Chronic heart failure with reduced left ventricular ejection fraction (HFrEF) has become one of the most serious health problems. The basic clinical symptoms of HFrEF include: dyspnoea, physical effort intolerance and edema. The pharmacological treatment of HFrEF is multidirectional through a detailed understanding of the mechanisms (etiology and pathophysiology) leading to the development of the disease. The basic goals of the HFrEF pharmacological treatment is to improve the clinical condition, effort tolerance, quality of life, reduce the number of hospitalizations caused by exacerbation of the disease and mortality. The basis for the pharmacological treatment of patients with HFrEF and with left ventricular systolic dysfunction represent three groups of drugs blocking the nerohormonal system (angiotensin converting enzyme inhibitors, cardioselective β-blockers and mineralocorticoid / aldosterone receptor antagonists). These drugs reduce the risk of death and re-hospitalization. In the treatment of HFrEF are also used drugs which are expected to reduce the clinical symptoms observed in patients with HFrEF, which include: diuretics, angiotensin receptor antagonists and neprilysin inhibitors, If channel inhibitors, combination of hydralazine and isosorbide dinitrate, digoxin and other digitalis glycosides.

Keywords: chronic heart failure with reduced left ventricular ejection fraction, pharmacological treatment.