Reverse Left Ventricular Remodeling With Transcatheter Interventions in Chronic Heart Failure Syndromes: An Updated
Michael I Brener1, Samir R Kapadia2, Daniel Burkhoff1,3
1Division of Cardiology, Columbia University Medical Center, New York, New York.
Insights
Device-based therapies aim to reverse adverse left ventricular remodeling in chronic heart failure (HF). This review explores current and future device mechanisms for biological and physical reverse remodeling in HF patients.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Chronic heart failure (HF) involves myocardial dysfunction and adverse left ventricular remodeling.
- Remodeling includes ventricular dilation, altered volumes, and increased wall stress, worsening HF progression.
Purpose of the Study:
- To review existing and emerging device-based strategies for reverse remodeling in chronic HF.
- To highlight mechanisms for both biological and physical left ventricular reverse remodeling.
Main Methods:
- Literature review of device-based therapies for HF.
- Analysis of mechanisms targeting cellular and structural changes in the left ventricle.
Main Results:
- Device therapies offer biological approaches by modifying loading conditions.
- Physical approaches involve direct alteration of myocardial mass or shape using devices.
Conclusions:
- Device-based interventions are crucial for achieving reverse remodeling in chronic HF.
- Emerging technologies hold promise for both biological and physical reversal of left ventricular dysfunction.
Abstract:
Chronic heart failure (HF) is a clinical syndrome of myocardial dysfunction characterized by inadequate cardiac output or preserved output that can only be achieved by sustaining abnormal loading conditions. Morphologically, HF with reduced left ventricular function results in progressive chamber remodeling, meaning the ventricle dilates, operating at larger end-diastolic and end-systolic volumes, and takes on an abnormal, spherical shape that increases wall stress. Reverse remodeling is the goal of HF-directed therapies and can be achieved by biological means, ie, altering the loading conditions that, at a cellular level, promote myocardial dysfunction, or physical means, ie, directly altering myocardial mass or shape. In this review, we highlight the existing and emerging device-based mechanisms for biologically and physically reverse remodeling the left ventricle in chronic HF.
More Related Videos
Related Concept Videos
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:17Pathophysiology of Heart Failure