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Ventricular remodeling

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327: 2332: 2362: 2372: 2352: 132: 2342: 159:(cell death) and disproportionate thinning of the heart. This thin, weakened area is unable to withstand the pressure and volume load on the heart in the same manner as the other healthy tissue. As a result, there is dilatation of the chamber arising from the infarct region. The initial remodeling phase after a myocardial infarction results in repair of the necrotic area and 210:
Besides, the cardiac interstitium which consisted of largely Type I and Type III collagen fibres are also involved in cardiac remodeling. Cardiac collagen is synthesized by fibroblasts and degraded by metalloproteinases. Fibroblasts are activated post MI, leading to increased collagen synthesis and
186:, leading to thinning of the cardiac wall. The surviving cardiac myocytes either arrange in parallel or in series to each other, contributing to ventricular dilatation or ventricular hypertrophy, depending on the loading stress on the ventricular wall. Besides, reduced expression of V1 myosin and 95:
Physiological remodeling is reversible while pathological remodeling is mostly irreversible. Remodeling of the ventricles under left/right pressure demand make mismatches inevitable. Pathologic pressure mismatches between the pulmonary and systemic circulation guide compensatory remodeling of the
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have been consistently shown to decrease remodeling in animal models or transmural infarction and chronic pressure overload. Clinical trials have shown that ACE inhibitor therapy after myocardial infarction leads to improved myocardial performance, improved
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accounts for 60 to 90% of the energy supply of the heart. Post MI, as fatty acid oxidation decreases, it leads to reduced energy supply for the cardiac myocytes, accumulation of fatty acids to toxic levels, and dysfunction of
167:. Over time, however, as the heart undergoes ongoing remodeling, it becomes less elliptical and more spherical. Ventricular mass and volume increase, which together adversely affect cardiac function. Eventually, 83:
and structural changes occur in the left ventricular myocardium that lead to progressive decline in left ventricular performance. Ultimately, ventricular remodeling may result in diminished contractile
307:(CRT) has shown the ability to reverse left ventricular remodeling in some patients. Early correction of congenital heart defects, if appropriate, may prevent remodeling, as will treatment of chronic 520:
Saavedra, W.Federico; Tunin, Richard S; Paolocci, Nazareno; Mishima, Takayuki; Suzuki, George; Emala, Charles W; Chaudhry, Pervaiz A; Anagnostopoulos, Petros; Gupta, Ramesh C (2002).
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left and right ventricles. The term "reverse remodeling" in cardiology implies an improvement in ventricular mechanics and function following a remote injury or pathological process.
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Yu, Cheuk-Man; Bleeker, Gabe B.; Fung, Jeffrey Wing-Hong; Schalij, Martin J.; Zhang, Qing; Wall, Ernst E. van der; Chan, Yat-Sun; Kong, Shun-Ling; Bax, Jeroen J. (2005-09-13).
563:"Prevalence, Clinical Characteristics, and Outcomes Associated with Eccentric Versus Concentric Left Ventricular Hypertrophy in Heart Failure with Preserved Ejection Fraction" 703:
Pitt, Bertram; Remme, Willem; Zannad, Faiez; Neaton, James; Martinez, Felipe; Roniker, Barbara; Bittman, Richard; Hurley, Steve; Kleiman, Jay; Gatlin, Marjorie (2003).
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Many factors influence the time course and extent of remodeling, including the severity of the injury, secondary events (recurrent ischemia or infarction),
975: 207:, and induction of apoptosis, which would be explained below. Besides, inflammatory immune response after MI also contributes to the above changes. 820: 481:"Long-Term Prognosis After Cardiac Resynchronization Therapy Is Related to the Extent of Left Ventricular Reverse Remodeling at Midterm Follow-Up" 479:
Ypenburg, Claudia; Bommel, Rutger J. van; Borleffs, C. Jan Willem; Bleeker, Gabe B.; Boersma, Eric; Schalij, Martin J.; Bax, Jeroen J. (2009).
1861: 432:"Left Ventricular Reverse Remodeling but Not Clinical Improvement Predicts Long-Term Survival After Cardiac Resynchronization Therapy" 2202: 1198: 883:
St John Sutton, Martin G.; Plappert, Ted; Hilpisch, Kathryn E.; Abraham, William T.; Hayes, David L.; Chinchoy, Edward (2006-01-17).
