Cardiovascular remodelling in coronary artery disease and heart failure.
Remodelling is a response of the myocardium and vasculature to a range of potentially noxious haemodynamic, metabolic, and inflammatory stimuli. Remodelling is initially functional, compensatory, and adaptive but, when sustained, progresses to structural changes that become self-perpetuating and pathogenic. Remodelling involves responses not only of the cardiomyocytes, endothelium, and vascular smooth muscle cells, but also of interstitial cells and matrix. In this Review we characterise the remodelling processes in atherosclerosis, vascular and myocardial ischaemia-reperfusion injury, and heart failure, and we draw attention to potential avenues for innovative therapeutic approaches, including conditioning and metabolic strategies.
Institut für Pathophysiologie, Universitätsklinikum Essen, Essen, Germany.
Gerd
G
Heusch
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Peter
P
Libby
Division of Cardiovascular Diseases, Mayo Clinic, and Mayo Clinic College of Medicine, Rochester, MN, USA.
Bernard
B
Gersh
The Hatter Cardiovascular Institute, University College London, London, UK.
Derek
D
Yellon
Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
Michael
M
Böhm
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada.
Gary
G
Lopaschuk
Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa. Electronic address: lionel.opie@uct.ac.za.
Lionel
L
Opie
D000222:Adaptation, Physiological / Q000502:physiology*; D003324:Coronary Artery Disease / Q000503:physiopathology*; D003331:Coronary Vessels / Q000503:physiopathology; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods; D008929:Mitochondria, Heart / Q000378:metabolism; D015428:Myocardial Reperfusion Injury / Q000503:physiopathology; D010084:Oxidation-Reduction; D020257:Ventricular Remodeling / Q000502:physiology