1, the cause and prognosis of heart failure (heart failure): heart failure is not an independent disease, is a serious stage of various causes of heart disease, the main reason is a variety of causes caused by the damage or death of myocardial cells, myocardial contraction and diastolic function is severely reduced, so that the heart pumping blood to reduce, can not meet the needs of the body, and the resulting series of symptoms. The prevalence of heart failure is 1-2% in the general population and increases with age, reaching 10% in people older than 75 years. Heart failure has a high mortality rate, with a 1-year mortality rate approaching 46% and a 2-year mortality rate approaching 87% in severely ill patients. In addition, patients with heart failure are prone to sudden cardiac death and cerebral infarction. 2, the performance of heart failure: heart failure is divided into left heart failure and right heart failure. The main manifestation of left heart failure is fatigue and dyspnea, initially exertional dyspnea, feeling shortness of breath after going up a few flights of stairs, and still feeling shortness of breath and dyspnea even after resting for 20-30 minutes. In severe cases, shortness of breath is felt even when walking on a flat road. Eventually, it evolves into dyspnea at rest, often waking up suddenly at night when sleeping, feeling that there is not enough breath, and needing to sit up immediately and gasp for air before gradually improving, accompanied by chest tightness, shortness of breath, cough, croup, and even pink foamy sputum containing blood in particularly severe cases. The main manifestations of right heart failure are lower limb edema, jugular vein anger, epigastric distention, loss of appetite, little urination, and even pleural fluid and ascites in severe cases. Related examinations can reveal chest X-ray suggesting enlarged heart shadow and increased cardiothoracic ratio, and echocardiography suggesting reduced ejection fraction of the heart and enlarged ventricular cavity. How to treat heart failure: There are three main treatments for heart failure: medication, resynchronization therapy and heart transplantation. Drug therapy is mainly through cardiotonic, diuretic, vasodilator, application of beta-blockers and angiotensin-converting enzyme inhibitors or antagonists. Drug therapy is effective for early and mild heart failure, slowing down the progression of the disease and improving the patient’s symptoms, but as the disease worsens, drug therapy is not effective for advanced heart failure. Resynchronization therapy is a treatment for left and right ventricular contraction asynchrony in heart failure. Some heart failure patients with enlarged heart chambers will have left and right ventricular contraction asynchrony leading to further decline in heart pumping function, and a triple-chamber pacemaker has a therapeutic effect on the asynchronous heart, but cannot ultimately solve the problem of myocardial damage. Heart transplantation involves removing the diseased and failing heart and reinstalling a normal, healthy heart in the patient. The advantage is that the new heart is fully functional and the majority of patients have no limitations on their ability to work after surgery. The disadvantage is that there may be risks such as rejection, so it should only be used for patients with advanced – end-stage heart failure. 4, the indications and timing of heart transplantation: (1) cardiomyopathy: dilated cardiomyopathy, restrictive cardiomyopathy and subendocardial myocardial fibrosis, advanced lesions and poor results with drug therapy. (2) Coronary artery disease; severe multi-branch coronary artery disease, massive myocardial infarction, heart failure, massive loss of cardiomyocytes with significant decline in cardiac function. (3) Congenital heart disease; complex heart malformations that cannot be corrected, such as left ventricular dysplasia syndrome. (4) Rheumatic heart disease; joint valvular lesions with extensive myocardial lesions. (5) Cardiac tumors; those that cannot be removed surgically. Heart transplantation is a treatment for advanced – end-stage heart failure and is not indicated for patients with early lesions and effective drug therapy. In patients who are identified as needing transplantation, it should be performed early because as the disease progresses, pulmonary stasis can occur leading to increased pulmonary artery pressure, and severe pulmonary hypertension can lead to the inability to perform transplantation losing the chance of salvation. In addition, heart failure leads to heart pumping function can not meet the body’s needs, there will be liver stasis, poor nutritional status and other problems, and in serious cases, even liver and kidney insufficiency to increase the risk of surgical treatment. 5, the effect of heart transplantation: the world’s first allogeneic in situ heart transplantation in 1967, now heart transplantation has been widely used in the world, with an annual increase of 4,000 cases, the longest surviving cases have been more than 20 years. Heart transplantation is considered to be the most effective treatment for end-stage heart failure.