The place of bisoprolol cardioselective beta-adrenoblocker in treatment of patients with different chronic heart failure phenotypes


DOI: https://dx.doi.org/10.18565/therapy.2022.1.123-132

Larina V.N., Larin V.G.

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow
Abstract. Beta-adrenoblockers (β-AB) have proven their positive effect at the prognosis of patients with chronic heart failure (CHF) and low ejection fraction (EF) of the left ventricle (LV), with myocardial infarction and asymptomatic LV dysfunction. Activation of the sympathoadrenal system determines the necessity for prescribing this group of medicines, which is confirmed in controlled studies, and bisoprolol was the first β-AB medicine that proved its effectiveness in CHF and low LVEF. Blockade of adrenergic receptors has a direct effect on cardiomyocytes and reduces the neurohumoral response. These advantages may also be applied to patients with CHF and LVEF of 40–49%, for whom b-AB therapy is more likely to help than harm. The benefits of β-AB prescription for patients with CHF and LVEF ≥50% were not noted in order to make reliable conclusions about their effectiveness or safety. Considering all abovementioned information, the purpose of the review is to discuss the possibilities and prospects of prescribing cardioselective β-AB, in particular bisoprolol, for multimorbid CHF patients.
Keywords: phenotypes, beta-adrenoblockers, bisoprolol, survival, heart failure, prognosis
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About the Autors

Vera N. Larina, MD, professor, head of the Department of polyclinic therapy of the faculty of general medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova Str. Tel.: +7 (910) 473-35-66. E-mail: larinav@mail.ru. ORCID: 0000-0001-7825-5597
Vladimir G. Larin, PhD, associate professor, associate professor of the Department of polyclinic therapy of the faculty of general medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova Str. Tel.: +7 (910) 477-71-80. E-mail: larinvladimir@mail.ru. ORCID: 0000-0002-3177-3407


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