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Endothelial dysfunction in the pathophysiology of HF. Endothelial dysfunction through vascular, renal and neurohormonal mechanisms leads to fluid overload. It also causes vasoconstriction of the capacitance veins leading to centralisation of blood volume. Moreover, congestion itself, through the same mechanisms, leads to more fluid retention and consequently to the vicious cycle of heart failure. An insult combined with the progressive fluid overload may lead to decompensated HF.
