Fig. 8.

Development of heart failure (HF) in response to hypertension (HTN). T-tubule disruption and subsequent Ca²⁺ cycling defects occur very early in response to HTN. With the development of LV hypertrophy (LVH), these defects in Ca²⁺ cycling lead to simultaneous reductions in systolic and diastolic myocardial mechanics, which, in turn, lead to the development of overt HF (with either preserved or reduced LV EF).