# Finn Waagstein and the paradigm shift in the treatment of heart failure with β-adrenergic receptor antagonists (‘β-blockers’)

## TL;DR

This paper reviews how Finn Waagstein challenged the belief that beta-blockers were harmful in heart failure, leading to their acceptance as a key treatment.

## Contribution

The paper highlights Waagstein's pivotal role in changing the medical paradigm regarding beta-blockers in heart failure treatment.

## Key findings

- Waagstein successfully treated cardiac decompensation with beta-blockers despite initial opposition.
- Clinical trials eventually confirmed the efficacy of beta-blockers in heart failure.
- The scientific community gradually accepted beta-blockers as first-line treatment.

## Abstract

Beta-adrenergic receptor antagonists, formerly called ‘β-blockers’ (which name will be used throughout this historical review), were initially used for their antihypertensive, anti-ischemic, and antiarrhythmic effects. In the early 1970s, the Swedish cardiologist Finn Waagstein opposed the paradigm that β-blockers were contraindicated in patients with decompensated heart failure. This review retraces the exciting paths of Waagstein’s personal fight for recognition of his successful therapy of cardiac decompensation in patients with acute myocardial infarction and also of heart failure. In the second part, we summarise the clinical trials that led to the slow acceptance by the scientific community of the paradigm shift from contraindication to first-line treatment with β-blockers in heart failure.