[The best of cardiac failure in 2005]

The year 2005 saw the validation of resynchronisation treatment of cardiac failure with improved mortality in certain symptomatic patients under optimal medical therapy with QRS duration >150 msec. The implantable defibrillator has ousted the last antiarrhythmic drug, amiodarone, on which hopes for a reduction in mortality had been based. The positive inotropic agents have thrown their last reserves into the fight against cardiac failure: the anti-endothelins have not yet been shown to have significant benefits. The year 2005 was also the year of recommendations: European in acute and chronic heart failure, and American. The importance of clinical practice has been emphasised by the role given to registers. Finally, the diseases change: cardiomyopathy of stress is recognised in this stressful era; the importance of polypathology is increasingly understood in the elderly; the importance of renal function has been underlined although the method of its evaluation is less clear. As usual, there have been many advances in 2005, difficult to summarise in just a few lines.