“…However, it is not clear whether all β-blockers share these benefits as a ‘class effect’ or whether different formulations exert different effects [6, 7]. To date, only 4 β-blockers, the nonselective β 1 -/β 2 -/α 1 -blocker carvedilol and the selective β 1 -blockers controlled release/extended release (CR/XL) metoprolol succinate, bisoprolol and, more recently, nebivolol, have been shown to be beneficial in large-scale controlled randomized clinical trials and consequently approved for the treatment of HF [1,2,3]. Atenolol, a selective β 1 -blocker, is currently approved as an antihypertensive [8] and anti-ischemic drug [9], but is commonly prescribed ‘off-label’ in patients with HF [10, 11], despite the absence of evidence-based efficacy data in this patient population based on the assumption that all β-blockers share the same salutary effects in the treatment of HF [12,13,14,15].…”