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Chronic heart failure is a pandemic of the 21st century with an increasing number of heart failure subjects surviving, living, working and hopefully enjoying themselves. Indeed, the aging of the population, the improved survival to acute cardiovascular events frequently ending up to chronic heart failure and the improved survival to heart failure itself and, on the other side of the coin, the impressive costs of heart failure both for its treatment and for its social consequences, make a precise heart failure prognosis an urgent need. Up to now, prognosis has been analized considering several single parameters, looking for the one able to predict prognosis in all chronic heart failure patients. Unfortunately, this is a chimera, and, unfortunately, it does not exist. Indeed, chronic heart failure prognosis is influenced by comorbidities, by heart failure phenotypes, by human genetics, by treatment efficacy specific for a given subject, just to mention some of the variables that have a role in the chronic heart failure scenario. To try to overcome these difficulties, several multiparametric approaches have been developed, but they rarely reached the clinical field. In the present International Symposium kindly sponsored by Fondazione Internazionale Menarini, we will discuss chronic heart failure prognosis in the 21st century. Please accept my warmest welcome to Milan at the end of the winter season, when several signs of nature tell us that a new spring is coming, hopefully for our patients too. 

Prof. Piergiuseppe Agostoni President of the Meeting

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