Are beta-adrenergic-blocking drugs useful in the treatment of dilated cardiomyopathy?

CONVENTIONAL treatment of patients with dilated cardiomyopathy has focused on the use of diuretic, inotropic, and vasodilator drugs. Despite the development of new vasodilators and inotropic agents, the bleak prognosis for these patients has changed little. An innovative and somewhat radical approach to the therapy of dilated cardiomyopathy was reported in 1975 by Waagstein et al. l in Goteborg, Sweden. These investigators described seven patients with dilated cardiomyopathy who responded to,3-adrenergic-blocking drugs with marked clinical improvement over a period of several months. Since 1975 several groups of investigators have studied the effects of 8-adrenergic blockers on the hemodynamics, clinical course, and survival of patients with dilated cardiomyopathy. Despite a widespread belief by the medical community that /3-adrenergic blockers are harmful to patients with congestive heart failure, several studies have reported a salutary effect of these drugs in patients with idiopathic dilated cardiomyopathy. The results of published studies on this subject have been inconsistent, however.