beta-blockers in heart failure: recently completed and ongoing clinical trials

beta-blockers have emerged as an important therapy in patients with symptom atic left ventricular systolic dysfunction. Early studies demonstrated that beta-blocker therapy improved left ventricular function, reduced neurohumo ral activity and reduced heart failure symptoms in these patients. While no ne of these small studies demonstrated a significant benefit in terms of ov erall survival, several meta-analyses suggested that beta-blocker therapy c ould, in fact, reduce mortality in patients with left ventricular systolic dysfunction and mild to moderate heart failure symptoms (New York Heart Ass ociation class II or III). Three large, recently completed, trials have con firmed the benefit of beta-blockade in these patients. This report reviews some of the initial clinical studies of beta-blockade in heart failure, exa mines the findings of the three large multicentre trials and other relevant research. Finally, ongoing trials designed to assess the relative efficacy of different beta-blockers and evaluate the utility of beta-blockade in sp ecific subsets of patients with heart failure are discussed.