BETA BLOCKER EVALUATION OF SURVIVAL TRIAL

β受体阻滞剂生存评价试验（BEST）是一项多中心， 由NIH和退伍军人支持的合作临床试验 管理评估是否添加β受体阻滞剂， 标准治疗（洋地黄、血管紧张素转换酶抑制剂） 将降低中度至重度（NYHA分级）患者的死亡率 III-IV）充血性心力衰竭（CHF）和左心室射血 馏分2 35%。 CHF是残疾和死亡的主要来源， 随着人口老龄化，患病率正在增加。血管扩张 治疗是唯一被证明可以降低死亡率的干预措施。增加 有证据表明，CHF患者神经激素水平升高可能 加速死亡率，初步数据表明， 神经激素与β受体阻滞剂治疗可以改善功能状态， 但没有令人信服的证据表明β受体阻滞剂治疗可以改善 CHF患者的寿命。 BEST，最大的beta测试 迄今为止，在CHF中使用阻滞剂的研究正在寻求随机化2400名患者， 在90家美国医院进行了长达10年的研究， 布新洛尔和安慰剂。 主要终点是全因死亡率。 次要终点包括心血管死亡率，生活质量， 术后3个月和12个月的住院和费用、射血分数 入组、心肌梗死发生率和其他治疗需求， 包括心脏移植。

The Beta Blocker Evaluation of Survival Trial (BEST) is a multicenter, collaborative clinical trial supported by the NIH and Veterans Administration assessing whether the addition of a beta blocker to standard therapy (digitalis, angiotensin converting enzyme inhibitor) will reduce mortality in patients with moderate to severe (NYHA Class III-IV) congestive heart failure (CHF) and left ventricular ejection fraction 2 35%. CHF is a major source of disability and death in the US and is increasing in prevalence as the population ages. Vasodilator therapy is the only intervention proven to reduce mortality. Increasing evidence suggests that elevated neurohormones in patients with CHF may hasten mortality, Preliminary data suggest that blunting the impact of neurohormones with beta blocker therapy may improve functional status, but there is no convincing evidence that beta blocker treatment improves longevity in patients with CHF. BEST, the largest trial of beta blockers in CHF to date, is seeking to randomize 2400 patients over 3 years at 90 US hospitals between an investigational beta blocker, bucindolol, and placebo. Primary endpoint is all-cause mortality. Secondary endpoints include cardiovascular mortality, quality of life, hospitalization and costs, ejection fraction at 3 and 12 months post- entry, incidence of myocardial infarction and need for other therapy, including cardiac transplantation.