↑ Preload Myocyte loss ↓ Energy supply Cellular Altered collagen hypertrophy matrix afterload Remodelling 小 Cardiac output ↑ Inotropy ↓ Baroreflex Neurohormonal sponse Natriuretic Renin-angiotensin peptides aldosterone Prostaglandins -Sympathetic nervous ↑Ca Arrhythmias Bradyki ↓ Response to system Sudden death Endothelin stress Arginine Fluid& salt tention Vasoconstriction, vascular remodelling, endothelial dysfunction ↑ Peripheral Maintains blood pressure s Perfusion Altered skeletal muscle resistance > Redistributes cardiac output /of vital blood flow and metabolism organs Dyspnea, edema, fatigue