Which statement most accurately describes Heart failure?

A. Heavy proteinuria with hypoalbuminaemia, oedema and often hyperlipidaemia. B. Life-threatening organ dysfunction caused by a dysregulated host response to infection. C. A clinical spectrum caused by acute myocardial ischaemia, including unstable angina and myocardial infarction. D. A syndrome in which the heart cannot meet metabolic demands or does so only at elevated filling pressures.