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Ventricular remodeling

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338: 2343: 2373: 2383: 170:(cell death) and disproportionate thinning of the heart. This thin, weakened area is unable to withstand the pressure and volume load on the heart in the same manner as the other healthy tissue. As a result, there is dilatation of the chamber arising from the infarct region. The initial remodeling phase after a myocardial infarction results in repair of the necrotic area and 2363: 143: 2353: 221:
Besides, the cardiac interstitium which consisted of largely Type I and Type III collagen fibres are also involved in cardiac remodeling. Cardiac collagen is synthesized by fibroblasts and degraded by metalloproteinases. Fibroblasts are activated post MI, leading to increased collagen synthesis and
197:, leading to thinning of the cardiac wall. The surviving cardiac myocytes either arrange in parallel or in series to each other, contributing to ventricular dilatation or ventricular hypertrophy, depending on the loading stress on the ventricular wall. Besides, reduced expression of V1 myosin and 106:
Physiological remodeling is reversible while pathological remodeling is mostly irreversible. Remodeling of the ventricles under left/right pressure demand make mismatches inevitable. Pathologic pressure mismatches between the pulmonary and systemic circulation guide compensatory remodeling of the
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have been consistently shown to decrease remodeling in animal models or transmural infarction and chronic pressure overload. Clinical trials have shown that ACE inhibitor therapy after myocardial infarction leads to improved myocardial performance, improved
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accounts for 60 to 90% of the energy supply of the heart. Post MI, as fatty acid oxidation decreases, it leads to reduced energy supply for the cardiac myocytes, accumulation of fatty acids to toxic levels, and dysfunction of
178:. Over time, however, as the heart undergoes ongoing remodeling, it becomes less elliptical and more spherical. Ventricular mass and volume increase, which together adversely affect cardiac function. Eventually, 94:
and structural changes occur in the left ventricular myocardium that lead to progressive decline in left ventricular performance. Ultimately, ventricular remodeling may result in diminished contractile
318:(CRT) has shown the ability to reverse left ventricular remodeling in some patients. Early correction of congenital heart defects, if appropriate, may prevent remodeling, as will treatment of chronic 531:
Saavedra, W.Federico; Tunin, Richard S; Paolocci, Nazareno; Mishima, Takayuki; Suzuki, George; Emala, Charles W; Chaudhry, Pervaiz A; Anagnostopoulos, Petros; Gupta, Ramesh C (2002).
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left and right ventricles. The term "reverse remodeling" in cardiology implies an improvement in ventricular mechanics and function following a remote injury or pathological process.
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Yu, Cheuk-Man; Bleeker, Gabe B.; Fung, Jeffrey Wing-Hong; Schalij, Martin J.; Zhang, Qing; Wall, Ernst E. van der; Chan, Yat-Sun; Kong, Shun-Ling; Bax, Jeroen J. (2005-09-13).
574:"Prevalence, Clinical Characteristics, and Outcomes Associated with Eccentric Versus Concentric Left Ventricular Hypertrophy in Heart Failure with Preserved Ejection Fraction" 986: 714:
Pitt, Bertram; Remme, Willem; Zannad, Faiez; Neaton, James; Martinez, Felipe; Roniker, Barbara; Bittman, Richard; Hurley, Steve; Kleiman, Jay; Gatlin, Marjorie (2003).
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Many factors influence the time course and extent of remodeling, including the severity of the injury, secondary events (recurrent ischemia or infarction),
1872: 2213: 1209: 218:, and induction of apoptosis, which would be explained below. Besides, inflammatory immune response after MI also contributes to the above changes. 1812: 979: 492:"Long-Term Prognosis After Cardiac Resynchronization Therapy Is Related to the Extent of Left Ventricular Reverse Remodeling at Midterm Follow-Up" 490:
Ypenburg, Claudia; Bommel, Rutger J. van; Borleffs, C. Jan Willem; Bleeker, Gabe B.; Boersma, Eric; Schalij, Martin J.; Bax, Jeroen J. (2009).
2112: 2412: 2248: 1590: 972: 443:"Left Ventricular Reverse Remodeling but Not Clinical Improvement Predicts Long-Term Survival After Cardiac Resynchronization Therapy" 894:
St John Sutton, Martin G.; Plappert, Ted; Hilpisch, Kathryn E.; Abraham, William T.; Hayes, David L.; Chinchoy, Edward (2006-01-17).
