Over the past three centuries, medical understanding of heart failure has evolved from a simple appreciation of biomechanical and circulatory changes accompanying heart failure to recognition of the complex multiorgan physiology of this syndrome. Within the past few decades, breakthroughs in genetics and molecular investigation have revealed a vast array of cellular and molecular changes that occur in the heart and systemically as a result of hemodynamic insult. The picture of changes occurring in cardiac hypertrophy and heart failure has become increasingly complex. The goal of this chapter is to summarize the cellular and molecular changes that occur in clinical and experimental heart failure and to highlight established and potential therapeutic targets.
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