The long-term action of elevated catecholamine concentrations on the heart muscle causes a number of adverse effects from apoptosis to malignant arrhythmia or terminal failure of the cardiac pump. Recently completed mortality studies with beta-blockers (BB) in chronic heart failure CIBIS II and MERIT HF confirmed the conclusions of pilot studies with carvedilol that in stabilized chronic heart failure BB reduces the mortality rate as well as the need of hospital admission on account of deteriorating heart failure. Proper selection of patients for administration of BB is necessary, assessment of absolute and relative contraindications. It is also necessary to define the initiation and increase of dosage and the target dose of the beta-blocker. The sooner treatment with beta-blockers is started, the greater the foreseen benefit for the patient.

Keywords: Adrenergic beta-Antagonists /therapeutic use/; Bisoprolol /therapeutic use/; Carbazoles /therapeutic use/; Carvedilol; Heart Failure /drug therapy/; Humans; Metoprolol /therapeutic use/; Propanolamines /therapeutic use/