[Chronic heart failure treatment in the year 2006]

Heart failure (HF) has a high incidence, near 2% of the population suffered this process, that increases with the age, affecting between 15-20 % of the population elder than 70 years. In the last 20 years the knowledge in pathophysiological mechanisms has improved, mainly, the role of neurohormonal response in the development and worsening of HF. In the last 15 years the efficient blockade of these mechanisms have improved the follow-up of these patients. The use of Angiotensin Converting Enzyme inhibitors, angiotensin II receptor blockers, Beta-blockers and antialdosteronic drugs have significantly decreased cardiovascular morbidity and mortality of these patients. Nevertheless 50% of patients with HF dies for electrical disturbance of the ventricular rithm, tachycardia and ventricular fibrillation. Also, disorders of intraventricular conduction worsen the functional degree. The implantable cardioverter defibrillator reduce mortality in patients at higher risk for mortality due to HF and Cardiac Resynchronization Therapy may lead to remarkable improvement in clinical status in selected patients with HF. Other measures, as cardiac transplantsand implantable left ventricular assist devices are becaming more exceptional in all occidental countries. Cell transplantation is an innovative technology and has the potential to revolutionize alternative therapeutic approaches to management of heart failure, but still a numkber of problems persist before the extending use of these techniques.