Cardiac remodeling--concepts and clinical implications: a consensus paper from an international forum on cardiac remodeling. Behalf of an International Forum on Cardiac Remodeling.

By J. Cohn, R. Ferrari, N. Sharpe. 2000

2,591 citations recorded by the source corpus.

Cardiac remodeling is generally accepted as a determinant of the clinical course of heart failure (HF). Defined as genome expression resulting in molecular, cellular and interstitial changes and manifested clinically as changes in size, shape and function of the heart resulting from cardiac load or injury, cardiac remodeling is influenced by hemodynamic load, neurohormonal activation and other factors still under investigation. Although patients with major remodeling demonstrate progressive worsening of cardiac function, slowing or reversing remodeling has only recently become a goal of HF therapy. Mechanisms other than remodeling can also influence the course of heart disease, and disease progression may occur in other ways in the absence of cardiac remodeling. Left ventricular end-diastolic and end-systolic volume and ejection fraction data provide support for the beneficial effects of therapeutic agents such as angiotensin-converting enzyme (ACE) inhibitors and beta-adrenergic blocking agents on the remodeling process. These agents also provide benefits in terms of morbidity and mortality. Although measurement of ejection fraction can reliably guide initiation of treatment in HF, opinions differ regarding the value of ejection fraction data in guiding ongoing therapy. The role of echocardiography or radionuclide imaging in the management and monitoring of HF is as yet unclear. To fully appreciate the potential benefits of HF therapies, clinicians should understand the relationship between remodeling and HF progression. Their patients may then, in turn, acquire an improved understanding of their disease and the treatments they are given.

Subfields: Cardiology and Cardiovascular Medicine, Surgery

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Citations in the corpus

Learning Interpretable Anatomical Features Through Deep Generative Models: Application to Cardiac Remodeling (2018, methodology): “Alterations in the geometry and function of the heart (remodeling) are used as criteria to diagnose and classify cardiovascular diseases as well as risk-stratify individual patients [1].”
Atlas-based Anatomical Modeling and Analysis of Heart Disease (2014, background): “As the heart remodels, its geometry changes to become less elliptical and more spherical [14].”
Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Coun (2008, background): “Because these obstructive events may occur hundreds of times over the course of the night, these abrupt increases in left ventricular transmural pressure could play an important role in the development of myocardial ischemia, myocyte slippage, contractile dysfunction, and ventricular dilation (190).”
The role of TGF-β Signaling in Myocardial Infarction and Cardiac Remodeling (2007, background): “Pathologic remodeling occurs in three major patterns: a) concentric remodeling when pressure overload causes growth in cardiomyocyte thickness, b) eccentric remodeling resulting from a volume load that produces cardiomyocyte lengthening and c) post-infarction remodeling, which involves a combined pr”
Statistical shape modeling of the left ventricle: myocardial infarct classification challenge (2017, background): “Heart shape also becomes more spherical and less conical [12].”