{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:52:06Z","timestamp":1789663926887,"version":"4.0.1"},"reference-count":76,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Treatment with \u03b2-blockers is the main strategy for managing patients with heart failure and reduced ejection fraction because of their ability to reverse the neurohumoral effects of the sympathetic nervous system, with consequent prognostic and symptomatic benefits. However, to date, they are underused, mainly because of the misconception that hypotension and bradycardia may worsen the haemodynamic status of patients with HFrEF and because of the presence of comorbidities falsely believed to be absolute contraindications to their use. To promote proper use of \u03b2-blockers in this article, we review the clinical pharmacology of \u03b2-blockers, the evidence of the beneficial effects of these drugs in heart failure with reduced ejection fraction, and the current guidelines for their use in clinical practice and in the presence of comorbidities (e.g., pulmonary disease, diabetes, atrial fibrillation, peripheral arterial disease, etc.). It is hoped that the practical approach discussed in this review will allow for a proper diffusion of knowledge about the correct use of \u03b2-blockers and the drug-disease interactions to achieve their increased use and titration, as well as for the selection of a specific agent with a view to a properly tailored approach for HFrEF patients.<\/jats:p>","DOI":"10.3390\/jcdd8090101","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T22:12:22Z","timestamp":1629843142000},"page":"101","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["The Use of \u03b2-Blockers in Heart Failure with Reduced Ejection Fraction"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6781-7424","authenticated-orcid":false,"given":"Daniele","family":"Masarone","sequence":"first","affiliation":[{"name":"Heart Failure Unit, Department of Cardiology, A. O. dei Colli, Monaldi Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luigia","family":"Martucci","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Department of Cardiology, A. O. dei Colli, Monaldi Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittoria","family":"Errigo","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Department of Cardiology, A. O. dei Colli, Monaldi Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Pacileo","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Department of Cardiology, A. O. dei Colli, Monaldi Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.15420\/cfr.2016:25:2","article-title":"Global public health burden of heart failure","volume":"3","author":"Savarese","year":"2017","journal-title":"Card. Fail. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.1161\/CIR.0000000000000558","article-title":"Heart disease and stroke statistics-2018 update: A report from the American Heart Association","volume":"137","author":"Benjamin","year":"2018","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1002\/ejhf.1234","article-title":"Incremental benefit of drug therapies for chronic heart failure with reduced ejection fraction: A network meta-analysis","volume":"20","author":"Komajda","year":"2018","journal-title":"Eur. J. Heart Fail."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1056\/NEJMcp0909392","article-title":"Systolic heart failure","volume":"362","author":"McMurray","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1016\/S0140-6736(17)31071-1","article-title":"Heart failure","volume":"390","author":"Metra","year":"2017","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/ejhf.592","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"18","author":"Ponikowski","year":"2016","journal-title":"Eur. J. Heart Fail."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1016\/j.jacc.2020.11.022","article-title":"2021 Update to the 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment: Answers to 10 Pivotal Issues About Heart Failure with Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee","volume":"77","author":"Maddox","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.cjca.2021.01.017","article-title":"CCS\/CHFS Heart Failure Guidelines Update: Defining a New Pharmacologic Standard of Care for Heart Failure With Reduced Ejection Fraction","volume":"37","author":"McDonald","year":"2021","journal-title":"Can. J. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"323","DOI":"10.3389\/fphys.2013.00323","article-title":"New advances in beta-blocker therapy in heart failure","volume":"4","author":"Barrese","year":"2013","journal-title":"Front. Physiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1161\/CIRCRESAHA.113.300308","article-title":"Adrenergic nervous system in heart failure: Pathophysiology and therapy","volume":"113","author":"Lymperopoulos","year":"2013","journal-title":"Circ. Res."},{"key":"ref_11","first-page":"2","article-title":"Medical inertia in the optimization of heart failure treatment after discharge and its relationship to outcome","volume":"6","author":"Berthelot","year":"2018","journal-title":"Health Care Curr. Rev."},{"key":"ref_12","first-page":"31102","article-title":"Low Utilization of Beta-Blockers Among Medicare Beneficiaries Hospitalized for Heart Failure with Reduced Ejection Fraction","volume":"16","author":"Loop","year":"2018","journal-title":"J. Card. Fail."