Related Experiment Video

Updated: May 13, 2026

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
08:42

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China

Published on: February 11, 2022

Medical management is the way to go for ventricular reconstruction post STICH?

Brisham Harchandani1, Alex Reyentovich

  • 1The Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY 10016, USA.

Progress in Cardiovascular Diseases
|March 23, 2013
PubMed

Insights

Neurohormonal antagonists are foundational for treating heart failure with reduced ejection fraction, improving outcomes by blocking remodeling. Surgical ventricular reconstruction showed no clinical benefit in the STICH trial.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Medical Science

Background:

  • Ventricular remodeling, a response to injury, involves cellular and systemic factors leading to left ventricular dilation and heart failure.
  • Neurohormonal activation initiates remodeling, making antagonists key therapeutic agents.
  • Surgical ventricular reconstruction aimed to reduce ventricular size and wall stress, but lacked clinical benefit.

Purpose of the Study:

  • To review the evidence supporting neurohormonal blockade in managing heart failure with reduced ejection fraction.
  • To explore the concept of "medical ventricular reconstruction" through pharmacological interventions.

Main Methods:

  • Literature review and evidence synthesis.
  • Analysis of clinical trial data, including the STICH trial.
  • Examination of the pathophysiological mechanisms of ventricular remodeling.

Main Results:

  • Neurohormonal antagonists have demonstrated efficacy in improving outcomes for heart failure with reduced ejection fraction.
  • The STICH trial found no clinical benefit from surgical ventricular reconstruction in addition to coronary artery bypass surgery.

Conclusions:

  • Neurohormonal blockade is a cornerstone therapy for heart failure with reduced ejection fraction.
  • The concept of "medical ventricular reconstruction" highlights the potential of pharmacologic agents to modify ventricular remodeling.
  • Surgical interventions like ventricular reconstruction have not proven beneficial in this patient population.

More Related Videos

Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart08:49

Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart

Published on: May 11, 2018

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.
Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...