1470: 1801: 968: 885:"Sustained Reverse Left Ventricular Structural Remodeling With Cardiac Resynchronization at One Year Is a Function of Etiology" 744:
Khattar, R. S. (2003). "Effects of ACE-inhibitors and beta-blockers on left ventricular remodeling in chronic heart failure".
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to a lesser extent, also play a role. A common scenario for remodeling is after myocardial infarction. There is myocardial
43:(physiological remodeling) or after injury to the heart muscle (pathological remodeling). The injury is typically due to 705:"Eplerenone, a Selective Aldosterone Blocker, in Patients with Left Ventricular Dysfunction after Myocardial Infarction" 2401: 2237: 1579: 961: 522:"Reverse remodeling and enhancedadrenergic reserve from passive externalsupport in experimental dilated heart failure" 163:
that may, to some extent, be considered beneficial since there is an improvement in or maintenance of LV function and
304: 47:(usually transmural or ST segment elevation infarction), but may be from a number of causes that result in increased 561:
Katz, Daniel H.; Beussink, Lauren; Sauer, Andrew J.; Freed, Benjamin H.; Burke, Michael A.; Shah, Sanjiv J. (2013).
303:, may actually reverse the remodeling process by reducing left ventricular volumes and improving systolic function. 224: 219:
led to degradation of collagen fibres, and subsequently dilatation of the heart. Several signal pathways such as
2355: 2227: 1661: 1111: 199:. These consequences also led to the increase in oxidative stress on the heart, causing the proliferation of 171:
function, or the heart's ability to relax between contractions may become impaired, further causing decline.
2207: 1488: 1243: 1221: 239: 656:"Cardiac Remodeling: Concepts, Clinical Impact, Pathophysiological Mechanisms and Pharmacologic Treatment" 1851: 1483: 1228: 44: 937:"Left Ventricular Remodeling in Heart Failure: Current Concepts in Clinical Significance and Assessment" 1831: 1309: 251: 2260: 1513: 1460: 1336: 1316: 1280: 1203: 1163: 984: 621: 2052: 1974: 1969: 1889: 1649: 1331: 1321: 1211: 417: 68: 413: 2396: 2032: 2006: 1518: 1450: 1395: 1296: 1216: 1100: 1078: 367:"Cardiac remodelling: Concentric versus eccentric hypertrophy in strength and endurance athletes" 345: 187: 100: 1096: 190:
on cardiac myocytes are also thought to cause cardiac remodeling. Under normal body conditions,
1624: 1572: 1455: 1445: 1105: 1063: 1058: 936: 312: 72: 2275: 2161: 2134: 2107: 2059: 2013: 1708: 1304: 814: 315:. Often, reverse remodeling, or improvement in left ventricular function, will also be seen. 291:, and decreased mortality compared to patients treated with placebo. Likewise, inhibition of 2295: 2255: 2122: 1936: 1931: 1911: 1846: 1698: 1053: 1036: 234:
Other factors such as high blood pressure, activation of sympathetic system which releases
104: 953: 770: 266:. The size and function of the atria and ventricles can be characterized using this test. 8: 2375: 2317: 2300: 1959: 1676: 1400: 1238: 1233: 1068: 1041: 160: 326: 2265: 2222: 2212: 2001: 1954: 1921: 1916: 1666: 1644: 1508: 1373: 1126: 797: 772: 680: 655: 587: 562: 391: 366: 85: 32: 901: 884: 538: 521: 448: 431: 2361: 2335: 2217: 2187: 2166: 2129: 2112: 2027: 1991: 1981: 1876: 1796: 1740: 1703: 1688: 1629: 1596: 1565: 1144: 1116: 914: 906: 865: 857: 802: 753: 726: 685: 592: 543: 502: 461: 453: 396: 288: 204: 116: 56: 2345: 2037: 2022: 1899: 1774: 1730: 1493: 1088: 896: 847: 792: 784: 716: 675: 667: 582: 574: 533: 492: 443: 386: 378: 263: 76: 578: 2365: 2310: 2171: 2156: 2139: 2079: 2074: 2018: 1996: 1693: 1639: 1619: 1343: 1073: 279: 152: 140: 120: 60: 852: 835: 231:
are known to trigger synthesis and degradation of collagen fibres in the heart.
