Cardiology MCQ: Beta blocker in heart failure

Which of the following beta blocker in heart failure had no benefit? a) Carvedilol b) Metoprolol extended release c) Nebivolol d) Bucindolol Correct answer: d) Bucindolol Bucindolol is a beta blocker with partial agonist activity, which did not reduce mortality in heart failure trial [Beta-Blocker Evaluation of Survival Trial (BEST) Investigators. A trial of the beta-blocker bucindolol in patients with advanced chronic heart failure. N Engl J Med. 2001;344:1659 –1667]. Earlier on beta blockers were contraindicated in heart failure because of their negative inotropic effects. But later several large scale trials showed the benefits of beta blocker in heart failure, establishing them as standard therapy in heart failure: The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet. 1999;353:9–13. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet. 1999;353:2001–7. Packer M, Bristow MR, Cohn JN, Colucci WS, Fowler MB, Gilbert EM, et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group. N Engl J Med. 1996;334:1349–55. But a word of caution is needed while using beta blocker therapy in heart failure. Beta blocker should not be initiated in those with decompensated heart failure requiring intravenous diuretics or inotropes. Typically beta blockers are started in small do...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs