What are structural changes of the heart that may contribute to CHF?

Decreased myocardial contractility is a significant factor in the development of congestive heart failure (CHF). In CHF, the heart's ability to contract and pump blood effectively is compromised, which may result from various structural changes such as hypertrophy or dilation of the heart muscle. When contractility decreases, the heart cannot eject an adequate volume of blood, leading to poor cardiac output and fluid accumulation in the lungs and other tissues, which are hallmark signs of CHF.

This decline in contractility can be caused by various underlying conditions, including ischemic heart disease, hypertension, or cardiomyopathy. Each of these conditions can result in structural alterations to the myocardium, including changes in muscle fiber structure and the overall geometry of the heart. As myocardial contractility worsens, it directly impacts the heart’s pumping efficiency, further perpetuating the cycle of heart failure.

The other options involve processes that generally do not contribute to CHF as a direct cause. Increased coronary perfusion typically suggests better oxygen and nutrient supply to the heart muscle, which would not be detrimental. Enhanced valve function would indicate proper functioning of the heart's valves, which assists in maintaining effective blood flow. Impaired sodium excretion might influence fluid balance but is not primarily a structural change of the heart itself