Third-generation beta-blocking agents developed for the hypertension marked are proving useful in the treatment of chronic heart failure (HF). These compounds share the ancillary property of vasodilation, which improves acute tolerability by unloading the failing left ventricle at a time when beta-adrenergic produces myocardial depression. In the case of carvedilol and bucindolol, this allows for the administration of nonselective beta blockade. Because of blockade of both β1 and β2 adrenergic receptors as well as other properties, these compounds possess a more comprehensive antiadrenergic profile than second-generation, β1-selective compounds. For this and potentially other reasons, this-generation beta-blocking agents have theoretical efficacy advantages that have yet to be demonstrated in large- scale trials. Ongoing trials with either second- or third-generation compounds and one trial directly comparing a compound from each class will provide the answer as to whether third-generation compounds have an advantage in the treatment of chronic HF.
- Adrenergic nervous system
- Beta-blocking agents
- Heart failure
- Third- generation beta-blocking agents
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine