What is the action of carvedilol in heart failure?

What is the action of carvedilol in heart failure?

Příspěvekod doxamajog » úte 26. čer 2018 11:08:44

Hello,

The original thinking was that beta blockers were bad for you is you were in heart failure as they reduce heart rate and myocardial contractility. However when ACE inhibitors were introduced we realised that heart failure brings with it major activation of the sympathetic nervous system and this in turn activates the renin-angiotensin system which then activates the sympathetic nervous system and leading to a vicious cycle of salt and water retention and worsening cardiac perfornance - heart failure begetting heart failure if you like. Beta blockers (particularly when used with ace-inhibitors ) block this cycle. They also probably have a rhythm stabilising effect. There are 4 beta blocker drugs used to treat heart failure carvedilol, metoprolol, bisoprolol and nebivolol. Metoprolol has fallen out of favour (you might like to look at the COMET trial). Carvedilol is a nonselective beta blocker that also vasodilates peripherally potentially reducing some beta blocker side effects. To my knowledge there is very little good data telling us which beta blocker to use in heart failure. I'm not sure if anyone esle knows of any?

Any help will be apprecited.

I didn't find the right solution from the Internet.

References:
http://www.doctorshangout.com/forum/top ... rt-failure
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Thank you.
doxamajog
 
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