Cardiodynamic effects and mechanisms of action of β-blockers

The long-term beneficial effects of beta-blocker therapy in heart failure have been clearly established. However, the underlying mechanisms responsible for the improvement in the clinical course and natural history of heart failure remain unclear. beta-blockade could work through any number of pathways to improve survival and decrease the risk of progressive heart failure. The possibilities include favorable effects on cardiac structure and function, protection from sudden cardiac death, prevention of coronary events, and reduction in oxidative stress. In all likelihood, no single mechanism accounts for the clinical benefits of beta-blockade, but further studies are needed to identify and clarify the roles of the different mechanisms that contribute to the clinical benefits.