this group of drugs can reverse or slow the progressive left ventricular dilation that characterizes hear t failure. Although the mechanism of this favourable effect on remodel ling remains unclear, the present evidence indicates that at least a p ortion of the long-term benefit of these drugs is mediated through the ir beta-blocking action. A direct effect on myocyte and interstitial g rowth may be a key factor in their ability to inhibit the remodelling process. The growing database will eventually raise the possibility th at all patients with left ventricular dilation should take one of thes e drugs. A better understanding of differing mechanisms in individual patients would ideally provide selectivity in the therapeutic approach .