Pathophysiology of Heart Failure

Heart failure (HF) is a clinical syndrome resulting from structural or functional disorders that impair the heart’s ability to fill with or eject blood. The pathophysiologic mechanisms leading to HF are complex and encompass hemodynamic alterations and neurohormonal changes that contribute to the chronic, progressive nature of the disease. This chapter reviews the pathophysiologic mechanisms that underlie the clinical manifestations of the HF syndrome, primarily focusing on HF due to left ventricular systolic dysfunction. Cardiac compensatory mechanisms, hemodynamic adjustments, neurohormonal activation, ventricular remodeling, and arrhythmogenesis will be reviewed.