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A little more than a decade ago, a workshop on advanced congestive heart failure was held at the National Institutes of Health. At that time, the armamentarium for treating heart failure was limited. However, there appeared to be a consensus favoring the use of diuretics and digoxin, and theoretical evidence supported the use of other agents, including vasodilators and angiotensin-converting-enzyme inhibitors. Indeed, in 1982, only 12 centers were performing cardiac transplantation, with a three-year mortality of nearly 50 percent. That the past decade has been associated with an explosion of new and novel therapies for heart failure is clear from
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