The rate of generation of new knowledge and expansion of therapeutic approaches to the diagnosis and treatment of acute and chronic HF continues to be dramatic. Recent updates of major clinical guidelines have facilitated the translation of clinical evidence into everyday practice. However, as more and more options become available for this patient population, resource allocation and cost-effectiveness become challenging issues. Device therapies will continue to evolve with newer and broader indications. However, there are still major knowledge gaps regarding the prediction of treatment response and disease progression. New concepts in HF therapeutics (such as NO homeostasis and renal preservation) will need rigorous testing, and traditional strategies should continue to be challenged.