Understanding the pathophysiologic mechanisms responsible for producing heart, failure is necessary before effective treatments can be developed that increase survival and improve quality of life. Recent advances in the treatment of heart failure can be traced directly to improved appreciation of the role of neurohumoral activation in the pathophysiology of heart failure. Initially adaptive, neurohumoral activation ultimately results in a series of overadjustments that actively participate, in the progression of heart failure. In this article, the role of neurohumoral activation, ventricular remodeling and various peripheral vascular abnormalities in the pathophysiology of heart failure are explored

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