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Heart failure currently constitutes one of the greatest health problems in the Western world. Its incidence, far from diminishing or even remaining stable, is actually still increasing in association with the aging of the population and its lifestyle. A better knowledge of physiopathological mechanisms has allowed for the development of new therapeutic focal points and lines of research. Nevertheless, its treatment is complex and encompasses a multidisciplinary approach. Patients in an advanced stage still have a very high mortality rate in spite of receiving optimum medical care. The development of new therapeutic techniques that afford a better prognosis has therefore been essential. Of these, and leaving aside surgical treatments, myocardial regeneration by means of cellular therapy, new concepts in tissue engineering and their results, and the applications of new advances in the field of immunomodulation have all recently experienced development. In this article, the aim is to bring the latest concepts in the physiopathology and humoral response of cardiac failure up to date as well as doing the same with the therapeutic approaches in this area.

A patient with Finnish type familial systemic amyloidosis associated with lattice corneal dystrophy (Meretoja's syndrome) underwent heart transplantation with uneventful postoperative course. Five years later the patient has mild chronic renal failure, normal cardiac allograft function and almost total bilateral blindness.