ABSTRACT
In his landmark book on the structure of scientific revolutions, Thomas S Kuhn challenged the empiricist’s view of science as an orderly objective progression toward the truth.1 Scientific investigation is, in his view, a series of peaceful periods which are intermittently eclipsed by dramatic revolutions in which one scientific paradigm is replaced by another. It is instructive to view progress in our understanding of the causes and consequences of heart failure over the past half century in this light. A hemodynamic view of heart failure was replaced by a neurohormonal model. Genetic, molecular and cellular approaches now dominate mechanistic studies of the causes and potential treatment of heart failure. We are now on the verge of a new systems biology approach to this and other chronic diseases.
