Beta-blockers are a marked improvement in the treatment of chronic heart failure as has been confirmed by a number of mortality studies. The favorable effect of beta-blockers on mortality and morbidity has been found in patients already treated with ACE inhibitors and diuretics. Beta-blockers lower overall mortality by 36 % and markedly decrease even mortality due to sudden death. Beta-blockers on a long-term basis markedly improve the systolic function of the left ventricle and return the remodelation of the left ventricle to normal. In their effect several factors are in play, among the most significant being the anti-arrhythmic and anti-ischemic influence of beta-blockers as well as the protection of the myocardium against catecholamine toxicity. Cessation of treatment with beta-blockers leads to a deterioration of the patients' clinical state. Not all beta-blockers can be applied in therapy; only carvediolol, bisoprolol and retarded metoprolol succinate. Treatment begins with low doses which are gradually titered to higher ones.The combination of beta-blocker therapy withACEinhibitors has the greatest effect on overall mortality, lowering it by 46 %. The treatment of chronic heart failure is by far not optimal neither in the Czech Republic nor in Europe, and requires rapid improvement. As of now, clinical practice seriously lags behind scientific knowledge. It is surprising that in Europe therapy in hospitals is not better than treatment at the general practitioners. Shortcomings in the pharmacotherapy of patients with chronic heart failure can in part be explained by the fact that the revolutionary change in the role of beta-blockers from formerly contraindicated to absolutely indicated has come about at the close of the 1990s, and most of the major studies have not been published until 1999. Thus, one can only hope that the situation shall improve in our country as well as in Europe.

        Key words: beta-blockers - heart failure - IMPROVEMENT of HF - EuroHeart Failure Survey - state of the treatment of heart failure - Europe - Czech Republic.