Heart failure incidence and prevalence are increasing due to the success in treating acute myocardial infarction with primary angioplasty and due to the overall increase in life expectancy, with a significant increase in the elderly population. In the United States, 6.5 million patients have heart failure, with a similar number in Western Europe [1]. The incidence in the United States is close to 800,000 new cases annually, with more than 300,000 deaths/year being attributed to heart failure, and with an annual cost to manage these patients estimated at over $30 billion [1]. Close to 40% of the heart failure patients have heart failure with reduced ejection fraction, and approximately 5–10% of these patients have advanced disease, yielding an estimated cohort of 100,000–200,000 patients who have a high 1-year mortality (over 30%) and can benefit of advanced therapies such as heart transplantation or ventricular assist devices [1].