The Scientific Basis of Heart Failure

The aim of this chapter is to discuss the current literature surrounding the science that underlies heart failure. This encompasses the natural history of the syndrome, namely, an initial myocardial insult, apparent recovery, decompensation and finally failure of the organ. We will then expand upon some of the post-infarction changes to ventricular performance in both the compensatory and failure stages, including their manifestations on the Frank–Starling curve. Finally, the topic of cardiac regeneration will briefly be analysed. Understanding the science behind regeneration will provide a foundation to appreciate the basis of novel therapies, discussed later.