Choosing among ß-blockers in heart failure patients according to ß-receptors' location and functions in the cardiopulmonary system.
Pharmacol Res
; 156: 104785, 2020 06.
Article
en En
| MEDLINE
| ID: mdl-32224252
ABSTRACT
Several large clinical trials showed a favorable effect of ß-blocker treatment in patients with chronic heart failure (HF) as regards overall mortality, cardiovascular mortality, and hospitalizations. Indeed, the use of ß-blockers is strongly recommended by current international guidelines, and it remains a cornerstone in the pharmacological treatment of HF. Although different types of ß-blockers are currently approved for HF therapy, possible criteria to choose the best ß-blocking agent according to HF patients' characteristics and to ß-receptors' location and functions in the cardiopulmonary system are still lacking. In such a context, a growing body of literature shows remarkable differences between ß-blocker types (ß1-selective blockers versus ß1-ß2 blockers) with respect to alveolar-capillary gas diffusion and chemoreceptor response in HF patients, both factors able to impact on quality of life and, most likely, on prognosis. This review suggests an original algorithm for choosing among the currently available ß-blocking agents based on the knowledge of cardiopulmonary pathophysiology. Particularly, starting from lung physiology and from some experimental models, it focuses on the mechanisms underlying lung mechanics, chemoreceptors, and alveolar-capillary unit impairment in HF. This paper also remarks the significant benefit deriving from the correct use of the different ß-blockers in HF patients through a brief overview of the most important clinical trials.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Receptores Adrenérgicos beta
/
Antagonistas Adrenérgicos beta
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Insuficiencia Cardíaca
/
Pulmón
/
Miocardio
Tipo de estudio:
Guideline
/
Prognostic_studies
Límite:
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Pharmacol Res
Asunto de la revista:
FARMACOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Italia