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Studying Left Ventricular Reverse Remodeling by Aortic Debanding in Rodents
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Studying Left Ventricular Reverse Remodeling by Aortic Debanding in Rodents

Published on: July 14, 2021

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Pharmacologic and Endovascular Reversal of Left Ventricular Remodeling

Abhishek Jaiswal1, Vinh Q Nguyen1, Brendan J Carry1

  • 1Tulane University Heart and Vascular Institute, Tulane School of Medicine, New Orleans, Louisiana.

Journal of Cardiac Failure
|April 26, 2016
PubMed

Insights

Reversing left ventricular (LV) remodeling improves patient outcomes. Complete normalization of LV function and geometry indicates true reversal, associated with better survival rates in heart failure patients.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Cardiovascular Medicine

Background:

  • Pathologic left ventricular (LV) remodeling, characterized by adverse changes in mass, volume, geometry, and composition, is linked to poor prognosis in LV systolic dysfunction.
  • Reversal of LV remodeling is associated with improved morbidity and mortality, highlighting its clinical significance.
  • Distinguishing true reversal of remodeling (RR) from changes in loading conditions is crucial for accurate assessment.

Purpose of the Study:

  • To review the impact of specific therapies on left ventricular remodeling reversal (LVRR).
  • To evaluate the role of renin-angiotensin-aldosterone system inhibition, beta-adrenergic receptor blockade, cardiac resynchronization therapy, and endovascular mitral repair in LVRR.
  • To assess the influence of these interventions on LV geometry and function.

Main Methods:

  • Review of current literature on therapies affecting LV remodeling.
  • Analysis of studies investigating renin-angiotensin-aldosterone system inhibitors and beta-blockers.
  • Evaluation of data on cardiac resynchronization therapy and endovascular mitral repair outcomes.

Main Results:

  • Complete normalization of LV function (ejection fraction >50%) and geometry (indexed LV end-diastolic dimension <33 mm/m²) signifies true reversal of LV alteration.
  • Sustained improvement in LV function and dimensions after therapy withdrawal supports the occurrence of RR.
  • Differentiating incomplete RR from loading condition changes remains challenging without complete normalization.

Conclusions:

  • Therapeutic interventions can lead to significant improvements in LV geometry and function.
  • Achieving complete reversal of LV remodeling is associated with favorable clinical outcomes.
  • Further research is needed to refine the differentiation between true remodeling reversal and loading condition effects.

Keywords:
Beta blocker therapyLVRRheart failureleft ventricular remodelingremodeling reversal

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