Principles of heart failure

This chapter is a review of the epidemiology and physiology of heart failure. As heart failure imposes a significant burden on both the patient and the healthcare system, there is considerable effort to better understand its physiological basis. The chapter first discusses the response of the heart to hemodynamic stress in the healthy state and in heart failure. The chapter then focuses on the causes of heart failure as well as the elements that contribute to its progression. The focus shifts to the body's defenses to heart failure, which includes a coordination between the heart and kidney and a programmed remodeling response at the cellular level. The chapter concludes with a description of how these compensatory mechanisms may temporize the disease but ultimately serve to worsen heart failure in the long term.