Decreasing Contractility & Heart Rate

• Reduce contractility & heart rate:

  • beta blockers e.g. atenolol, propranolol, metaprolol, bisoprolol
  • beta blockers prevent overwork, by resting a failing heart
  • but the heart can only work less hard because pre-load/after-load have been reduced
• How beta blockers work in heart failure:

  • in addition, beta blockers also:
  • promote myocardial perfusion
  • boost cardiac filling -> augmenting stroke volume