Chronic heart failure (CHF) is one of the key sociomedical challenges that define the disease prognosis and patients’ quality of life. Modern pharmacotherapy shifts the focus from symptomatic treatment to early intervention and modified prognosis, thus necessitating a strict evidence-based/regulatory assessment and innovative drugs. In this context, an expert opinion on the evolution of CHF pharmacotherapy is of particular interest, alongside with a search for new therapeutic targets and the translation prospective of fundamental research findings into clinical practice through a lens of science, clinical experience, and regulatory reasoning. These and other questions are answered in an interview with Yury N. Belenkov, Academician of the Russian Academy of Sciences, Director of the Ostroumov Clinic for Hospital Therapy and Sechenov University Centre of Heart Failure, and President of Russian Society of Experts in Heart Failure.