the point that there are very well established guidelines promoted by the American Heart Association and The American College of Cardiology. This text will pick up where the guidelines leave off and address the real challenge of patients with advanced ischemic heart disease. Though therapy is clearly challenging, new advances are making effective therapy of these patients truly possible. This text embodies that notion. Finally, there is much still to learn about the basic mechanisms of the progression of heart failure due to coronary artery disease and how best to assess these therapeutic options. The text will address these with a focus on treatment so that it may be a practical reference for the practicing clinician as well as the basic or clinical researcher and student.