Beta-blockers, including carvediloland bisoprolol, are commonly recommended for the management of heart failurewith reduced ejection fraction (HFrEF). Variations in dosing regimens and theircomparative efficacy in reducing morbidity and mortality remain a subject ofdebate. Howeverdifferent doses and their relative efficacy in reducing morbidity &mortality cause are contradictory. The present study evaluated the effects ofCarvedilol and Bisoprolol in different doses on Left Ventricle Ejection Fraction(LVEF), Heart Rate, Blood Pressure, Arrhyhthmias, Inflammatory markers, MACE,Hospital Admission & Mortality in patients with HFrEF along with guidelinedirected medical or device therapy (GDMT). 

Materials and Methods: A prospective study was conducted involving 138 individuals presentingwith symptomatic HFrEF classified as New York Heart Association (NYHA) classIII-IV. Participants were randomized into two treatment groups, receivingeither carvedilol or bisoprolol at dosages determined by physician discretion,in conjunction with guideline-directed medical or device therapy (GDMT).Clinical parameters and objective evidence were assessed at baseline and after6 to 12 months of follow-up.

Result: Baseline male predominance was observed in both groups (63.33% forcarvedilol, 56.67% for bisoprolol). The majority of patients were NYHA classIII. Both treatment groups demonstrated statistically significant improvements followingthree months of therapy (p ≤ 0.05). In the carvedilol cohort, mean LVEFincreased from 32.26% to 46.4%, heart rate and blood pressure decreased from104.23 to 85.13 bpm and from 125.6/83.3 to 91.3/62.5 mmHg, respectively. Thebisoprolol group showed improvements from 31.5% to 45.3% LVEF, 102.8 to 72.4bpm, and 127.4/82.2 to 102.2/74.2 mmHg, respectively. No statisticallysignificant differences were evident between the cohorts (p > 0.05).Hospitalization due to hypotension occurred more frequently in the carvedilolgroup (22.2% vs. 5.4% for bisoprolol). Adequate rate control was observed in54% of carvedilol and 72% of high-dose bisoprolol-treated patients. Mortalityrates were higher in the carvedilol cohort, which reached statisticalsignificance

Conclusion: Bisoprolol, administered twice daily at either low or high dose,demonstrated superiority in reducing rates of hospitalization, hypotension, andmortality compared to carvedilol in patients with HFrEF.