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Heart failure remains a significant health challenge globally, influencing millions of individuals and imposing a considerable burden on healthcare systems. Factors influencing heart failure include Cardiac remodeling, neuro hormonal activation, impaired contractility as well as ejection fraction, ventricular dysfunction as well as chamber dilation, inflammatory as well as oxidative stress, endothelial dysfunction and microbial dysfunction. Finally it is concluded that heart failure is a complex syndrome resulting from multiple pathophysiological mechanisms.