Novel use of a short-acting intravenous beta blocker in combination with inotropic therapy as a bridge to chronic oral beta blockade in patients with advanced heart failure

Paul Hauptman, Daniel Woods, Marc R. Pritzker

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

The role for beta blockers in advanced heart failure (New York Heart Association class IV) remains undefined because of concerns about tolerability and uncertainty about efficacy. We report the use of a short-acting intravenous beta blocker in combination with inotropic therapy as a means to bridge five patients with advanced heart failure to chronic oral beta blockade; two of these patients had been chronically managed with intravenous inotrope. At 4 months' follow-up, all patients remained on beta-blocker therapy and none was hospitalized for heart failure or had received intravenous diuretics. Given the early separation of survival curves in the randomized clinical trials of beta blockers in heart failure, it is possible that these patients will accrue a survival benefit. We conclude that some patients with advanced heart failure can be offered oral betablocker therapy by bridging with a combination of intravenous inotrope and short-acting intravenous beta blocker.

Original languageEnglish (US)
Pages (from-to)247-249
Number of pages3
JournalClinical Cardiology
Volume25
Issue number5
DOIs
StatePublished - Jan 1 2002

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Heart Failure
Therapeutics
Survival
Diuretics
Uncertainty
Randomized Controlled Trials

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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abstract = "The role for beta blockers in advanced heart failure (New York Heart Association class IV) remains undefined because of concerns about tolerability and uncertainty about efficacy. We report the use of a short-acting intravenous beta blocker in combination with inotropic therapy as a means to bridge five patients with advanced heart failure to chronic oral beta blockade; two of these patients had been chronically managed with intravenous inotrope. At 4 months' follow-up, all patients remained on beta-blocker therapy and none was hospitalized for heart failure or had received intravenous diuretics. Given the early separation of survival curves in the randomized clinical trials of beta blockers in heart failure, it is possible that these patients will accrue a survival benefit. We conclude that some patients with advanced heart failure can be offered oral betablocker therapy by bridging with a combination of intravenous inotrope and short-acting intravenous beta blocker.",
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