Use of β-Blockers in Pulmonary Hypertension

Circ Heart Fail. 2017 Apr;10(4):e003703. doi: 10.1161/CIRCHEARTFAILURE.116.003703.

Abstract

Contrasting with the major attention that left heart failure has received, right heart failure remains understudied both at the preclinical and clinical levels. However, right ventricle failure is a major predictor of outcomes in patients with precapillary pulmonary hypertension because of pulmonary arterial hypertension, and in patients with postcapillary pulmonary hypertension because of left heart disease. In pulmonary hypertension, the status of the right ventricle is one of the most important predictors of both morbidity and mortality. Paradoxically, there are currently no approved therapies targeting the right ventricle in pulmonary hypertension. By analogy with the key role of β-blockers in the management of left heart failure, some authors have proposed to use these agents to support the right ventricle function in pulmonary hypertension. In this review, we summarize the current knowledge on the use of β-blockers in pulmonary hypertension.

Keywords: heart failure; heart ventricles; hypertension, pulmonary; receptors, adrenergic; sympathetic nervous system; β-blocker.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / adverse effects
  • Adrenergic beta-Antagonists / therapeutic use*
  • Animals
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / therapeutic use*
  • Arterial Pressure / drug effects*
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy
  • Heart Failure / physiopathology
  • Humans
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / drug therapy*
  • Hypertension, Pulmonary / mortality
  • Hypertension, Pulmonary / physiopathology
  • Patient Selection
  • Pulmonary Artery / drug effects*
  • Pulmonary Artery / physiopathology
  • Risk Factors
  • Treatment Outcome
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / drug therapy
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Right / diagnosis
  • Ventricular Dysfunction, Right / drug therapy
  • Ventricular Dysfunction, Right / physiopathology
  • Ventricular Function, Left / drug effects
  • Ventricular Function, Right / drug effects

Substances

  • Adrenergic beta-Antagonists
  • Antihypertensive Agents