as from indirect costs related to the reduction in the quality of life and to productivity loss [1][2][3] . Two million Brazilians are currently estimated to live with HF, and up to one third of hospital admissions in the Brazilian public health system are estimated to result from this disease 2,3 ; moreover, among patients older than 60 years of age, HF is the major cause of hospital admissions and mortality in Brazil and in the rest of the Western world 1,3 . The epidemiological setting seems to be even more discouraging: there is enough evidence suggesting that this problem will worsen in the future, since prevalence and mortality rates only increase year after year, in direct contrast to what has been observed for several other cardiovascular disorders 2,3 . All these considerations, that were formulated for a disease whose pathophysiological mechanisms have been recurrently reviewed and reformulated in the past years, only show how challenging it is to bring out the multifaceted character and the multisystemic progression inherent to HF 1,4