Carvedilol differs from metoprolol in heart failure management principally because carvedilol additionally blocks:

• A α1-adrenoceptors, reducing afterload ✓
• B Muscarinic M2 receptors in the SA node
• C Dopamine D2 receptors in the renal cortex
• D Angiotensin II AT1 receptors, preventing ventricular remodelling

Explanation

Carvedilol is a non-selective β-blocker with additional α1-blocking activity; this combined action reduces both heart rate (β1) and afterload (α1 blockade on resistance vessels), which is advantageous in heart failure. Metoprolol is a selective β1-blocker without α-blocking properties. Carvedilol has no clinically significant M2 or AT1 receptor antagonism.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

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