ABSTRACT
BENEFICIAL EFFECTS OF BETA-ADRENERGIC BLOCKERS The long-term effects of beta blockade on myocardial function are diametrically opposite to their short-term negative inotropic effects (1,2). Table 18.1 summarizes the potential cellular and hemodynamic benefi cial effects of these agents. Improvement in left ventricular ejection fraction (LVEF) (typically 5-8 EF units) has been one of the most consistent long-term effects of these agents, seen with both cardioselective and nonselective agents (Fig. 18.1A). The observed rise in ejection fraction has been shown to be dose-related (3). Treatment with beta blockers generally leads to improvement in heart failure symptoms, as manifested by a decrease in New York Heart Association (NYHA) functional class and Minnesota Living with Heart Failure scores (4).
