Of the three beta blockers recommended in patients with heart failure with reduced ejection fraction, only carvedilol exerts antagonist effects at α1 receptors. However, its benefits in heart failure are presumably a result of myocardial β1 receptor inhibition, as the β1-selective agents bisoprolol and metoprolol succinate confer similar improvements in morbidity and mortality. So what’s the significance of α1 receptor blockade?
