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Ventricular remodeling without cellular contractile dysfunction.

Inder S Anand1

  • 1University of Minnesota Medical School and Veterans Administration Medical Center, Minneapolis, Minnesota 55417, USA.

Journal of Cardiac Failure
|January 30, 2003
PubMed
Summary
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Global left ventricular (LV) dysfunction after heart damage can occur without impaired myocyte contractility. Structural changes and cell loss, not just myocyte issues, drive early LV remodeling and dysfunction.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Myocardial Infarction Studies

Background:

  • Progressive left ventricular (LV) remodeling and global LV dysfunction after myocardial damage involve myocyte loss, extracellular matrix (ECM) changes, myocyte contractile dysfunction, and geometric alterations.
  • The relative importance of these factors and whether LV dysfunction can occur without myocyte contractile dysfunction remain unclear.

Purpose of the Study:

  • To investigate the natural history of LV remodeling in a rat infarct model.
  • To determine if structural alterations in the heart can directly cause LV dysfunction or if myocyte contractile dysfunction is essential for systolic LV dysfunction development.

Main Methods:

  • Studied the rat infarct model over 6 weeks.
  • Assessed LV remodeling, global LV dysfunction, and biochemical markers (SERCA2a, BNP, Na(+)-Ca(2+) exchanger).

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  • Isolated and evaluated contractile and calcium transient parameters of remote LV myocytes.

    • Main Results:

    • Post-myocardial infarction (MI) rats showed progressive LV remodeling and dysfunction with altered biochemical markers.
    • Remodeled myocytes were hypertrophied, and their length changes correlated with global LV remodeling.
    • No significant defects in myocyte contractile or intracellular calcium transient parameters were observed in unloaded or loaded states.

    Conclusions:

    • Myocyte hypertrophy can be dissociated from contractile defects, indicating global LV systolic dysfunction can occur without significant myocyte contractile dysfunction.
    • Factors like myocyte loss, increased wall stress, and ECM alterations may be more critical in early LV remodeling before myocyte contractile dysfunction becomes apparent.