Physiologic changes in heart failure--"What's new".

Abstract

The physiologic changes that accompany heart failure are complex and evolve over time. Adaptations to an initial insult include both central (myocardial) and peripheral mechanisms that attempt to maintain adequate cardiac output at rest, as well as during increased metabolic demands such as exercise. Physiologic models provide insight into these complex changes and are necessary to design and evaluate the efficacy of pharmacologic and nonpharmacologic interventions. Recent advances in ventricular remodeling and changes in myocardial adrenergic receptors are presented as are alterations in vasodilatory response, skeletal muscle structure, function, and metabolism.