Heart Failure (HF)  is one of the major health issues in Europe  affecting 6 million patients and growing substantially because of the ageing population and improving survival following myocardial infarction. The poor short to medium term prognosis of these patients means that treatments such as cardiac re-synchronisation therapy and mitral valve repair can have substantial impact. However, these therapies are ineffective in up to 50% of the treated patients and involve significant morbidity and substantial cost.