Heart failure(HF)and atrial fibrillation(AF)are common conditions that share similar clinical phenotype and frequently coexist.The classification of HF in patients with preserved ejection fraction(>50%,HFpEF),midra...Heart failure(HF)and atrial fibrillation(AF)are common conditions that share similar clinical phenotype and frequently coexist.The classification of HF in patients with preserved ejection fraction(>50%,HFpEF),midrange reduced EF(40%−49%,HFmrEF)and reduced EF(<40%,HFrEF)are crucial for optimising the therapeutic approach,as each subgroup responds differently.Betablocker constitute an important component of our pharmacological regimen for chronic HF.Betablocker administration is reccomended in patients with HF with reduced ejection fraction in stable sinus rhythm,due to improvement of symptoms,the better long termoutcome and survival.The beneficial role of betablocker use in patients with preserved EF still remain unclear,as no treatment showed a positive impact,regarding morbidity or mortality reduction.The presence of AF in HF patients increases as the disease severity evolves and is associated with a higher rate of cardiovascular morbidity and mortality.But more question is the use of betablocker in HF patients irrespective of EF and concomitant AF.There are many conflicting data and publications,regarding the beta blocker benefit in this population.Generally,it is supported an attenuation of betablockers beneficial effect in HF patients with AF.A design of more randomised trials/studies with HF patients and concomitant AF may improve our clinical approach of betablockers use and identify the patients with HF,who mostly profit from an invasive approach.展开更多
文摘Heart failure(HF)and atrial fibrillation(AF)are common conditions that share similar clinical phenotype and frequently coexist.The classification of HF in patients with preserved ejection fraction(>50%,HFpEF),midrange reduced EF(40%−49%,HFmrEF)and reduced EF(<40%,HFrEF)are crucial for optimising the therapeutic approach,as each subgroup responds differently.Betablocker constitute an important component of our pharmacological regimen for chronic HF.Betablocker administration is reccomended in patients with HF with reduced ejection fraction in stable sinus rhythm,due to improvement of symptoms,the better long termoutcome and survival.The beneficial role of betablocker use in patients with preserved EF still remain unclear,as no treatment showed a positive impact,regarding morbidity or mortality reduction.The presence of AF in HF patients increases as the disease severity evolves and is associated with a higher rate of cardiovascular morbidity and mortality.But more question is the use of betablocker in HF patients irrespective of EF and concomitant AF.There are many conflicting data and publications,regarding the beta blocker benefit in this population.Generally,it is supported an attenuation of betablockers beneficial effect in HF patients with AF.A design of more randomised trials/studies with HF patients and concomitant AF may improve our clinical approach of betablockers use and identify the patients with HF,who mostly profit from an invasive approach.
