Mechanisms of myocardial reverse remodelling and its clinical significance: A scientific statement of the ESC Working Group on Myocardial Function.

Autor: Falcão-Pires I; UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal., Ferreira AF; UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal., Trindade F; UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal., Bertrand L; Université Catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Pôle of Cardiovascular Research, Brussels, Belgium.; WELBIO, Department, WEL Research Institute, Wavre, Belgium., Ciccarelli M; Cardiovascular Research Unit, Department of Medicine and Surgery, University of Salerno, Baronissi, Italy., Visco V; Cardiovascular Research Unit, Department of Medicine and Surgery, University of Salerno, Baronissi, Italy., Dawson D; Aberdeen Cardiovascular and Diabetes Centre, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK., Hamdani N; Department of Cellular and Translational Physiology, Institute of Physiology, Ruhr University Bochum, Bochum, Germany.; Institut für Forschung und Lehre (IFL), Molecular and Experimental Cardiology, Ruhr University Bochum, Bochum, Germany.; HCEMM-SU Cardiovascular Comorbidities Research Group, Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary.; Department of Physiology, Cardiovascular Research Institute Maastricht University Maastricht, Maastricht, the Netherlands., Van Laake LW; Division Heart and Lungs, Department of Cardiology and Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands., Lezoualc'h F; Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France., Linke WA; Institute of Physiology II, University Hospital Münster, Münster, Germany., Lunde IG; Oslo Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevaal, Oslo, Norway.; KG Jebsen Center for Cardiac Biomarkers, Campus Ahus, University of Oslo, Oslo, Norway., Rainer PP; Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.; BioTechMed Graz, Graz, Austria.; St. Johann in Tirol General Hospital, St. Johann in Tirol, Austria., Abdellatif M; Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.; BioTechMed Graz, Graz, Austria., Van der Velden J; Department of Physiology, Amsterdam UMC, Amsterdam, The Netherlands., Cosentino N; Centro Cardiologico Monzino IRCCS, Milan, Italy.; Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy., Paldino A; Cardiovascular Biology Laboratory, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy.; Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy., Pompilio G; Centro Cardiologico Monzino IRCCS, Milan, Italy.; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy., Zacchigna S; Cardiovascular Biology Laboratory, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy.; Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy., Heymans S; Department of Cardiology, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.; Centre of Cardiovascular Research, University of Leuven, Leuven, Belgium., Thum T; Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany., Tocchetti CG; Department of Translational Medical Sciences (DISMET), Center for Basic and Clinical Immunology Research (CISI), Interdepartmental Center of Clinical and Translational Sciences (CIRCET), Interdepartmental Hypertension Research Center (CIRIAPA), Federico II University, Naples, Italy.
Jazyk: angličtina
Zdroj: European journal of heart failure [Eur J Heart Fail] 2024 Jul; Vol. 26 (7), pp. 1454-1479. Date of Electronic Publication: 2024 Jun 04.
DOI: 10.1002/ejhf.3264
Abstrakt: Cardiovascular disease (CVD) is the leading cause of morbimortality in Europe and worldwide. CVD imposes a heterogeneous spectrum of cardiac remodelling, depending on the insult nature, that is, pressure or volume overload, ischaemia, arrhythmias, infection, pathogenic gene variant, or cardiotoxicity. Moreover, the progression of CVD-induced remodelling is influenced by sex, age, genetic background and comorbidities, impacting patients' outcomes and prognosis. Cardiac reverse remodelling (RR) is defined as any normative improvement in cardiac geometry and function, driven by therapeutic interventions and rarely occurring spontaneously. While RR is the outcome desired for most CVD treatments, they often only slow/halt its progression or modify risk factors, calling for novel and more timely RR approaches. Interventions triggering RR depend on the myocardial insult and include drugs (renin-angiotensin-aldosterone system inhibitors, beta-blockers, diuretics and sodium-glucose cotransporter 2 inhibitors), devices (cardiac resynchronization therapy, ventricular assist devices), surgeries (valve replacement, coronary artery bypass graft), or physiological responses (deconditioning, postpartum). Subsequently, cardiac RR is inferred from the degree of normalization of left ventricular mass, ejection fraction and end-diastolic/end-systolic volumes, whose extent often correlates with patients' prognosis. However, strategies aimed at achieving sustained cardiac improvement, predictive models assessing the extent of RR, or even clinical endpoints that allow for distinguishing complete from incomplete RR or adverse remodelling objectively, remain limited and controversial. This scientific statement aims to define RR, clarify its underlying (patho)physiologic mechanisms and address (non)pharmacological options and promising strategies to promote RR, focusing on the left heart. We highlight the predictors of the extent of RR and review the prognostic significance/impact of incomplete RR/adverse remodelling. Lastly, we present an overview of RR animal models and potential future strategies under pre-clinical evaluation.
(© 2024 European Society of Cardiology.)
Databáze: MEDLINE
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