[Remodeling of the left ventricle].
Left ventricular remodeling is a frequent and unfavorable evolution of both ischemic and non-ischemic dilative cardiomyopathy with a significant reduction in left ventricular systolic and diastolic performance. By the term "remodeling" we refer to a variety of alterations in left ventricular morphology and volume; while patients with non-ischemic cardiomyopathy frequently show global and quite homogeneous enlargement of the left ventricle, transmural myocardial infarctions can be followed initially by regional expansion and only in a second stage by a global increase in ventricular size. Cardiologists have a number of therapeutic options from which to choose: ACE-inhibitors and probably angiotensin II antagonists can contrast the unfavorable progression of the phenomenon, while beta-blockers such as metoprolol and carvedilol probably can reverse the process. In addition, moderate exercise training not only produces no detrimental effects on infarct size or left ventricular topography, but can prevent the progression of left ventricular dysfunction and its attendant morbidity and mortality in selected populations.
Giannuzzi
P
P
Divisione di Cardiologia, Fondazione Salvatore Maugeri, Clinica del Lavoro e della Riabilitazione, IRCCS, Veruno.
Eleuteri
E
E
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D005081:Exercise Therapy; D006322:Heart Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D020257:Ventricular Remodeling / Q000502:physiology*
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors