The enormous impact of the growing epidemic of heart failure mandates the development of easily accessible registries for patients with all classes of CHF, particularly those with advanced heart failure. It also is important to compile data from patients not enrolled in randomized trials to truly appreciate the natural history of this disease. The continued aging of the United States population will surely lead to continual increase in the prevalence of heart failure and its impact on the health care economy. It also is important to develop methods to reliably identify patients with systolic versus primary diastolic dysfunction to better understand the demographics, risk factors, and natural history of diastolic dysfunction. Increased attention clearly is warranted to better understand the demographics and risk factors for development CHF and to help devise strategies to reduce the morbidity, mortality, and economic impact of this disease.