The concept of cardioreparation: Part 2. Medical implications of cardioreparation.
OBJECTIVE
Left ventricular hypertrophy (LVH) caused by systemic hypertension, myocardial infarction and congestive heart failure is associated with pathological changes in the structure of the heart, collectively described as remodelling (see part 1 of this review). The reversal of remodelling, termed cardioreparation, might restore cardiac structure and function towards normal, thereby improving the prognosis of these conditions. We aimed to explore the medical implications of this concept.


METHODS
Clinical trials of angiotensin converting enzyme (ACE) inhibitors and other drugs in patients with hypertension, myocardial infarction and congestive heart failure were reviewed. The results showed that ACE inhibitors induce regression of LVH in hypertensive patients, reduce mortality in acute myocardial infarction, and reduce morbidity and mortality in patients with congestive heart failure or left ventricular dysfunction subsequent to myocardial infarction. These observations are consistent with cardioreparation by ACE inhibitors.


CONCLUSIONS
ACE inhibitors reduce morbidity and mortality in patients with myocardial infarction or congestive heart failure. Theoretical considerations and some clinical observations suggest that these benefits might result from cardioreparation.
Cleland
J G
JG
Clinical Research Initiative in Heart Failure, University of Glasgow, UK.
Dewhurst
N G
NG
Murphy
R L
RL
Struijker Boudier
H A
HA
Tan
L B
LB
Visser
C A
CA
D000959:Antihypertensive Agents / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D017379:Hypertrophy, Left Ventricular / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy; D012307:Risk Factors
D000959:Antihypertensive Agents