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Remodelling and adverse remodelling in CAD

Remodelling und Maladaption bei koronarer Herzerkrankung

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Abstract

Remodelling is the adaptive or maladaptive response to cardiac overload or injury resulting in changes of size and function of the heart. The final pathway of maladaptive or adverse cardiac remodelling is the evolution of heart failure or sudden cardiac death. In coronary artery disease, ischemic injury leads to changes in the cellular and extra-cellular architecture of the infarcted and non-infarcted region resulting in cavity enlargement and loss of contractility of the entire heart. During the last three decades, potential therapeutic concepts have been established and reversal of adverse remodelling could be demonstrated in up-to end-stage disease. A further understanding of the underlying cellular, extracellular, molecular and genetic alterations in ischemic remodelling should reveal other promising targets for prevention and reversal of remodelling.

Zusammenfassung

Kardiales Remodelling ist die morphologische und funktionelle Adaptation oder Maladaptation des Herzens als Reaktion auf einen physiologischen oder pathologischen Stressor. Sie wird durch genetische, molekulare, zelluläre und extrazelluläre Veränderungen vermittelt. Dabei stellen die Entwicklung einer Herzinsuffizienz und der plötzliche Herztod die pathophysiologische Endstrecke eines maladaptiven Remodelling dar. In den letzten 3 Jahrzehnten haben sich potente Therapiekonzepte des kardialen Remodelling etabliert und gezeigt, dass eine Reversion des Remodelling auch im späten Stadium der Herzinsuffizienz noch möglich ist. Das tiefere Verständnis der kardialen Umbauvorgänge auf genetischer, molekularer, zellulärer und extrazellulärer Ebene ist Voraussetzung für weitere vielversprechende Therapieansätze zur Prävention und Reversion des Remodelling.

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On behalf of all authors, the corresponding author states the following: there are no conflicts of interest, including specific financial interests and relationships relevant to the subject of this manuscript.

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  1. Department of Internal Medicine I/Comprehensive Heart Failure Center, University Hospital Würzburg, Oberdürrbacherstr. 6, 97080, Würzburg, Germany

    S. Brenner & G. Ertl MD

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Brenner, S., Ertl, G. Remodelling and adverse remodelling in CAD. Herz 37, 590–597 (2012). https://doi.org/10.1007/s00059-012-3660-7

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  • DOI: https://doi.org/10.1007/s00059-012-3660-7

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