Implication of cardiac remodeling in heart failure: mechanisms and therapeutic strategies.
The concept and clinical implication of left ventricular remodeling have been gradually extended. Cardiac remodeling plays important roles in the progression of cardiovascular diseases including myocardial infarction, valvular heart diseases, myocarditis, and dilated cardiomyopathy. In addition to cardiac myocytes, fibroblasts, extracellular matrix proteins and coronary vasculature are also involved in the remodeling process. Cardiac remodeling is associated with alterations of many mediators such as neurohumoral factors, cytokines, enzymes, ion channels, oxidative stress and mechanical stress. Although remodeling is initially an adaptive response to maintain normal cardiac function, it gradually becomes maladaptive and leads to progressive decompensation. Recent research has attempted to elucidate underlying molecular mechanisms of cardiac remodeling and to develop novel therapeutic strategies for heart failure. The modulation of remodeling process is effective for preventing the progression of heart failure.
Takano
Hiroyuki
H
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Chiba.
Hasegawa
Hiroshi
H
Nagai
Toshio
T
Komuro
Issei
I
D000222:Adaptation, Physiological; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000818:Animals; D016207:Cytokines / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D020782:Matrix Metalloproteinases / Q000378:metabolism; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D020257:Ventricular Remodeling / Q000187:drug effects / Q000502:physiology*
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D016207:Cytokines; D020782:Matrix Metalloproteinases