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Figure 1 Vasopressin could aggravate the progression of heart failure by adversely affecting ventricular remodeling, worsening clinical congestion, and contributing to hyponatremia. V1a effects would be predominantly those causing arterial vasoconstriction, increasing afterload, and adversely affecting ventricular structure and function. Direct myocardial V1a effects could also be present. V2 effects could lead to excessive circulatory congestion, adversely affecting myocardial structure and function via increasing preload. V2 effects would also lead to hyponatremia. AVP = arginine vasopressin; LV = left ventricular.