What is the secret of carvidilol’s superiority in CHF over other beta blockers ?
Beta blockers(BBs) have become key drugs in management of CHF .It helps by blocking toxic effects of inappropriately elevated catecholamine , which is actually a compensatory response(A fight and survival reaction ) from the sympathetic system to a failing heart . This process becomes a liability in the long run as the adrenergic receptors either down regulate or even promote apoptosis and cell death .Along with RASS-ACE it affects every cell in the body promoting neuro- humoral catabolic state.
By trial and error methodology we have found blocking the sympathetic system by BBs confer consistent benefits in CHF .This is in contrary to the days we were ignorantly stimulating the beta receptors with positive inotropic agents and wary to give BBs in cardiac failure .This is one the most dramatic 180 degree turn around in the annals of clinical cardiac therapeutics last century.
Is all BBs same ? Is it the class effect ?
It is tempting to think all BBs are equal and to conclude they simply represent a class effect.But carvidilol seems to be the flag bearer , for whatever reason . (Apart from the outcome of landmark studies , there is a pharmacological basis for it’s superiority COMET/COPERNICUS)
What is the secret of carvidilol’s superiority in CHF than other BBs ?
We know CHF is a systemic syndrome as do the sympathetic activation .Hence , In CHF , it would require a non selective , systemically acting beta block...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: dr s venkatesan Tags: Beta Blocker beta blockers in chf carvidilol vs metoprolol and bisoprolol How carvidilol is superior in chf cardiac failure Source Type: blogs
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