Open AccessNovel 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
Author(s) -
Hauptman Paul J.,
Woods Daniel,
Pritzker Marc R.
Publication year - 2002
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4950250512
Subject(s) - medicine , heart failure , inotrope , tolerability , blockade , beta blocker , intravenous therapy , beta (programming language) , cardiology , adverse effect , receptor , computer science , programming language
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 beta‐blocker therapy by bridging with a combination of intravenous inotrope and short‐acting intravenous beta blocker.