LVEF < 40% (isotopic or angiographic performed within 4 weeks before randomization) aetiology of heart failure was defined as (1) idiopathic dilated cardiomyopathy when no known cause of cardiomyopathy could be found, (2) ischaemia when typical history of coronary artery disease, history of myocardial infarction, or presence of significant (70%) coronary artery stenoses had been hypertension when history of established hypertension or antihypertensive therapy was present, and (4)valvular heart disease; people with primary valvular disease (that had to be surgically repaired for at least 6 months) and people with nonischaemic dilated cardiomyopathy associated with a significant mitral valve insufficiency clinical stability, defined as the absence of any episode of heart failure decompensation during the 6 week period before entry into the trial and the absence of major modification of heart failure therapy in the previous 3 weeks. cardiomyopathy with predominant left ventricular diastolic dysfunction, heart failure secondary to mitral or aortic valve disease that was not surgically repaired or had been surgically repaired for less than 6 months, patient with coronary heart disease awaiting bypass surgery or a recent history of myocardial infarction (less than 3 months) people already on a heart transplantation waiting list nonambulatory patient with disabling permanent dyspnea at rest insulin-dependant diabetes asthma renal insufficiency (serum creatinine >300 mol/L) hypothyroidism or hyperthyroidism people whose life expectancy was shortened by a severe illness such as malignant disease resting heart rate <65 bpm or systolic blood pressure < 100 mm Hg or >160 mm Hg immediately before randomization. Flather Nebivolol (n=1067) Aged 70 years new drug therapy for heart Chronic Heart Failure Beta-blockers in heart failure and concomitant atrial fibrillation NICE 2018. All rights reserved. Subject to Notice of rights. 