Ventricular remodeling
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Ventricular Remodeling |
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Differentiating Ventricular Remodeling From Other Conditions |
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Diagnosis |
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Treatment |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-in-Chief: Mohammad I. Barouqa, M.D.
Synonyms and keywords: Left ventricular remodeling, LV remodeling
Overview
The Left Ventricle has an enormous ability to respond to any type of stress or pathological process. Such a response includes a complex a wide range of transcriptional, signaling, structural, electrophysiological and functional events of cardiac myocytes as well as other cells within the ventricle.
Ventricular remodeling is classified as Pathological or Physiological.
Historical Perspective
Classification
Ventricular remodeling can be either physiological or pathological. Physiological changes occur in cases of pregnancy, exercise and post-natal growth and considered to be normal, whereas pathological remodeling occur due to cardiac injury and can end up with cardiac arrhythmia and heart failure.
Remodeling has three patterns. Concentric remodeling where there is an increase in relative wall thickness (Ventricular wall thickness compared to cavity size) and with or without increase cardiac mass.This change is noticed in cases of pressure overload.Eccentric Hypertrophy where there is an increase in cardiac mass and chamber volume with relative wall thickness varying between being decreased, the same or increased. This change is noticed in cases of volume overload, after infarction and isotonic exercise. Mixed Concentric and Eccentric changes as in Myocardial Infarction (MI), Where there is a combined volume and pressure overload on noninfarcted areas.
Remodeling can be classified as adaptive or maladaptive.
Pathophysiology
Causes
Differentiating Ventricular remodeling from other Diseases
Epidemiology and Demographics
Maladaptive remodeling is age dependent and the mortality rate resulting from Myocardial Infarction increases with age.
Coronary artery disease which is the leading cause of heart failure with reduced systolic function occurs more in males than females.However, heart failure with preserved systolic function affects females more than males with a ratio of 2:1.
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | Other Imaging Findings | Other Diagnostic Studies
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Future or Investigational Therapies