Left ventricular reverse remodeling
In this study, change in LVESV was the single most important predictor of all cause and cardiovascular mortality. Clinical parameters could not predict outcome events in this study. Similar beneficial effect on left ventricular remodeling was demonstrated long back in the trials with angiotensin converting enzyme inhibitors. SOLVD (Studies of Left Ventricular Dysfunction) study showed that in patients with heart failure and reduced left ventricular ejection fraction, chronic treatment with angiotensin converting enzyme inhibitor enalapril prevented progressive left ventricular dilatation, systolic dysfunction and increase in end systolic volume . Mean end systolic volume decreased from 106 to 93 ml/m2 in the study group while it increased from 103 to 116 ml/m2 in the control group. Survival and Ventricular Enlargement (SAVE) trial with captopril showed that left ventricular end diastolic and end systolic areas at 1 year were larger in placebo group than in captopril group . They noted that left ventricular enlargement and dysfunction after myocardial infarction were associated with the development of adverse cardiac events. Preventing ventricular enlargement with captopril was associated with a reduction in adverse events. Left ventricular reverse remodeling after cardiac resynchronization therapy with more than 20% reduction in LVESV is considered to be much larger than that observed in medical therapy for heart failure . Generally about one third of patients do not...
Source: Cardiophile MD - Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
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