Some of the main problems associated with decreased contractility in those with heart failure are issues arising from imbalances in the concentration of calcium. Calcium permits myosin and actin to interact which allows initiation of contraction within the cardiomyocytes.
Some complications associated with decreased cardiac muscle efficiency in heart failure patients are due to calcium concentration discrepancies. Calcium facilitates the binding of myosin and actin, leading to contraction initiation in cardiomyocytes.