Herzinsuffizienz quo vadis?

Abstract

Already in the ancient world, clinical pictures were described that can be clearly recognised as heart failure nowadays. However not until the 17 th century, the first anatomic descriptions of heart failure were published. Another 200 years later, the physiology of the circulation was discovered and in the 20 th century, haemodynamic alterations in heart failure were described as well as insights in the cellular biochemistry and biophysics and finally in molecular-biological coherences. These six paradigms of the development of the understanding of heart failure have formed our thinking and acting in heart failure and have helped to develop countless diagnostic and therapeutic tools. The present article summarises where we are now and how we have achieved this. Then, it dares to give an outlook on what we will possibly have to expect in the coming years and decades. This will not only include the development and investigation of new diagnostics and therapeutics, but also additional tasks such as the implementation and transfer of knowledge, the selection of the best options from an increasing number of possibilities and the optimal distribution of the limited resources.