[Is it necessary to suspend betablockers in decompensated heart failure with low output?].

Autor: Lima MV; Instituto do Coração, Faculdade de Medicina, USP, São Paulo, SP, Brasil. villacalima@cardiol.br, Cardoso JN, Ochiai ME, Grativvol KM, Grativvol PS, Brancalhão EC, Munhoz RT, Morgado PC, Scipioni AR, Barretto AC
Jazyk: Multiple languages
Zdroj: Arquivos brasileiros de cardiologia [Arq Bras Cardiol] 2010 Oct; Vol. 95 (4), pp. 530-5. Date of Electronic Publication: 2010 Aug 13.
DOI: 10.1590/s0066-782x2010005000108
Abstrakt: Background: there is evidence that the suspension of betablockers (BB) in decompensated heart failure may increase mortality. Dobutamine (dobuta) is the most commonly used inotrope in decompensation, however, BB and dobuta act with the same receptor with antagonist actions, and concurrent use of both drugs could hinder compensation.
Objective: to evaluate whether the maintenance of BB associated with dobuta difficults cardiac compensation.
Methods: we studied 44 patients with LVEF < 45% and the need for inotropics. Divided into three groups according to the use of BB. Group A (n=8): those who were not using BB at baseline; Group B (n=25): those who used BB, but was suspended to start dobuta; Group C (n = 11): those who used BB concomitant to dobuta. To compare groups, we used the Student t, Fisher exact and chi-square tests. Considered significant if p < 0.05.
Results: mean LVEF 23.8 ± 6.6%. The average use of dobuta use was similar in all groups (p = 0.35), and concomitant use of dobutamine with BB did not increase the length of stay (BB 20.36 ± 11.04 days vs without BB 28.37 ± 12.76 days, p = NS). In the high dose, BB was higher in patients whose medication was not suspended (35.8 ± 16.8 mg/day vs 23.0 ± 16.7 mg/day, p = 0.004).
Conclusion: maintaining BB associated with dobutamine did not increase the length of hospitalization and was not associated with the worst outcome. Patients who did not suspend BB were discharged with higher doses of the drug.
Databáze: MEDLINE
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