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2837","DOI":"10.1161\/CIRCULATIONAHA.104.500546","article-title":"Mechanisms and models in heart failure: The biomechanical model and beyond","volume":"111","author":"Mann","year":"2005","journal-title":"Circulation"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1038\/nature06798","article-title":"Tackling heart failure in the twenty-first century","volume":"451","author":"Mudd","year":"2008","journal-title":"Nature"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1016\/j.jacc.2009.05.015","article-title":"The sympathetic nervous system in heart failure physiology, pathophysiology, and clinical implications","volume":"54","author":"Triposkiadis","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"R262","DOI":"10.1152\/ajpregu.00183.2004","article-title":"Cardiac neuronal hierarchy in health and disease","volume":"287","author":"Armour","year":"2004","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/0163-7258(93)90030-H","article-title":"Beta-adrenoceptors in cardiac disease","volume":"60","author":"Brodde","year":"1993","journal-title":"Pharmacol. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1161\/01.RES.0000102042.83024.CA","article-title":"What is the role of beta-adrenergic signaling in heart failure?","volume":"93","author":"Lohse","year":"2003","journal-title":"Circ. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/BF00795359","article-title":"Mechanisms of beta-adrenergic receptor desensitization: From molecular biology to heart failure","volume":"91","author":"Lohse","year":"1996","journal-title":"Basic Res. Cardiol."},{"key":"ref_20","first-page":"S164","article-title":"Receptor systems affecting force of contraction in the human heart and their alterations in chronic heart failure","volume":"11","author":"Brodde","year":"1992","journal-title":"J. Heart Lung Transplant."},{"key":"ref_21","first-page":"I12","article-title":"Beta-adrenergic pathways in nonfailing and failing human ventricular myocardium","volume":"82","author":"Bristow","year":"1990","journal-title":"Circulation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/s10741-014-9418-y","article-title":"Pathophysiological mechanisms of catecholamine and cocaine-mediated cardiotoxicity","volume":"19","author":"Liaudet","year":"2014","journal-title":"Heart Fail. Rev."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/S0014-2999(02)02643-2","article-title":"Toxic cardiac effects of catecholamines: Role of beta-adrenoceptor downregulation","volume":"456","author":"Brouri","year":"2002","journal-title":"Eur. J. Pharmacol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1161\/01.CIR.101.14.1634","article-title":"Catecholamines, cardiac beta-adrenergic receptors, and heart failure","volume":"101","author":"Lefkowitz","year":"2000","journal-title":"Circulation"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1046\/j.1472-8206.2001.00019.x","article-title":"Beta-blocker treatment in heart failure","volume":"15","author":"Bouzamondo","year":"2001","journal-title":"Fundam. Clin. Pharmacol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1161\/CIRCRESAHA.111.245092","article-title":"Treatment of chronic heart failure with \u03b2-adrenergic receptor antagonists: A convergence of receptor pharmacology and clinical cardiology","volume":"109","author":"Bristow","year":"2011","journal-title":"Circ. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1001\/archinte.160.9.1237","article-title":"Beta-blockers: The new standard of therapy for mild heart failure","volume":"160","author":"Abraham","year":"2000","journal-title":"Arch. Intern. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s11936-015-0435-5","article-title":"Pathophysiologic insights into heart rate reduction in heart failure: Implications in the use of beta-blockers and ivabradine","volume":"18","author":"Kitai","year":"2016","journal-title":"Curr. Treat. Options Cardiovasc. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"104274","DOI":"10.1016\/j.phrs.2019.104274","article-title":"Antiarrhythmic mechanisms of beta blocker therapy","volume":"146","author":"Grandi","year":"2019","journal-title":"Pharmacol. Res."},{"key":"ref_30","first-page":"844","article-title":"Role of Beta-blockers in Cardiovascular Disease in 2019","volume":"72","year":"2019","journal-title":"Rev. Esp. Cardiol. (Engl. Ed.)"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1586\/14779072.5.1.21","article-title":"Carvedilol: Use in chronic heart failure","volume":"5","author":"Doughty","year":"2007","journal-title":"Expert Rev. Cardiovasc. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e015502","DOI":"10.1161\/JAHA.119.015502","article-title":"Stunned and Hibernating Myocardium: Where Are We Nearly 4 Decades Later?","volume":"9","author":"Kloner","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1161\/01.CIR.0000054530.87613.36","article-title":"Antiadrenergic therapy of chronic heart failure: Surprises and new opportunities","volume":"107","author":"Bristow","year":"2003","journal-title":"Circulation"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1016\/0140-6736(93)92930-R","article-title":"Beneficial effects of metoprolol in idiopathic dilated cardiomyopathy. Metoprolol in Dilated Cardiomyopathy (MDC) Trial Study Group","volume":"342","author":"Waagstein","year":"1993","journal-title":"Lancet"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Merit-HF Study Group (1999). Effect of metoprolol CR\/XL in chronic heart failure: Metoprolol CR\/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet, 353, 2001\u20132007.","DOI":"10.1016\/S0140-6736(99)04440-2"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/S0140-6736(03)13800-7","article-title":"Carvedilol or Metoprolol European Trial Investigators. Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol or Metoprolol European Trial (COMET): Randomized controlled trial","volume":"362","author":"Swedberg","year":"2003","journal-title":"Lancet"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1056\/NEJM199605233342101","article-title":"The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group","volume":"334","author":"Packer","year":"1996","journal-title":"N. Engl. J. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/S0140-6736(00)04560-8","article-title":"Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: The CAPRICORN randomized trial","volume":"357","author":"Dargie","year":"2001","journal-title":"Lancet"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.amjcard.2004.01.004","article-title":"Carvedilol prospective randomized cumulative survival (COPERNICUS) trial: Carvedilol in severe heart failure","volume":"93","author":"Fowler","year":"2004","journal-title":"Am. J. Cardiol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"The Cardiac Insufficiency Bisoprolol Study (CIBIS) (1994). CIBIS Investigators and Committees. A randomized trial of beta-blockade in heart failure. Circulation, 90, 1765\u20131773.","DOI":"10.1161\/01.CIR.90.4.1765"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"CIBIS-II Investigators (1999). The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): A randomized trial. Lancet, 353, 9\u201313.","DOI":"10.1016\/S0140-6736(98)11181-9"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1093\/eurheartj\/ehi115","article-title":"Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS)","volume":"26","author":"Flather","year":"2005","journal-title":"Eur. Heart J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1093\/eurheartj\/ehaa1012","article-title":"Heart failure drug treatment: The fantastic four","volume":"42","author":"Bauersachs","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1161\/01.CIR.0000065187.80707.18","article-title":"Beta-blockers in chronic heart failure","volume":"107","author":"Gheorghiade","year":"2003","journal-title":"Circulation"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1002\/ejhf.1369","article-title":"The use of diuretics in heart failure with congestion\u2014A position statement from the Heart Failure Association of the European Society of Cardiology","volume":"21","author":"Mullens","year":"2019","journal-title":"Eur. J. Heart Fail."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1053\/euhj.1999.1717","article-title":"Beta-blockers continue to surprise us","volume":"21","author":"Cruickshank","year":"2000","journal-title":"Eur. Heart J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1001\/archinte.164.13.1389","article-title":"Adverse effects of beta-blocker therapy for patients with heart failure: A quantitative overview of randomized trials","volume":"164","author":"Ko","year":"2004","journal-title":"Arch. Intern. Med."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Inamdar, A.A., and Inamdar, A.C. (2016). Heart Failure: Diagnosis, Management and Utilization. J. Clin. Med., 5.","DOI":"10.3390\/jcm5070062"},{"key":"ref_49","first-page":"2267","article-title":"Beta blocker therapy for chronic heart failure","volume":"62","author":"Ramahi","year":"2000","journal-title":"Am. Fam. Physician"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"359","DOI":"10.2165\/00002018-199513060-00005","article-title":"beta-blockers. Drug interactions of clinical significance","volume":"13","author":"Blaufarb","year":"1995","journal-title":"Drug Saf."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.ejheart.2004.01.015","article-title":"Beta-blocker induced bradycardia-should we pace?","volume":"6","author":"Hoppe","year":"2004","journal-title":"Eur. J. Heart Fail."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.ejim.2019.10.008","article-title":"Comorbidities in chronic heart failure: An update from Italian Society of Cardiology (SIC) Working Group on Heart Failure","volume":"71","author":"Correale","year":"2020","journal-title":"Eur. J. Intern. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"3859","DOI":"10.1002\/ehf2.12978","article-title":"Effect of disease-modifying agents and their association with mortality in multi-morbid patients with heart failure with reduced ejection fraction","volume":"7","author":"Straw","year":"2020","journal-title":"ESC. Heart Fail."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1002\/ejhf.183","article-title":"Chronic obstructive pulmonary disease in heart failure: Accurate diagnosis and treatment","volume":"16","author":"Brenner","year":"2014","journal-title":"Eur. J. Heart Fail."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1365-2796.2008.01975.x","article-title":"Chronic obstructive pulmonary disease in patients admitted with heart failure","volume":"264","author":"Iversen","year":"2008","journal-title":"J. Intern. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.ahj.2007.10.040","article-title":"Chronic obstructive pulmonary disease in heart failure. Prevalence, therapeutic and prognostic implications","volume":"155","author":"Mascarenhas","year":"2008","journal-title":"Am. Heart J."