Although it did not reduce mortality in a large clinical trial, it did reduce the symptoms of heart failure and the rate of hospitalization. It is important to keep the blood level of this drug in an appropriate range, since excess levels can cause toxicity. Beta Blockers - This class of drugs has been shown to improve the function of the heart and to prolong life. They work by antagonizing the adverse effects of elevated catecholamines on the heart. They must be administered initially at very low doses, and then gradually increased.
Benefit takes many weeks to appear.
Because they can initially cause worsening heart failure, they must be given gradually and under careful supervision. Spironolactone - This drug is a weak diuretic. In patients with severe heart failure, spironolactone reduced mortality on top of all of the other drugs and thus can have benefit in this circumstance. Amiodarone - Many patients with heart failure have serious arrhythmias. The antiarrhythmic of choice in this circumstance is amiodarone.