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Related Concept Videos

Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

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Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
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Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

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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...
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Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

46
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Related Experiment Video

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Studying Left Ventricular Reverse Remodeling by Aortic Debanding in Rodents
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Left Atrial Reverse Remodeling in Dilated Cardiomyopathy.

Vincenzo Nuzzi1, Anne Raafs2, Paolo Manca1

  • 1Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|November 4, 2022
PubMed
Summary

Reducing left atrial volume index (LAVI) in patients with dilated cardiomyopathy (DCM) is linked to better outcomes. A significant decrease in LAVI over one year correlated with a lower risk of death, heart transplantation, or heart failure hospitalization.

Keywords:
Clinical outcomeDilated cardiomyopathyHeart failureLeft atrial reverse remodelingLeft atrium

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Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Heart Failure Research

Background:

  • Left atrial (LA) dilation is a known negative prognostic factor in cardiovascular disease.
  • Therapeutic interventions can induce LA reverse remodeling.
  • The prognostic significance of LA volume index (LAVI) reduction in dilated cardiomyopathy (DCM) requires characterization.

Purpose of the Study:

  • To characterize LAVI reduction in patients with DCM.
  • To define the prognostic implications of LAVI reduction in DCM patients.
  • To investigate the association between LAVI changes and adverse cardiovascular outcomes.

Main Methods:

  • Retrospective analysis of 560 DCM patients from two centers with baseline and 1-year echocardiograms.
  • LA dilation defined as LAVI > 34 mL/m²; 1-year relative LAVI reduction (ΔLAVI) calculated.
  • Composite outcome: death, heart transplantation (HTx), or heart failure hospitalization (HFH).

Main Results:

  • Baseline LAVI showed a non-linear association with adverse outcomes, independent of other factors (P < .01).
  • 67% of patients achieved LAVI reduction (median ΔLAVI, -24%) at 1 year; higher baseline LAVI and lower LVEF predicted reduction.
  • ΔLAVI demonstrated a linear association with reduced risk of death, HTx, or HFH (HR, 0.96 per 5% decrease; P = .042).
  • LAVI normalization (≤34 mL/m²) or >10% reduction was associated with significantly lower risk (HR, 0.37; P = .028).

Conclusions:

  • One-year LAVI reduction is achievable in a significant proportion of DCM patients.
  • LA structural reverse remodeling, indicated by LAVI reduction, may serve as a valuable tool for risk stratification in DCM.
  • Monitoring LAVI changes can aid in individualized risk assessment and management of DCM patients.