Pathophysiology of systolic and diastolic heart failure.

Systolic and diastolic heart failure are the 2 most common clinical subsets of chronic heart failure. Left ventricular "Starling" function is depressed in patients with systolic heart failure. In systolic heart failure, left ventricular mass is increased, which can be measured by transthoracic echocardiography. Cardiac magnetic resonance imaging is a more precise technique to measure left ventricular mass. Neurohormonal activation is a major pathophysiologic mechanism for ventricular remodeling and progression of heart failure in systolic heart failure.