West Suburban Cardiologists, Ltd (Chicago)

Heart Failure

Recent Publications:

MERIT-HF: In heart failure patients, controlled release Metoprolol CR/XL improved outcomes and survival in the Metoprolol Randomized Intervention Trial in Congestive Heart Failure (MERIT-HF). Patients with Class 2-4 heart failure EF < 40% were stabilized with optimal standard therapy and then randomized to addition of Metoprolol once daily (25 mg once daily if in Class 2 and 12.5 mg daily if in Class 3-4). The dose was then titrated to 200 mg once daily. Metoprolol reduced total mortality or all-cause hospitalizations by 19% and total mortality or CHF-hospitalizations by 31%. (Both highly significant findings) The drug also reduced the number of days hospitalized for CHF. Patients on this drug also felt better and the treatment was well tolerated. (Hjalmarson et al, JAMA 2000;283:1295)

This is another study demonstrating the efficacy of beta blocker therapy for patients with Congestive Heart Failure

Traditional medical therapy now consists of diuretics, ACE inhibitors (or angiotensin receptor blockers for those intolerant to ACE), beta blockers, digoxin, and spironolactone. Device therapy is the next major horizon for patients with refractory symptoms. These modalities include Biventricular pacemakers and resynchronization therapy. Acute treatment may now include IV infusion of nesiritide.

Read about Mangement of Acute Heart Failure (Written by Dr. Levin in 1997)
View a presentation by Dr. Gary Gibbs on CHF
External Link to a Low Sodium Cook Book
See links to defibrillator trials for patients with left ventricular dysfunction