Cardiac Remodeling: Concepts, Clinical Impact, Pathophysiological Mechanisms and Pharmacologic Treatment

Arq Bras Cardiol. 2016 Jan;106(1):62-9. doi: 10.5935/abc.20160005. Epub 2015 Dec 8.
[Article in En, Portuguese]

Abstract

Cardiac remodeling is defined as a group of molecular, cellular and interstitial changes that manifest clinically as changes in size, mass, geometry and function of the heart after injury. The process results in poor prognosis because of its association with ventricular dysfunction and malignant arrhythmias. Here, we discuss the concepts and clinical implications of cardiac remodeling, and the pathophysiological role of different factors, including cell death, energy metabolism, oxidative stress, inflammation, collagen, contractile proteins, calcium transport, geometry and neurohormonal activation. Finally, the article describes the pharmacological treatment of cardiac remodeling, which can be divided into three different stages of strategies: consolidated, promising and potential strategies.

Publication types

  • Review

MeSH terms

  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Arrhythmias, Cardiac / drug therapy
  • Arrhythmias, Cardiac / metabolism
  • Arrhythmias, Cardiac / physiopathology
  • Calcium / metabolism
  • Collagen / metabolism
  • Humans
  • Myocardial Infarction / drug therapy
  • Myocardial Infarction / metabolism
  • Myocardial Infarction / physiopathology
  • Oxidative Stress
  • Ventricular Dysfunction / drug therapy*
  • Ventricular Dysfunction / metabolism
  • Ventricular Dysfunction / physiopathology*
  • Ventricular Remodeling / physiology*

Substances

  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Collagen
  • Calcium