Bisoprolol is a selective beta-1 adrenergic receptor blocker primarily used in the management of heart failure. It works by reducing heart rate and myocardial contractility, thereby decreasing the heart's workload and oxygen demand. This improvement in cardiac efficiency helps to reduce symptoms and increase survival in patients with chronic heart failure. Unlike non-selective beta blockers, bisoprolol has minimal effects on beta-2 receptors, which helps avoid bronchoconstriction, making it safer in heart failure patients. Its proven benefits in reducing hospitalizations and mortality make it a cornerstone therapy in heart failure management.

Reference: Harrison's Principles of Internal Medicine, J. Larry Jameson, 20th Edition.