Inclusion Criteria:  Patients over 18 years of age  Patients who meet at least one of the following criteria :  A- Patients who have agreed to be placed on the heart transplant list whose wait for a suitable heart transplant is prolonged while their clinical condition deteriorates ("Bridge To Transplantation" or BTT situation). Commonly used indicators of disease deterioration for LVAD implantation include a declining ejection fraction ≤ 25%, frequent or prolonged hospitalizations due to heart failure, intolerance to heart failure drug therapies manifested by hypotension or renal failure, and reduced maximal or submaximal exercise performance.  or  B- Patients who would be candidates for heart transplantation but who have a relative contraindication at the time of the heart transplant screening visit that may resolve after a period of "Bridge To Decision" or BTD mechanical circulatory support. These relative contraindications to heart transplantation include:  Active infection (patients with chronic viral infections such as hepatitis B, hepatitis C, and HIV may be considered if viral titers are undetectable following treatment and without damage to other organs). Progressive symptomatic cerebral or peripheral vascular disease. Diabetes with end-organ damage, e.g. nephropathy, neuropathy, proliferative retinopathy. Poorly controlled diabetes with glycosylated hemoglobin consistently > 7.5%. Tumor with life expectancy greater than one year. Severe lung disease: FEV1 and FVC < 50% of expected values or evidence of parenchymal lung disease. Renal dysfunction with estimated glomerular filtration < 30 ml/min/1.73 m². Hepatic dysfunction, e.g., cirrhosis. Recent pulmonary thromboembolism (usually within the last 3 months). Pulmonary arterial hypertension with pulmonary systolic blood pressure > 60 mmHg, transpulmonary gradient ≥ 15 mmHg and/or pulmonary vascular resistance > 5 Wood units. If this pulmonary hypertension is irreversible despite pharmacological treatment or mechanical circulatory support, the contraindication to heart transplantation becomes absolute. Psychosocial factors, including history of medication noncompliance, inadequate support, ongoing/recent drug or alcohol abuse, smoking. Obesity (body mass index > 35 kg/m²). Other systemic disease with limited survival (monoclonal gammopathy). or  C- Patients with end-stage heart failure who would not be candidates for heart transplantation but who would have a life expectancy greater than one year "Destination Therapy" or DT :  Patients > 70 years of age with Irreversible pulmonary arterial hypertension despite pharmacological treatment Current or recent tumor: risk of recurrence should be discussed with the oncologist.  or D- Patients who can fully recover their cardiac function after prolonged circulatory assistance (Bridge To Recovery BTR): patients in cardiogenic shock following viral myocarditis.  Patients affiliated to a social security system (beneficiaries or beneficiaries entitled to benefits, excluding AME) Signature of an informed consent by the patient or by the trusted person, or a close relative, if the patient is not able to do so  Exclusion Criteria:  Heart transplant patients Patients who already had LVAD Chronic renal failure patients on dialysis Patients refusing to give informed consent Patients deprived of liberty or under legal protection (guardianship, curators) Pregnant or breastfeeding women Ongoing participation in another intervention research protocol