315: 896:"Sustained Reverse Left Ventricular Structural Remodeling With Cardiac Resynchronization at One Year Is a Function of Etiology" 235: 755:
Khattar, R. S. (2003). "Effects of ACE-inhibitors and beta-blockers on left ventricular remodeling in chronic heart failure".
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to a lesser extent, also play a role. A common scenario for remodeling is after myocardial infarction. There is myocardial
1122: 1499: 250: 54:(physiological remodeling) or after injury to the heart muscle (pathological remodeling). The injury is typically due to 2218: 1254: 1232: 716:"Eplerenone, a Selective Aldosterone Blocker, in Patients with Left Ventricular Dysfunction after Myocardial Infarction" 1862: 1494: 1239: 533:"Reverse remodeling and enhancedadrenergic reserve from passive externalsupport in experimental dilated heart failure" 174:
that may, to some extent, be considered beneficial since there is an improvement in or maintenance of LV function and
55: 58:(usually transmural or ST segment elevation infarction), but may be from a number of causes that result in increased 572:
Katz, Daniel H.; Beussink, Lauren; Sauer, Andrew J.; Freed, Benjamin H.; Burke, Michael A.; Shah, Sanjiv J. (2013).
314:, may actually reverse the remodeling process by reducing left ventricular volumes and improving systolic function. 1842: 1320: 262: 2271: 1524: 1481: 1471: 1347: 1327: 1291: 1214: 1174: 995: 230:
led to degradation of collagen fibres, and subsequently dilatation of the heart. Several signal pathways such as
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function, or the heart's ability to relax between contractions may become impaired, further causing decline.
2407: 2043: 2017: 1529: 1461: 1406: 1307: 1227: 1111: 1089: 356: 198: 111: 1069: 337: 1635: 1583: 1466: 1456: 1116: 1074: 667:"Cardiac Remodeling: Concepts, Clinical Impact, Pathophysiological Mechanisms and Pharmacologic Treatment" 323: 83: 2286: 2172: 2145: 2118: 2070: 2024: 1719: 1315: 948:"Left Ventricular Remodeling in Heart Failure: Current Concepts in Clinical Significance and Assessment" 825: 2306: 2266: 2133: 1947: 1942: 1922: 1857: 1709: 1064: 1047: 632: 115: 2386: 2328: 2311: 1970: 1687: 1411: 1249: 1244: 1079: 1052: 171: 2372: 424: 2276: 2233: 2223: 2012: 1965: 1932: 1927: 1677: 1655: 1519: 1384: 1137: 378:"Cardiac remodelling: Concentric versus eccentric hypertrophy in strength and endurance athletes" 96: 43: 201:
on cardiac myocytes are also thought to cause cardiac remodeling. Under normal body conditions,
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Other factors such as high blood pressure, activation of sympathetic system which releases
2376: 2321: 2182: 2167: 2150: 2090: 2085: 2029: 2007: 1704: 1650: 1630: 1354: 1084: 964: 290: 277:. The size and function of the atria and ventricles can be characterized using this test. 163: 151: 131: 71: 2208: 2162: 1975: 1905: 1724: 1514: 1439: 1431: 1025: 1012: 808: 783: 691: 666: 598: 573: 402: 377: 343: 246: 175: 123: 91: 912: 895: 549: 532: 459: 442: 2401: 2291: 2080: 2075: 1937: 1877: 1780: 1132: 1042: 1035: 1020: 351: 294: 100: 2356: 2296: 2281: 2107: 1832: 1682: 1667: 1613: 1546: 1536: 1509: 1398: 1389: 1186: 1160: 319: 311: 286: 239: 207: 119: 75: 589: 17: 2155: 2100: 1997: 1852: 1827: 1645: 1551: 1541: 1269: 1264: 1259: 1170: 863: 846: 303: 258: 242:
are known to trigger synthesis and degradation of collagen fibres in the heart.
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After a myocardial infarction (MI), cardiac myocyte death can be triggered by
155: 31: 921: 872: 468: 2316: 2058: 2053: 1917: 1895: 1770: 1734: 1421: 1192: 1059: 194: 190: 179: 929: 880: 817: 784:"Reverse Cardiac Remodeling: A Marker of Better Prognosis in Heart Failure" 768: 741: 700: 607: 558: 517: 476: 411: 142: 665:
Azevedo, Paula S; Polegato, Bertha F; Minicucci, Marcos F (January 2016).
