title: "Targeting the Heart" in Heart Failure: Myocardial Recovery in Heart Failure With Reduced Ejection Fraction.
abstract: Myocardial recovery in heart failure (HF) is possible, but its determinants are not fully defined. At least partial functional improvement is possible with current evidence-based therapies. However, once significant HF symptoms develop, patients have varied trajectories, including: 1) structural and functional recovery; 2) stabilization (remission); and 3) acceleration to end-stage HF/death. All 3 trajectories may be interrupted by sudden death. These trajectories may represent the interplay of heterogeneous causality, genetic predeterminants, and disease phenotypes. Enhanced phenotypic description with cardiac magnetic resonance imaging, molecular imaging, or circulating biomarkers of the heterogeneous HF population may provide insights regarding specific biological targets amenable to existing and novel therapeutic strategies. The identification of patients in "remission," before progression to the end stage of predominantly nonviable tissue (e.g., fibrosis), has implications for clinical practice and future trials because such patients may be more likely to experience myocardial recovery (cardiac reserve). The identification of dysfunctional but viable myocardium and its diverse pathophysiological causes may provide opportunities to investigate existing and novel therapeutics aimed at enhancing myocardial recovery.
authors.affiliation: Northwestern University Division of Cardiology, Feinberg School of Medicine, Chicago, Illinois; Northwestern University Department of Preventive Medicine, Chicago, Illinois.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Wilcox
authors.affiliation: Ahamson-UCLA Cardiomyopathy Center, UCLA Medical Center, Los Angeles, California.
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.affiliation: Northwestern University Division of Cardiology, Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Hossein
authors.initials: H
authors.lastname: Ardehali
authors.affiliation: Northwestern University Division of Cardiology, Feinberg School of Medicine, Chicago, Illinois; Northwestern University Center for Cardiovascular Innovation, Chicago, Illinois.
authors.forename: Robert O
authors.initials: RO
authors.lastname: Bonow
authors.affiliation: Cardiology Division, Emory University Hospital, Atlanta, Georgia.
authors.forename: Javed
authors.initials: J
authors.lastname: Butler
authors.affiliation: Northwestern University Division of Cardiology, Feinberg School of Medicine, Chicago, Illinois; Northwestern University Department of Preventive Medicine, Chicago, Illinois.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Sauer
authors.affiliation: MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, MedStar Cardiovascular Research Network, Washington, DC.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Epstein
authors.affiliation: Northwestern University Division of Cardiology, Feinberg School of Medicine, Chicago, Illinois; Northwestern University Department of Preventive Medicine, Chicago, Illinois.
authors.forename: Sadiya S
authors.initials: SS
authors.lastname: Khan
authors.affiliation: Division of Cardiology and Department of Radiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Kim
authors.affiliation: Department of Medicine, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Hani N
authors.initials: HN
authors.lastname: Sabbah
authors.affiliation: Cardiovascular Diseases Program, Centre for Applied Medical Research and University Clinic, University of Navarra, Pamplona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Díez
authors.affiliation: Northwestern University Division of Cardiology, Feinberg School of Medicine, Chicago, Illinois; Northwestern University Center for Cardiovascular Innovation, Chicago, Illinois. Electronic address: m-gheorghiade@northwestern.edu.
authors.forename: Mihai
authors.initials: M
authors.lastname: Gheorghiade
mesh_terms: D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D009200:Myocardial Contraction / Q000502:physiology*; D009206:Myocardium / Q000473:pathology; D020127:Recovery of Function; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: cardiac MRI; heart failure; myocardial recovery; myocardium