The peripheral syndrome of heart failure: the overlooked aspects.

Heart failure is a leading cause of morbidity and mortality and an increasing economic burden in the developed world. The vicious circle of cardiac dysfunction and peripheral organ dysfunction involves aspects of heart failure that have tended to be overlooked in the past and which have an influence on prognosis. These include chronic inflammatory responses, cachexia, endothelial dysfunction, pulmonary hypertension, increased ventilatory response to exercise and ventricular volume-type hypertrophy.