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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

New concepts in managing patients with chronic heart failure: the evolving importance of beta-blockade{dagger}

* Corresponding author. Tel: +33 1 42 16 16 82; fax: +33 01 42 16 16 88. E-mail address: philippe.lechat@psl.ap-hop-paris.fr

The first 10% of the full text of this article appears below.

The publication of the results of the Cardiac Insufficiency Bisoprolol Study III (CIBIS III) in September 20051,2 marked a turning point in the practical treatment of chronic heart failure (CHF). Up to that point, physicians had no evidence on which to base their treatment strategy; ACE-inhibitor first or beta-blocker first. The only reason for the sequence of medication in current guidelines,3 i.e. an ACE-inhibitor first, is the history of the major beta-blocker trials in CHF, all of which were conducted in patients already receiving standard treatment with ACE-inhibitors and diuretics.

For the first time, CIBIS III showed that starting treatment of stable, mild-to-moderate CHF with a beta-blocker (bisoprolol), followed by the addition of an ACE-inhibitor (enalapril), is as effective and safe as starting with an ACE-inhibitor. . . . [Full Text of this Article]

Ronnie Willenheimer1 and Philippe Lechat2,*

1 Department of Cardiology, Lund University, University Hospital, Malmö, Sweden
2 Service de Pharmacologie, Hopital Pitié-Salpetriere, 47 Boulevard de l'Hôpital, 75013 Paris, France


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