[Morphologic consideration of heart failure (author's transl)].

Area of Science:

• Cardiology
• Pathophysiology

Background:

• Left ventricular failure presents with diverse ventricle shapes (elliptical, spherical, funnel) without clear hemodynamic correlation.
• Left ventricular failure leads to left atrial dilatation, deformation, and impaired funnel function.
• Advanced stages manifest as pulmonary vein coiling/dilatation and pulmonary parenchyma changes like fibrosis and siderosis.

Purpose of the Study:

• To describe the morphological and functional changes associated with left ventricular failure.
• To elucidate the progression to global heart failure and its consequences.
• To differentiate primary global failure from secondary global failure.

Main Methods:

• Observational study analyzing cardiac and pulmonary morphology in heart failure.
• Histopathological examination of pulmonary parenchyma.
• Correlation of ventricular morphology with hemodynamic status.

Main Results:

• Left ventricle shapes do not correlate with hemodynamics in left heart failure.
• Left atrial function is compromised, and pulmonary veins show abnormal narrowing.
• Fibrosis, siderosis, and heart failure cells are noted in advanced stages.
• Secondary global heart failure involves the right ventricle, potentially causing liver dysfunction.

Conclusions:

• Left ventricular failure induces significant structural and functional changes in the left atrium and pulmonary vasculature.
• Progression to global heart failure has distinct hemodynamic and clinical implications.
• The severity of left vs. right ventricular failure dictates the clinical presentation.