Heart failure has become in the last 20 years the most important problem in cardiology as it is one of the leading causes of death and morbidity. The number of patients suffering from this condition is increasing steadily, as, paradoxically, more persons with cardiac insufficiency survive, due to better medical treatment and progress in the surgery of many cardiac disorders. The quadruple epidemics of aging, diabetes, obesity, and atrial fibrillation have set the stage for the fight against heart failure, which may be the last great battle of cardiac disease. Despite the progress, several problems about the physiology, clinical aspects, diagnosis, and therapy of heart failure are neither completely elucidated nor solved. This monograph takes into account the different facets of the condition, from the basic molecular, biophysics, and genetic aspects of the syndrome, to the recognition of and treatment for this severe and intricate disease. The author leads us from the molecular to the physiological, clinical, and epidemiological aspects of this condition and provides a remarkable summary of clinical trials that are reshaping its management.  

What has been learned thus far is that heart failure, due to the multiple interplays of genetic, molecular, biophysical, and biochemical factors, is usually a progressive disorder, which in the end, through the continuous negative remodeling of the heart, tends to lead to irreversibility in the disease and to death, without appropriate treatment. The progress in therapy, mostly in pharmacology, has increased the rate of survival in the general population by 20 to 25% and prolonged life for the individual patient by some 5 to 8 years. The drugs that have primarily produced these results are the angiotensin-converting-enzyme (ACE) inhibitors and sartans, and the beta blockers; the latter probably the drugs most capable of producing positive heart remodeling and improving left ventricular function. Early use of these compounds is one of the most interesting methods of simultaneous prevention of heart failure and treatment of ventricular dysfunction even in the earlier phases of the syndrome. The monograph also provides a description of the electrical, mechanical, and surgical treatments available in the fight against this syndrome.  

This monograph provides cardiologists and internists interested in the topic of heart failure with a synopsis of modern views in the different aspects of the condition. It provides a succinct and thorough discussion of the treatments available and future directions, which is invaluable to trainees, their teachers, and practicing cardiologists.