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1093\/eurheartj\/ehx026","article-title":"Determinants and clinical outcome of uptitration of ACE-inhibitors and beta-blockers in patients with heart failure: A prospective European study","volume":"38","author":"Ouwerkerk","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1016\/j.jacc.2010.01.024","article-title":"Differences between beta-blockers in patients with chronic heart failure and chronic obstructive pulmonary disease: A randomized crossover trial","volume":"55","author":"Jabbour","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Morales, D.R., Lipworth, B.J., Donnan, P.T., Jackson, C., and Guthrie, B. (2017). Respiratory effect of beta-blockers in people with asthma and cardiovascular disease: Population-based nested case control study. BMC Med., 15.","DOI":"10.1186\/s12916-017-0781-0"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1038\/s41598-020-79837-3","article-title":"Do beta-adrenergic blocking agents increase asthma exacerbation? A network meta-analysis of randomized controlled trials","volume":"11","author":"Huang","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1023\/A:1022146721098","article-title":"Beta-blockers and diabetes: The bad guys come good","volume":"16","author":"Cruickshank","year":"2002","journal-title":"Cardiovasc. Drugs Ther."},{"key":"ref_62","first-page":"246","article-title":"Beta-blockers and glucose control","volume":"19","author":"Mills","year":"1985","journal-title":"Drug Intell. Clin. Pharm."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1002\/clc.22288","article-title":"Hypoglycemia from a cardiologist\u2019s perspective","volume":"37","author":"Sanon","year":"2014","journal-title":"Clin. Cardiol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1016\/S0002-8703(03)00403-4","article-title":"Are beta-blockers as efficacious in patients with diabetes mellitus as in patients without diabetes mellitus who have chronic heart failure? A meta-analysis of large-scale clinical trials","volume":"146","author":"Haas","year":"2003","journal-title":"Am. Heart J."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/1475-2840-11-14","article-title":"Beta blocker use in subjects with type 2 diabetes mellitus and systolic heart failure does not worsen glycaemic control","volume":"11","author":"Wai","year":"2012","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/S0002-9149(02)03373-8","article-title":"Atrial fibrillation in heart failure: Epidemiology, pathophysiology, and rationale for therapy","volume":"91","author":"Maisel","year":"2003","journal-title":"Am. J. Cardiol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.1016\/S0140-6736(14)61373-8","article-title":"Beta-Blockers in Heart Failure Collaborative Group. Efficacy of \u03b2 blockers in patients with heart failure plus atrial fibrillation: An individual-patient data meta-analysis","volume":"384","author":"Kotecha","year":"2014","journal-title":"Lancet"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.jchf.2016.10.015","article-title":"Decreased Mortality with Beta-Blockers in Patients with Heart Failure and Coexisting Atrial Fibrillation: An AF-CHF Substudy","volume":"5","author":"Shohoudi","year":"2017","journal-title":"JACC. Heart Fail."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"91","DOI":"10.15420\/aer.2018.17.2","article-title":"Treatment of Atrial Fibrillation in Patients with Co-existing Heart Failure and Reduced Ejection Fraction: Time to Revisit the Management Guidelines?","volume":"7","author":"Baher","year":"2018","journal-title":"Arrhythm. Electrophysiol. Rev."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1161\/01.HYP.11.3_Pt_2.II21","article-title":"Beta adrenergic receptor blockers: Adverse effects and drug interactions","volume":"11","author":"Frishman","year":"1988","journal-title":"Hypertension"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1136\/bmj.286.6371.1085","article-title":"Which beta-blocker?","volume":"286","author":"Breckenridge","year":"1983","journal-title":"BMJ"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/j.0954-6820.1979.tb00739.x","article-title":"Beta-adrenergic blockade and vasospasm","volume":"625","author":"Thulesius","year":"1979","journal-title":"Acta. Med. Scand."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1056\/NEJM198005083021914","article-title":"Exacerbation of intermittent claudication by propranolol","volume":"302","author":"Fogoros","year":"1980","journal-title":"NEJM"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Paravastu, S.C., Mendonca, D.A., and Da Silva, A. (2013). Beta blockers for peripheral arterial disease. Cochrane Database Syst. Rev., 2013.","DOI":"10.1002\/14651858.CD005508.pub3"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"2893","DOI":"10.1016\/j.jacc.2019.09.059","article-title":"Beta-Blockers in Heart Failure Collaborative Group. Impact of Renal Impairment on Beta-Blocker Efficacy in Patients with Heart Failure","volume":"74","author":"Kotecha","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Meyer, M., Du Fay Lavallaz, J., Benson, L., Savarese, G., Dahlstr\u00f6m, U., and Lund, L.H. (2021). Association Between \u03b2-Blockers and Outcomes in Heart Failure with Preserved Ejection Fraction: Current Insights From the SwedeHF Registry. J. Card. Fail.","DOI":"10.1016\/j.cardfail.2021.04.015"}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/8\/9\/101\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:50:33Z","timestamp":1760165433000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/8\/9\/101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,24]]},"references-count":76,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["jcdd8090101"],"URL":"https:\/\/doi.org\/10.3390\/jcdd8090101","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,24]]}}}