Second- and third-generation beta-blocking drugs in chronic heart failure

Michael R. Bristow, William T. Abraham, Tsutomu Yoshikawa, Michel White, Brack G. Hattler, Thomas S. Crisman, Brian D. Lowes, A. D. Robertson, Patti Larrabee, Edward M. Gilbert

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


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 β1-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.

Original languageEnglish (US)
Pages (from-to)291-296
Number of pages6
JournalCardiovascular Drugs and Therapy
Issue numberSUPPL. 1
StatePublished - 1997
Externally publishedYes


  • Antiadrenergic activity
  • Beta-blocking drugs
  • Chronic heart failure
  • Exercise response
  • Idiopathic dilated cardiomyopathy
  • Ischemic cardiomyopathy
  • Left ventricular function

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)


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