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After a myocardial infarction (MI), cardiac myocyte death can be triggered by
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Azevedo, Paula S; Polegato, Bertha F; Minicucci, Marcos F (January 2016).
2144: 2089: 1986: 1841: 1816: 1634: 1540: 1530: 1258: 1253: 1248: 1159: 788: 721: 704: 671: 292: 247: 220: 2232: 2117: 2084: 1856: 1806: 1791: 1786: 1779: 1764: 1754: 1478: 1263: 1153: 1136: 1019: 382: 296: 200: 191: 144: 20: 2305: 2047: 2042: 1906: 1884: 1759: 1723: 1410: 1181: 1048: 882: 295:, either directly or indirectly, leads to improvement in remodeling. 183: 179: 168: 1811: 1588: 1438: 1169: 771:
Reis Filho JR, Cardoso JN, Cardoso CM, Pereira-Barretto AC (2015).
175: 156: 148: 48: 40: 115:, of which there are many types. Concentric hypertrophy is due to 2290: 1750: 1718: 1611: 1433: 131: 1273: 1268: 52: 1405: 992: 478: 243: 36: 519: 250:
are important contributors of cardiac remodelling. However,
1557: 983: 216: 212: 895:(2). Ovid Technologies (Wolters Kluwer Health): 266–272. 834:
Leyva, Francisco; Nisam, Seah; Auricchio, Angelo (2014).
653: 282:, and treatment. Medications may attenuate remodeling. 31:) refers to changes in the size, shape, structure, and 560: 262:
Remodeling of the heart is evaluated by performing an
702: 429: 322: 876: 833: 620: 364: 2388: 365:Mihl, C.; Dassen, W. R. M.; Kuipers, H. (2008). 836:"20 Years of Cardiac Resynchronization Therapy" 619:Cohn, Jay N; Colucci, Wilson S; Yeon, Susan B. 284:Angiotensin-converting enzyme (ACE) inhibitors 211:fibrosis of the heart. Increase expression of 1573: 969: 840:Journal of the American College of Cardiology 649: 647: 645: 643: 526:Journal of the American College of Cardiology 485:Journal of the American College of Cardiology 819:: CS1 maint: multiple names: authors list ( 618: 554: 358: 1862:Reproductive endocrinology and infertility 1580: 1566: 976: 962: 827: 640: 614: 612: 610: 608: 606: 143:is the major cell involved in remodeling. 2203:Bachelor of Medicine, Bachelor of Surgery 900: 851: 796: 720: 679: 586: 537: 496: 447: 416:at the U.S. National Library of Medicine 390: 130: 119:, while eccentric hypertrophy is due to 111:, and other changes. It is an aspect of 63:(forms of strain) on the heart. Chronic 985:Physiology of the cardiovascular system 743: 603: 75:may also lead to remodeling. After the 2389: 16:Changes in the physiology of the heart 1561: 957: 2341: 2102:Physical medicine and rehabilitation 254:is thought to be cardio-protective. 2351: 777:Arquivos Brasileiros de Cardiologia 660:Arquivos Brasileiros de Cardiologia 622:"Cardiac remodeling: Basic aspects" 99:Ventricular remodeling may include 13: 2238:Medical Scientist Training Program 929: 567:The American Journal of Cardiology 126: 14: 2413: 902:10.1161/circulationaha.104.520817 449:10.1161/circulationaha.105.538272 305:Cardiac resynchronization therapy 39:. This can happen as a result of 2370: 2360: 2350: 2340: 2331: 2330: 325: 278:activation, genetic factors and 71:with intracardiac shunting, and 2371: 764: 737: 709:New England Journal of Medicine 225:Transforming growth factor beta 2228:Doctor of Osteopathic Medicine 1662:Oral and maxillofacial surgery 846:(10). Elsevier BV: 1047–1058. 