Pathophysiology of heart failure and an overview of therapies

Heart failure (HF) develops from a diverse range of genetic and environmental factors that compromise cardiac function, ultimately resulting in insufficient blood flow to the body. HF is a broad, encompassing term for a chronic, progressive, and highly complex clinical syndrome. The pathophysiology of HF has multiorgan manifestations, primarily in the renal, autonomic, vascular, and cardiac systems, stemming from the specific etiology of the disease. The vast array of factors initiating HF are equally accompanied by diverse and distinct cellular changes that compromise cardiomyocytes, along with the structure and function of the organ. Our understanding of the molecular and biochemical changes that underlie the development and progression of HF has expanded greatly, which facilitated improved patient clustering into HF-specific disease pathobiology and subsequent advancements in both surgical and pharmacological approaches in the therapeutic management of HF. This chapter provides an overview of the recent advances regarding HF, spanning cardiac physiology to intracellular molecular events in the cardiomyocyte, and the current therapeutic strategies to clinically manage HF.