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Second- and Third-Generation Beta-Blocking Drugs in Chronic Heart Failure

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Abstract

The left-ventricular (LV) functional, hemodynamic, and antiadrenergic effects of metoprolol, bucindolol, and carvedilol have been compared in three concurrent placebo-controlled clinical trials in patients with symptomatic idiopathic dilated cardiomyopathy. All three drugs were well tolerated, all produced at least moderate degrees of β-blockade as assessed by reduction in exercise heart rate, and all increased the left-ventricular ejection fraction. Compared with the β_1-selective, second-generation compound metoprolol, the third-generation compounds bucindolol and carvedilol lowered indices of adrenergic activity and tended to improve LV function to a greater extent. In patients with chronic heart failure there may be important therapeutic response differences between second- and third-generation beta-blocking agents.

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Authors and Affiliations

  1. University of Colorado Health Sciences Center, Denver, CO

    Michael R. Bristow, William T. Abraham, Tsutomu Yoshikawa, Michel White, Brack G. Hattler, Thomas S. Crisman, Brian D. Lowes & A.D. Robertson

  2. Salt Lake City, UT

    Patti Larrabee & Edward M. Gilbert

Authors
  1. Michael R. Bristow
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  2. William T. Abraham
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  3. Tsutomu Yoshikawa
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  4. Michel White
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  5. Brack G. Hattler
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  6. Thomas S. Crisman
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  7. Brian D. Lowes
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  8. A.D. Robertson
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  9. Patti Larrabee
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  10. Edward M. Gilbert
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Bristow, M.R., Abraham, W.T., Yoshikawa, T. et al. Second- and Third-Generation Beta-Blocking Drugs in Chronic Heart Failure. Cardiovasc Drugs Ther 11 (Suppl 1), 291–296 (1997). https://doi.org/10.1023/A:1007748131847

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  • DOI: https://doi.org/10.1023/A:1007748131847

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