696: 513: 472: 423: 407: 1: 1112:Aortic valve area calculation 579:10.1016/j.amjcard.2013.05.061 539:10.1016/s0735-1097(02)01890-9 351: 257: 2208:Bachelor of Medical Sciences 1975:Neurosurgical anesthesiology 1587: 269: 151:, the interstitium, and the 7: 1229:Effective refractory period 1108:) / End-diastolic dimension 853:10.1016/j.jacc.2014.06.1178 318: 45:acute myocardial infarction 10: 2418: 498:10.1016/j.jacc.2008.10.032 252:atrial natriuretic peptide 2402:Cardiovascular physiology 2326: 2248: 2186: 1947: 1875: 1830: 1739: 1610: 1595: 1514:Tubuloglomerular feedback 1469: 1461:Critical closing pressure 1419: 1386: 1372: 1352: 1289: 1281:Hexaxial reference system 1204:Cardiac electrophysiology 1191: 1135: 1087: 1000: 991: 746:Minerva Cardioangiologica 371:Netherlands Heart Journal 2162:Transplantation medicine 2053:Clinical neurophysiology 1970:Obstetric anesthesiology 1890:Interventional radiology 1650:Digestive system surgery 1489:Renin–angiotensin system 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microbiology 1847:Gynecologic oncology 1699:Reproductive surgery 1037:End-diastolic volume 789:10.5935/abc.20150025 722:10.1056/NEJMoa030207 672:10.5935/abc.20160005 105:ventricular dilation 79:occurs, a series of 2318:History of medicine 2301:Veterinary medicine 2108:Preventive medicine 1960:Adolescent medicine 1802:Infectious diseases 1401:Vascular resistance 1239:Electrocardiography 1234:Pacemaker potential 1164:Conduction velocity 1069:Venous return curve 1042:End-systolic volume 299:, a 3rd generation 161:myocardial scarring 2266:Molecular oncology 2223:Doctor of Medicine 2213:Master of Medicine 2130:Radiation oncology 2002:Emergency medicine 1955:Addiction medicine 1922:Clinical chemistry 1917:Clinical pathology 1709:Transplant surgery 1667:Orthopedic surgery 1645:Colorectal surgery 1509:Myogenic mechanism 1127:Left atrial volume 1059:Frank–Starling law 383:10.1007/BF03086131 205:metalloproteinases 137: 29:cardiac remodeling 2384: 2383: 2218:Master of Surgery 2182: 2181: 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1893: 1891: 1888: 1887: 1886: 1883: 1882: 1880: 1878: 1874: 1868: 1867:Urogynecology 1865: 1863: 1860: 1858: 1855: 1853: 1850: 1848: 1845: 1843: 1840: 1839: 1837: 1835: 1829: 1823: 1820: 1818: 1815: 1813: 1810: 1808: 1805: 1803: 1800: 1798: 1795: 1793: 1790: 1788: 1785: 1781: 1778: 1777: 1776: 1773: 1771: 1770:Endocrinology 1768: 1766: 1763: 1761: 1758: 1756: 1752: 1749: 1748: 1746: 1744: 1738: 1732: 1729: 1725: 1722: 1721: 1720: 1717: 1715: 1712: 1710: 1707: 1705: 1702: 1700: 1697: 1695: 1692: 1690: 1687: 1680: 1679: 1678: 1675: 1673: 1670: 1668: 1665: 1663: 1660: 1658: 1655: 1651: 1648: 1646: 1643: 1642: 1641: 1638: 1636: 1633: 1631: 1628: 1626: 1623: 1621: 1618: 1617: 1615: 1613: 1609: 1606: 1604: 1598: 1594: 1590: 1583: 1578: 1576: 1571: 1569: 1564: 1563: 1560: 1542: 1539: 1537: 1534: 1532: 1529: 1528: 1527: 1524: 1520: 1517: 1515: 1512: 1510: 1507: 1506: 1505: 1502: 1500: 1497: 1495: 1492: 1490: 1487: 1485: 1482: 1480: 1477: 1476: 1474: 1472: 1468: 1462: 1459: 1457: 