Use of beta-blockers in patients with heart failure - unresolved issues.

The analysis of literature data reflecting the issues of the mechanisms of action of beta-blockers in patients with heart failure are present. The heart failure has many variants. With each of these options, the concentration of catecholamines and the sensitivity of beta receptors change differently. The effectiveness of beta-blockers also differs in this. The beta-adrenergic receptors genes polymorphisms also affect the efficacy and safety of beta-blockers. The comorbidities also affect to the action and efficacy of beta-blockers in patients with heart failure. When using beta-blockers in patients with heart failure, there are still many unresolved questions: What is the best reference point for titration of drugs - dose or heart rate; what effects do these drugs have in heart failure with a preserved left ventricular ejection fraction? How do beta-blockers affect the course of heart failure in patients with comorbid thyroid pathology, taking into account their pharmacological properties and their effect on the activity of peripheral deidinases?