PMID- 19667605
OWN - NLM
STAT- MEDLINE
DCOM- 20090901
LR  - 20161025
IS  - 1941-9260 (Electronic)
IS  - 0032-5481 (Linking)
VI  - 112
IP  - 5 Suppl Unanswered
DP  - 2002 Nov
TI  - Treating patients with severe heart failure.
PG  - 24-31
AB  - The roles of the renin-angiotensin system and the sympathetic nervous system in 
      the pathogenesis and progression of heart failure are well established. 
      Angiotensin-converting enzyme (ACE) inhibitors and ss-adrenergic-receptor 
      antagonists have been shown to slow down and, in many cases, reverse the process 
      of cardiac remodeling, thus leading to improved cardiac function and clinical 
      outcomes in patients with heart failure. Standard treatment for heart failure 
      consists of a diuretic, an ACE inhibitor (or angiotensin-receptor blocker if the 
      ACE inhibitor is not well tolerated), a ss-blocker, and low-dose digoxin (if 
      needed). Numerous clinical trials have demonstrated reductions in morbidity and 
      mortality with this combination of medications. However, the majority of patients 
      included in these clinical trials had New York Heart Association (NYHA) 
      functional class II or III heart failure. Because few patients with NYHA class IV 
      heart failure have been evaluated in clinical trials, the treatment approach in 
      this patient population is less well defined. The purpose of this article is to 
      review the results of clinical trials with ss-blockers that included patients 
      with severe heart failure.
FAU - Eichhorn, Eric J
AU  - Eichhorn EJ
AD  - University of Colorado Health Science Center, Denver, Colorado, USA. 
      eeichhorn@csant.com
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Postgrad Med
JT  - Postgraduate medicine
JID - 0401147
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Cardiotonic Agents)
RN  - 0 (Diuretics)
RN  - 73K4184T59 (Digoxin)
SB  - IM
MH  - Adrenergic beta-Antagonists/*therapeutic use
MH  - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use
MH  - Antihypertensive Agents/therapeutic use
MH  - Cardiotonic Agents/*therapeutic use
MH  - Digoxin/therapeutic use
MH  - Diuretics/*therapeutic use
MH  - Heart Failure/*drug therapy/mortality
MH  - Humans
MH  - Renin-Angiotensin System/drug effects
MH  - Sympathetic Nervous System/drug effects
RF  - 28
EDAT- 2002/11/01 00:00
MHDA- 2009/09/02 06:00
CRDT- 2009/08/12 09:00
PHST- 2009/08/12 09:00 [entrez]
PHST- 2002/11/01 00:00 [pubmed]
PHST- 2009/09/02 06:00 [medline]
AID - 10.3810/pgm.2002.11.suppl22.117 [doi]
PST - ppublish
SO  - Postgrad Med. 2002 Nov;112(5 Suppl Unanswered):24-31. doi: 
      10.3810/pgm.2002.11.suppl22.117.