1454: 1452: 1449: 1447: 1444: 1440: 1437: 1435: 1432: 1431: 1430: 1427: 1426: 1424: 1422: 1418: 1412: 1409: 1407: 1404: 1402: 1399: 1397: 1394: 1393: 1391: 1389: 1385: 1382: 1380: 1375: 1371: 1361: 1358: 1357: 1355: 1351: 1345: 1342: 1338: 1335: 1333: 1330: 1329: 1327: 1323: 1320: 1319: 1318: 1315: 1311: 1308: 1306: 1303: 1302: 1300: 1298: 1295: 1294: 1292: 1288: 1282: 1279: 1275: 1272: 1270: 1267: 1265: 1262: 1260: 1257: 1255: 1252: 1250: 1247: 1245: 1242: 1241: 1240: 1237: 1235: 1232: 1230: 1227: 1223: 1220: 1218: 1215: 1213: 1210: 1209: 1207: 1205: 1202: 1200: 1197: 1196: 1194: 1190: 1183: 1180: 1177: 1174: 1171: 1168: 1165: 1161: 1158: 1155: 1151: 1148: 1146: 1143: 1142: 1140: 1138: 1134: 1128: 1125: 1123: 1122:Cardiac index 1120: 1118: 1115: 1113: 1110: 1107: 1104: 1102: 1098: 1095: 1094: 1092: 1090: 1086: 1080: 1077: 1075: 1072: 1070: 1067: 1065: 1062: 1060: 1057: 1055: 1052: 1050: 1047: 1043: 1040: 1038: 1035: 1034: 1033: 1032:Stroke volume 1030: 1026: 1025:Stroke volume 1023: 1021: 1018: 1017: 1016: 1013: 1011: 1010:Cardiac cycle 1008: 1007: 1005: 1003: 999: 996: 994: 990: 986: 979: 974: 972: 967: 965: 960: 959: 956: 942: 938: 934: 933: 920: 916: 912: 908: 903: 898: 894: 890: 886: 879: 871: 867: 863: 859: 854: 849: 845: 841: 837: 830: 822: 816: 808: 804: 799: 794: 790: 786: 783:(6): 502–06. 782: 778: 774: 767: 759: 755: 752:(2): 143–54. 751: 747: 740: 732: 728: 723: 718: 714: 710: 706: 699: 691: 687: 682: 677: 673: 669: 665: 661: 657: 650: 648: 646: 644: 628: 623: 615: 613: 611: 609: 607: 598: 594: 589: 584: 580: 576: 572: 568: 564: 557: 549: 545: 540: 535: 531: 527: 523: 516: 508: 504: 499: 494: 491:(6): 483–90. 490: 486: 482: 475: 467: 463: 459: 455: 450: 445: 441: 437: 433: 426: 419: 415: 410: 402: 398: 393: 388: 384: 380: 377:(4): 129–33. 376: 372: 368: 361: 357: 347: 344: 342: 341:Dor procedure 339: 338: 334: 328: 323: 316: 314: 310: 306: 302: 298: 294: 290: 285: 281: 277: 276:neurohormonal 267: 265: 255: 253: 249: 245: 241: 237: 232: 230: 226: 222: 218: 214: 208: 206: 202: 198: 193: 189: 185: 181: 177: 172: 170: 166: 162: 158: 154: 150: 146: 142: 135:Myocardiocyte 133: 124: 122: 118: 114: 110: 106: 102: 97: 93: 91: 90:stroke volume 87: 82: 78: 74: 70: 66: 62: 58: 54: 50: 46: 42: 38: 34: 30: 26: 22: 2286:Rural health 2271:Nanomedicine 1822:Rheumatology 1753: / 1672:Hand surgery 1657:Neurosurgery 1536:Carotid body 1499:Vasodilators 1379:hemodynamics 1359: 1184:(Relaxation) 1176:Bathmotropic 1150:Chronotropic 944:. 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Retrieved 627:UpToDate.com 626: 570: 566: 556: 529: 525: 515: 488: 484: 474: 439: 435: 425: 409: 374: 370: 360: 309:hypertension 301:beta blocker 273: 261: 233: 229:Endothelin 1 209: 197:mitochondria 173: 138: 109:cardiomegaly 98: 94: 65:hypertension 28: 24: 18: 2356:Wikiproject 2145:Venereology 2090:Neonatology 1987:Dermatology 1842:Gynaecology 1834:gynaecology 1817:Pulmonology 1635:Eye surgery 1597:Specialties 1541:Glomus cell 1531:Aortic body 1526:Paraganglia 1337:ventricular 1310:ventricular 1259:QT interval 1254:QRS complex 1249:PR interval 1222:ventricular 1160:Dromotropic 889:Circulation 436:Circulation 293:aldosterone 