[Management of heart failure: a challenge for healthcare systems].

Heart failure is a highly prevalent disorder associated with increased mortality, repeated and lengthy hospitalization, and disability. Major progress has been made in the treatment of chronic heart failure associated with a reduced ejection fraction, through the development of neuromodulators such as angiotensin-converting-enzyme inhibitors, betablockers, angiotensin receptor blockers, mineralocorticoid receptor antagonists and, more recently, the bradycardic agent ivabradine. By contrast, little or no progress has been made in the management of acute heart failure or of heart failure with a preserved ejection fraction. New treatment modalities, including drugs, devices, and other novel approaches are currently being developed with the aim of reducing morbidity and/or mortality and improving the quality of life of patients with these disorders, which are a major burden for healthcare systems.