Left ventricular remodeling

Left ventricular remodeling Left ventricular remodeling occurs in response to left ventricular stress and injury. It is progressive and occurs after large myocardial infarctions and dilated cardiomyopathy. Left ventricular volume increases and the normal elliptical shape becomes globular. Left ventricular remodeling is associated with changes at microscopic level which include myocyte hypertrophy, apoptosis and increased interstitial collagen deposition [1]. Left ventricular remodeling is a central pathophysiological mechanism in advancing heart failure. Reversal of remodeling with treatment is an important goal in the management of heart failure. Treatment modality could be either drugs or devices depending on the clinical scenario. In post myocardial infarction remodeling, two processes are infarct expansion and enlargement of the rest of the left ventricle. Infarct expansion occurs in the process of fibrotic repair of the necrotic area with scar formation and thinning of the infarct zone. Increase in left ventricular volume is initially beneficial as the force of contraction increases according to Starling’s law. Volume overload hypertrophy occurs in the non infarcted segments [2]. But as the left ventricle assumes a spherical shape later, it leads to decline in performance. In idiopathic dilated cardiomyopathy, there is elevated wall stress and left ventricle assumes a more spherical shape. A study comparing survivors and nonsurvivors showed that survivors had a sm...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Source Type: blogs