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Cardiac Remodeling: The Course Toward Heart Failure – I. General Concepts

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Myocardial Preservation

Abstract

Cardiac remodeling (REM) is a generally unfavorable process that leads to left ventricular dilation in response to noxious stimuli, mostly acute myocardial infarction. Thus it occurs in around 30% of anterior infarcts despite timely primary angioplasty and the use of the commonly used drugs. Infarct expansion, specifically at the border area is characteristic. Other causes are cardiomyopathy (dilated or hypertrophic), hypertension, valvular heart disease, antineoplastic chemotherapy, diabetes mellitus, morbid obesity, genetic diseases, arrhythmias and conduction defects. Cell death through apoptosis, chronic hypoxia, ROS production, inflammation, and defective collagen organization are the main contributing factors. The most widely used definition of REM is a >20% increase in left ventricular end-diastolic volume (LVEDV). There is also evidence that regression of REM can occur, i.e., reverse REM. The latter is defined as a ≥10% decrease in left ventricular end-systolic volume (LVESV) and confers a more favorable outcome.

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  1. Heart and Vessel Department, Biomedical Research Foundation, Academy of Athens - Gregory Skalkeas, Athens, Greece

    Dennis V. Cokkinos

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  1. Heart and Vessel Department, Biomedical Research Foundation of the Academy of Athens - Gregory Skalkeas, Athens, Greece

    Dennis V. Cokkinos

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Cokkinos, D.V. (2019). Cardiac Remodeling: The Course Toward Heart Failure – I. General Concepts. In: Cokkinos, D. (eds) Myocardial Preservation. Springer, Cham. https://doi.org/10.1007/978-3-319-98186-4_12

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  • DOI: https://doi.org/10.1007/978-3-319-98186-4_12

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