The evolution of modern theory and therapy for heart failure

Although there have been a number of attempts to develop a unifying theory that explains all aspects of the clinical syndrome of heart failure, none of these conceptual paradigms has withstood the test of time. The foregoing review will discuss four conceptual models that have informed the modern approach to treating heart failure with a reduced ejection fraction, including the cardiorenal model, the cardiocirculatory model, the neurohormonal model and the biomechanical model. The hope is that this historical rendering of the evolution of modern theory and therapy for heart failure will be of some use to the growing field of pediatric heart failure.