UNDERLYING CAUSES Primary myocardial dysfunction(systolic and/or diastolic) Cardiomyopathy Primary or secondary metabolic disturbances of myocardium Overloading of heart Pressure overloading Volume overloading limited diastolic function4 UNDERLYING CAUSES • Primary myocardial dysfunction (systolic and/or diastolic) – Cardiomyopathy – Primary or secondary metabolic disturbances of myocardium • Overloading of heart – Pressure overloading – Volume overloading – limited diastolic function