1822: 1599: 1449: 1180: 799: 732: 715: 682: 186: 167: 159: 59: 51: 2301: 1761: 1729: 1622: 1444: 393: 1284: 1279: 306:, either directly or indirectly, leads to improvement in remodeling. 63: 782:
Reis Filho JR, Cardoso JN, Cardoso CM, Pereira-Barretto AC (2015).
1416: 1003: 254: 141: 126:, of which there are many types. Concentric hypertrophy is due to 47: 227: 223: 1572: 968: 261:
are important contributors of cardiac remodelling. However,
1568: 906:(2). Ovid Technologies (Wolters Kluwer Health): 266–272. 845:
Leyva, Francisco; Nisam, Seah; Auricchio, Angelo (2014).
293:, and treatment. Medications may attenuate remodeling. 42:) refers to changes in the size, shape, structure, and 273:
Remodeling of the heart is evaluated by performing an
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It is an aspect of 74:(forms of strain) on the heart. Chronic 996:Physiology of the cardiovascular system 368: 86:may also lead to remodeling. After the 823: 27:Changes in the physiology of the heart 7: 2352: 2113:Physical medicine and rehabilitation 265:is thought to be cardio-protective. 2362: 788:Arquivos Brasileiros de Cardiologia 671:Arquivos Brasileiros de Cardiologia 633:"Cardiac remodeling: Basic aspects" 110:Ventricular remodeling may include 2249:Medical Scientist Training Program 578:The American Journal of Cardiology 25: 913:10.1161/circulationaha.104.520817 460:10.1161/circulationaha.105.538272 316:Cardiac resynchronization therapy 50:. This can happen as a result of 2381: 2371: 2361: 2351: 2342: 2341: 336: 289:activation, genetic factors and 82:with intracardiac shunting, and 2382: 720:New England Journal of Medicine 236:Transforming growth factor beta 2239:Doctor of Osteopathic Medicine 1673:Oral and maxillofacial surgery 857:(10). Elsevier BV: 1047–1058. 1: 1123:Aortic valve area calculation 590:10.1016/j.amjcard.2013.05.061 550:10.1016/s0735-1097(02)01890-9 2219:Bachelor of Medical Sciences 1986:Neurosurgical anesthesiology 162:, the interstitium, and the 1240:Effective refractory period 1119:) / End-diastolic dimension 864:10.1016/j.jacc.2014.06.1178 56:acute myocardial infarction 2429: 509:10.1016/j.jacc.2008.10.032 263:atrial natriuretic peptide 2413:Cardiovascular physiology 2337: 1525:Tubuloglomerular feedback 1472:Critical closing pressure 1292:Hexaxial reference system 1215:Cardiac electrophysiology 757:Minerva Cardioangiologica 382:Netherlands Heart Journal 2173:Transplantation medicine 2064:Clinical neurophysiology 1981:Obstetric anesthesiology 1901:Interventional radiology 1661:Digestive system surgery 1500:Renin–angiotensin system 429:Medical Subject Headings 251:renin–angiotensin system 80:congenital heart disease 2044:Intensive care medicine 2018:Mass gathering medicine 1863:Maternal–fetal medicine 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dilation 90:occurs, a series of 2329:History of medicine 2312:Veterinary medicine 2119:Preventive medicine 1971:Adolescent medicine 1813:Infectious diseases 1412:Vascular resistance 1250:Electrocardiography 1245:Pacemaker potential 1175:Conduction velocity 1080:Venous return curve 1053:End-systolic volume 310:, a 3rd generation 172:myocardial scarring 2277:Molecular oncology 2234:Doctor of Medicine 2224:Master of Medicine 2141:Radiation oncology 2013:Emergency medicine 1966:Addiction medicine 1933:Clinical chemistry 1928:Clinical pathology 1720:Transplant surgery 1678:Orthopedic surgery 1656:Colorectal surgery 1520:Myogenic mechanism 1138:Left atrial volume 