Figure 1 Time course and pattern of development of heart failure primarily caused by myocardial infarction (MI), with pronounced remodelling and shape change leading to systolic heart failure (SHF), and of heart failure primarily caused by hypertension (HT), with or without diabetes mellitus (DM), leading to heart failure with a normal ejection fraction (HFNEF). Lower normal limits of left ventricular ejection fraction (LVEF) and peak annular systolic velocity (Sm) are indicated on the axes. Both patients with an MI and patients with HT may pass through an HFNEF and an SHF period.