Left ventricular remodeling in heart failure: current concepts in clinical significance and assessment.
TLDR
The findings substantiate the importance of ventricular remodeling as central in the pathophysiology of advancing heart failure and support the role of measures of LV remodeling in the clinical investigation of novel heart failure treatments.Abstract:
Ventricular remodeling, first described in animal models of left ventricular (LV) stress and injury, occurs progressively in untreated patients after large myocardial infarction and in those with dilated forms of cardiomyopathy. The gross pathologic changes of increased LV volume and perturbation in the normal elliptical LV chamber configuration is driven, on a histologic level, by myocyte hypertrophy and apoptosis and by increased interstitial collagen. Each of the techniques used for tracking this process—echocardiography, radionuclide ventriculography, and cardiac magnetic resonance—carries advantages and disadvantages. Numerous investigations have demonstrated the value of LV volume measurement at a single time-point and over time in predicting clinical outcomes in patients with heart failure and in those after myocardial infarction. The structural pattern of LV remodeling and evidence of scarring on cardiac magnetic resonance have additional prognostic value. Beyond the impact of abnormal cardiac structure on cardiovascular events, the relationship between LV remodeling and clinical outcomes is likely linked through common local and systemic factors driving vascular as well as myocardial pathology. As demonstrated by a recent meta-analysis of heart failure trials, LV volume stands out among surrogate markers as strongly correlating with the impact of a particular drug or device therapy on patient survival. These findings substantiate the importance of ventricular remodeling as central in the pathophysiology of advancing heart failure and support the role of measures of LV remodeling in the clinical investigation of novel heart failure treatments.read more
Citations
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Journal ArticleDOI
Left Ventricular Remodeling and Myocardial Work: Results From the Population-Based STAAB Cohort Study.
Floran Sahiti,Caroline Morbach,Vladimir Cejka,Judith Albert,Felizitas A. Eichner,Götz Gelbrich,Peter U. Heuschmann,Stefan Störk +7 more
TL;DR: In this paper, a non-invasive LV myocardial work (MyW) assessment based on echocardiography-derived pressure-strain loops was performed to assess the relationship of abnormal LV geometry with MyW indices in general population free from heart failure.
Journal ArticleDOI
Leukocyte-Associated Immunoglobulin-like Receptor-1 is regulated in human myocardial infarction but its absence does not affect infarct size in mice
Guilielmus H.J.M. Ellenbroek,Judith J. de Haan,Bas R van Klarenbosch,Maike A.D. Brans,Sander M. van de Weg,Mirjam B. Smeets,Sanne De Jong,Fatih Arslan,Leo Timmers,Marie-José Goumans,Imo E. Hoefer,Pieter A. Doevendans,Gerard Pasterkamp,Linde Meyaard,Saskia C.A. de Jager +14 more
TL;DR: LAIR-1 expression on monocytes and neutrophils is increased in the acute phase after MI in patients, but the absence of LAIR- 1 in mice does not influence infarct size, inflammation, fibrosis or adverse cardiac remodelling.
Journal ArticleDOI
Effects of the chymase inhibitor fulacimstat on adverse cardiac remodeling after acute myocardial infarction-Results of the Chymase Inhibitor in Adverse Remodeling after Myocardial Infarction (CHIARA MIA) 2 trial.
Hans-Dirk Duengen,Raymond J. Kim,Doron Zahger,Katia Orvin,Ran Kornowski,Dan Admon,Jiri Kettner,Avraham Shimony,Christiane Otto,Michael Becka,Friederike Kanefendt,Andrés Íñiguez Romo,Tal Hasin,Petr Ostadal,Gonzalo Calvo Rojas,Michele Senni,Ivo Podpera,Hana Linkova,Petr Hájek,Johann Bauersachs,Niels Menck,Jan Fuisting,Sadrack Oumbe Tiam,Manuel Martinez Selles,Vicente Miro Palau,Mercedes Roque,Borja Ibanez,Yaron Arbel,Eugenia Nikolsky,Savina Nodari,Gian Carlo Silvio Marenzi,Felice Achilli,Bernhard Reimers +32 more
TL;DR: Fulacimstat was safe and well tolerated in patients with left-ventricular dysfunction (LVD) after first STEMI but had no effect on cardiac remodeling.
Journal ArticleDOI
Left Ventricular Mass and Thickness: Why Does It Matter?
Frank Lloyd Dini,Gian Giacomo Galeotti,Giuseppe Terlizzese,Iacopo Fabiani,Nicola Riccardo Pugliese,I Rovai +5 more
TL;DR: Patients who show left ventricular dilation and hypertrophy in association with a low relative wall thickness are likely to carry the highest risk of heart failure.
Journal ArticleDOI
Prediction of left ventricular reverse remodeling after therapy with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and β blockers in patients with idiopathic dilated cardiomyopathy.
Yoshihisa Matsumura,Eri Hoshikawa-Nagai,Toru Kubo,Naohito Yamasaki,Hiroaki Kitaoka,Jun Takata,Yoshinori Doi,Tetsuro Sugiura +7 more
TL;DR: Combined information on LV end-diastolic dimension and heart rhythm at diagnosis is useful in predicting future LVRR in patients with idiopathic dilated cardiomyopathy.
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