1070:Frank–Starling law 394:10.1007/BF03086131 216:metalloproteinases 148: 40:cardiac remodeling 18:Cardiac remodeling 2395: 2394: 2229:Master of Surgery 2193: 2192: 2178:Tropical medicine 2124:Prison healthcare 2039:Hospital medicine 2003:Disaster medicine 1993:Aviation medicine 1808:Hospital medicine 1715:Surgical oncology 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1891: 1889: 1885: 1879: 1878:Urogynecology 1876: 1874: 1871: 1869: 1866: 1864: 1861: 1859: 1856: 1854: 1851: 1850: 1848: 1846: 1840: 1834: 1831: 1829: 1826: 1824: 1821: 1819: 1816: 1814: 1811: 1809: 1806: 1804: 1801: 1799: 1796: 1792: 1789: 1788: 1787: 1784: 1782: 1781:Endocrinology 1779: 1777: 1774: 1772: 1769: 1767: 1763: 1760: 1759: 1757: 1755: 1749: 1743: 1740: 1736: 1733: 1732: 1731: 1728: 1726: 1723: 1721: 1718: 1716: 1713: 1711: 1708: 1706: 1703: 1701: 1698: 1691: 1690: 1689: 1686: 1684: 1681: 1679: 1676: 1674: 1671: 1669: 1666: 1662: 1659: 1657: 1654: 1653: 1652: 1649: 1647: 1644: 1642: 1639: 1637: 1634: 1632: 1629: 1628: 1626: 1624: 1620: 1617: 1615: 1609: 1605: 1601: 1594: 1589: 1587: 1582: 1580: 1575: 1574: 1571: 1553: 1550: 1548: 1545: 1543: 1540: 1539: 1538: 1535: 1531: 1528: 1526: 1523: 1521: 1518: 1517: 1516: 1513: 1511: 1508: 1506: 1503: 1501: 1498: 1496: 1493: 1491: 1488: 1487: 1485: 1483: 1479: 1473: 1470: 1468: 1465: 1463: 1460: 1458: 1455: 1451: 1448: 1446: 1443: 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1019: 1018: 1016: 1014: 1010: 1007: 1005: 1001: 997: 990: 985: 983: 978: 976: 971: 970: 967: 953: 949: 945: 944: 940: 931: 927: 923: 919: 914: 909: 905: 901: 897: 890: 887: 882: 878: 874: 870: 865: 860: 856: 852: 848: 841: 838: 833: 827: 819: 815: 810: 805: 801: 797: 794:(6): 502–06. 793: 789: 785: 778: 775: 770: 766: 763:(2): 143–54. 762: 758: 751: 748: 743: 739: 734: 729: 725: 721: 717: 710: 707: 702: 698: 693: 688: 684: 680: 676: 672: 668: 661: 659: 657: 655: 651: 639: 634: 626: 624: 622: 620: 618: 614: 609: 605: 600: 595: 591: 587: 583: 579: 575: 568: 565: 560: 556: 551: 546: 542: 538: 534: 527: 524: 519: 515: 510: 505: 502:(6): 483–90. 501: 497: 493: 486: 483: 478: 474: 470: 466: 461: 456: 452: 448: 444: 437: 434: 430: 426: 421: 418: 413: 409: 404: 399: 395: 391: 388:(4): 129–33. 387: 383: 379: 372: 369: 362: 358: 355: 353: 352:Dor procedure 350: 349: 345: 339: 334: 329: 327: 325: 321: 317: 313: 309: 305: 301: 296: 292: 288: 287:neurohormonal 280: 278: 276: 268: 266: 264: 260: 256: 252: 248: 243: 241: 237: 233: 229: 225: 219: 217: 213: 209: 204: 200: 196: 192: 188: 183: 181: 177: 173: 169: 165: 161: 157: 153: 146:Myocardiocyte 144: 137: 135: 133: 129: 125: 121: 117: 113: 108: 104: 102: 101:stroke volume 98: 93: 89: 85: 81: 77: 73: 69: 65: 61: 57: 53: 49: 45: 41: 37: 33: 19: 2297:Rural health 2282:Nanomedicine 1833:Rheumatology 1764: / 1683:Hand surgery 1668:Neurosurgery 1547:Carotid body 1510:Vasodilators 1390:hemodynamics 1370: 1195:(Relaxation) 1187:Bathmotropic 1161:Chronotropic 955:. 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Index

Cardiac remodeling
cardiology
function
heart
exercise
acute myocardial infarction
pressure
volume
pressure overload
volume overload
hypertension
congenital heart disease
valvular heart disease
insult
histopathological
systolic
stroke volume
ventricular hypertrophy
ventricular dilation
cardiomegaly
cardiomyopathy
pressure overload
volume overload

cardiac myocyte
Fibroblasts
collagen
coronary vessels
necrosis
myocardial scarring

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