Table 1 Inclusion and exclusion criteria

 1

Men or women aged 20 years or older

 2

Confirmed left ventricular ejection fraction ≤ 40% by echocardiography within the pre-analytical 6 months

 3

NT-proBNP level ≥ 125 pg/ml or BNP level ≥ 35 pg/ml within the pre-analytical 3 months

 4

Clinically stable patient without evidence of congestion or extracellular fluid retention

 5

Patients providing written informed consent

 1

Systolic blood pressure in a sitting position < 90 mmHg or resting heart rate < 50 beats/min at screening

 2

Patient has a contraindication to beta-blockers

 3

Patient who are expected to take another beta-blocker after randomization

 4

Cardiovascular diseases;

Ischemic heart disease (unstable angina, myocardial infarction) within 1 month

Hypertrophic cardiomyopathy

Cor pulmonale

Hemodynamically significant stenosis of the aorta, aortic valve, or mitral valve

Acute myocardial infarction with complications

 5

Severe cerebrovascular accident (for example, ischemic stroke or cerebral hemorrhage) within the pre-analytical within 6 months

 6

Glottic edema, allergic rhinitis, respiratory diseases with bronchospasm such as asthma and chronic obstructive lung disease

 7

Peripheral vascular disease (for example, Raynaud’s syndrome, intermittent claudication)

 8

Patients who needs vasopressor support due to prominent volume retention/overload

 9

Moderate-to-severe retinopathy (for example, retinal hemorrhage, visual disturbance, retinal microaneurysm within 6 months)

 10

Impaired renal function (serum creatinine ≥ 2.5 mg/dL) or hepatic function (AST or ALT ≥ 3 × ULM)

 11

Patients in a clinical status that can significantly influence absorption, distribution, metabolism, and secretion of drugs for clinical trials:

History of major gastrointestinal surgery, such as gastrectomy or gastric bypass surgery

Inflammatory bowel disease within 12 months

Current gastric ulcer, pancreatic function abnormality including pancreatitis, gastrointestinal/rectal bleeding which requires treatment

Current urologic stenosis or obstruction which requires treatment

 12

Confirmed or suspected drug/alcohol abuse within 6 months

 13

Pregnant or lactating women, suspected pregnant women or lactating women

 14

Chronic inflammatory diseases which require anti-inflammatory treatment

 15

Hypersensitivity to carvedilol

 16

Malignant disease including lymphoma and leukemia within 5 years

 17

Patients who were prescribed other medication for any other clinical trials within the pre-analytical 28 days

 18

Patients who are expected to have prolonged hospital stay due to other medical problems other than chronic heart failure (for example, femoral neck fracture)

 19

Patients who are considered inappropriate by researchers to participate in the clinical trial