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

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.