BETA BLOCKER EVALUATION OF SURVIVAL TRIAL

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Congestive heart failure is a major public health problem affecting millions of patients in the United States. Because heart transplantation can only be offered to a minority of these patients, pharmacological therapy remains the mainstay. Survival has improved with the use of current pharmacological therapy, but nevertheless mortality is high in patients with severe congestive heart failure. If beta-blockers reduce mortality by 25% or more, this finding would have major implications in the care of the patients with this common condition. This project seeks to evaluate the efficacy of beta-blockers to improve the survival of a common clinical condition with a high mortality rate, Class III-IV congestive heart failure. Bucindolol is an investigational non-selective beta-blocker with mild vasodilator properties. It has already been used in several hundred patients with heart failure and has been extremely well tolerated. Patients are randomized between Bucindolol and plcebo, titrated upward to the maximal tolerated dose of Bucindolol and followed for 4.5 years.