201:fibroblasts 145:Fibroblasts 2391:Categories 2118:Psychiatry 2104:(PM&R) 2097:Phlebology 2085:Pediatrics 1912:Anatomical 1877:Diagnostic 1857:Obstetrics 1807:Nephrology 1792:Hematology 1787:Geriatrics 1780:Hepatology 1765:Cardiology 1755:Immunology 1479:Baroreflex 1396:Compliance 1388:Blood flow 1264:ST segment 1192:Conduction 1182:Lusitropic 1154:Heart rate 1137:Heart rate 1089:Ultrasound 1020:Heart rate 946:2016-02-12 632:8 November 352:References 297:Carvedilol 258:Evaluation 192:fatty acid 55:, causing 21:cardiology 2306:Physician 2190:education 2048:Neurology 2043:Narcology 1907:Pathology 1885:Radiology 1760:Angiology 1724:Andrology 1439:Diastolic 1411:Perfusion 1170:Inotropic 1049:Afterload 911:0009-7322 862:0735-1097 458:0009-7322 270:Treatment 184:autophagy 180:apoptosis 169:diastolic 2336:Category 1812:Oncology 1743:medicine 1741:Internal 1589:Medicine 1434:Systolic 1212:cardiac 919:16401777 870:25190241 807:26131706 758:12783070 731:12668699 690:26647721 597:23810323 548:12084610 507:19195605 466:16144994 401:18427637 319:See also 176:necrosis 157:necrosis 149:collagen 86:systolic 49:pressure 41:exercise 33:function 2376:Outline 2346:Commons 2291:Therapy 2188:Medical 1751:Allergy 1719:Urology 1612:Surgery 1054:Preload 798:4484683 681:4728597 588:3788852 392:2300466 35:of the 2366:Portal 2233:MD–PhD 1344:Aortic 1332:atrial 1305:atrial 1301:Right 1274:U wave 1269:T wave 1244:P wave 1217:atrial 917:  909:  868:  860:  805:  795:  756:  729:  688:  678:  595:  585:  546:  505:  464:  456:  420:(MeSH) 399:  389:  77:insult 53:volume 1948:Other 1406:Pulse 1353:Other 1328:Left 1322:wedge 993:Heart 244:renin 182:, or 37:heart 915:PMID 907:ISSN 866:PMID 858:ISSN 821:link 803:PMID 754:PMID 727:PMID 686:PMID 634:2017 593:PMID 544:PMID 503:PMID 462:PMID 454:ISSN 397:PMID 246:and 217:MMP9 215:and 213:MMP1 139:The 27:(or 1682:ENT 1600:and 1099:= ( 897:doi 893:113 848:doi 793:PMC 785:doi 781:104 717:doi 713:348 676:PMC 668:doi 664:106 583:PMC 575:doi 571:112 534:doi 493:doi 444:doi 440:112 387:PMC 379:doi 311:or 59:or 51:or 19:In 2393:: 2021:/ 939:. 913:. 905:. 891:. 887:. 864:. 856:. 844:64 842:. 838:. 817:}} 813:{{ 801:. 791:. 779:. 775:. 750:51 748:. 725:. 711:. 707:. 684:. 674:. 662:. 658:. 642:^ 625:. 605:^ 591:. 581:. 569:. 565:. 542:. 530:39 528:. 524:. 501:. 489:53 487:. 483:. 460:. 452:. 438:. 434:. 395:. 385:. 375:16 373:. 369:. 223:, 178:, 147:, 123:. 107:, 103:, 92:. 67:, 23:, 1581:e 1574:t 1567:v 1376:/ 1166:) 1162:( 1156:) 1152:( 977:e 970:t 963:v 949:. 921:. 899:: 872:. 850:: 823:) 809:. 787:: 760:. 733:. 719:: 692:. 670:: 636:. 599:. 577:: 550:. 536:: 509:. 495:: 468:. 446:: 403:. 381:: 84:(

Index

cardiology
function
heart
exercise
acute myocardial infarction
pressure
volume
pressure overload
volume overload
hypertension
congenital heart disease
valvular heart disease
insult
histopathological
systolic
stroke volume
ventricular hypertrophy
ventricular dilation
cardiomegaly
cardiomyopathy
pressure overload
volume overload

cardiac myocyte
Fibroblasts
collagen
coronary vessels
necrosis
myocardial scarring
cardiac output

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