Enrolled patients had a left ventricular ejection fraction of less than 25 percent and symptoms at rest or minimal exertion despite treatment with diuretics and ACE inhibitors for at least two months, but no or minimal evidence of fluid retention at study entry. This study was stopped prematurely by the data and safety steering committee because of significant mortality benefit seen early with carvedilol. The study is undergoing final data analysis, and further study results are pending. Available data strongly support the effectiveness of long-term beta blockade in improving morbidity and mortality in patients with systolic heart failure. The philosophical and physiological evolution of three conceptual models of the disease.
Medical therapy can improve the biological properties of the chronically failing heart.
Khan NUA, Movahed A. Role of beta-blockers in congestive heart failure. Sabbah HN, Shimoyama H, Kono T, Gupta RC, Sharov VG, Scicli G, et al. Effects of long-term monotherapy with enalapril, metoprolol, and digoxin on the progression of left ventricular dysfunction and dilation in dogs with reduced ejection fraction. Packer M, Cohen JN, on behalf of the membership of the Advisory Council to Improve Outcomes Nationwide in Heart Failure. Consensus recommendations for the management of chronic heart failure.