Left ventricular remodeling
From Standard of Care
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Occurs after myocardial infarction and reflects reduced myocardial function.
A process that involves left ventricular enlargement and change in heart chamber geometry.
Correlates with progression of heart failure and poor prognosis.
The structural adaptation to increased vascular risks, and predictor of cardiovascular morbidity and mortality.
LV structural changes lead to functional impairment, mainly impaired LV filling with the development of diastolic dyysfunction and eventually left atrial enlargement.
Beneficial effects of angiotensin converting enzyme inhibitors and beta blockers are associated with their effects on left ventricular remodeling.
Surgical left ventricular reconstruction for heart failure with left ventricular remodeling caused by coronary artery disease attempts to reduce the left ventricular volume, increase the ejection fraction and improve left ventricular function.
Comparing coronary artery bypass graft surgery to coronary artery bypass surgery combined with surgical ventricular reconstruction in patients with coronary artery disease and left ventricular systolic dysfunction revealed the addition of the later surgery resulted in significantly greater reduction in left ventricular volume than achieved by CABG alone (Jones RH)
Surgical left ventricular reconstruction with CABG does improve left ventricle volume, but does not improve outcome in patients so treated compared to patients treated with CABG alone: no improvement in death or cardiac hospitalization or in any other clinical outcome (Jones RH).