Introduction .– Little study analyzed the effect of betablocker on echocardiographic, functional parameters and the capacity of exercise in case of heart failure.

Aim .– To analyze the impact of betablocker on several clinical, functional, echocardiographic, biochemical parameters, and to define predictive factors of improvement.

Methods .– Our study is prospective between August 2009 and June 2010 including patients followed in cardiology department of Hédi Chaker hospital for steady heart failure due to left ventricular systolic dysfunction. Patients benefited a clinical, functional (NYHA class, TM6M, Minnesota score), echocardiographic assessment and a dosage of the NT-proBNP before taking bisoprolol, and 3 months after the tolerated maximal dose.

Results .– Forty patients have been included in the study. The mean age was of 61,15 ± 9,86 years, the sex-ratio was 9. The heart failure was ischemic in 70% of cases. The mean dose of bisoporolol was 5,375 ± 0,75 mg. The tolerance to the betablocker was good at 70% of patients. A transient aggravation of the effort dyspnea has been noted at 10% of patients. Only one death occurred in the outside of the phase of titration. A reduction of the heart rate has been noted ( P = 0, 08). No meaningful elongation of the QRS and the QT has been noted. The NYHA class ( P < 0,001) and the TM6M improved of meaningful way ( P < 0,001). The left ventricle ejection fraction (LVEF) improved at 72,5% of patients. The average of the (LVEF) passed of 29,44 ± 6,51 to 34,49 ± 6,9; P < 0,001. Diastolic function improved of meaningful way at 33% of patients with improvement of the mitral profile ( P = 0, 08) and of replenishment pressures ( P = 0, 06). A meaningful improvement of the right ventricle function has been noted at 17,9% of patients. In univariate analysis, the heart rate < 76 bpms, the width of the QRS, a LVEF < 30, 5% were predictive of improvement of the LVEF. The E/Ea ratio was predictive of diastolic function improvement and no predictive factor of improvement of the right ventricle function has been recovered.

Conclusion .– The bisoprolol permitted to improve clinical, functional, echocardiographic parameters and to decrease the NT-proBNP of meaningful way.