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 -Blocker Therapy for Heart Failure
The Evidence Is In, Now the Work Begins
Robert M. Califf, MD;
Christopher M. O'Connor, MD
JAMA. 2000;283:1335-1337.
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The young intern, Dr O'Connor, is beginning his rotation in the cardiac care unit in 1983. His faculty attending, Dr Califf, notices that Dr O'Connor has initiated  -blockade in a patient with heart failure. The discussion that ensues does not reflect positively on Dr O'Connor's future career. In 2000, both physicians realize that their understanding of blockade of the -receptor as a simple matter of reducing myocardial contractility was shortsighted and fundamentally incorrect. Dr O'Connor had initiated the right therapy but for the wrong reason.
This issue of THE JOURNAL contains the complete results of the Metoprolol CR/XL Randomized Intervention Trial in Congestive Heart Failure (MERIT-HF),1 including detailed quality-of-life and hospitalization data. As previously reported,2 the trial emphasizes the improvement in mortality among patients with moderate heart failure when treated with the long-acting -blocker controlled-release/extended-release metoprolol succinate (metoprolol CR/XL). (Similar survival information . . . [Full Text of this Article]
Author Affiliations: Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC.
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