Cardiac remodeling tends to develop as a result of adaptive responses. I am sharing a vide below on remodeling. It explores the underlying pathophysiology and what you would expect to see on various tests such as echocardiography.
Class- what are some interventions we use to try to minimize remodeling? What is our overall goal? Cardiac Remodeling Assignment Essay
Remodeling of the heart refers to the clinical changes in molecular, cellular and interstitial as the heart changes in size, shape, and function following a heart injury. Various interventions that can be used to minimize heart remodeling include use of ACE inhibitors, regular assessment of changes in the dimensions of the heart, use of angiotensin II AT1 receptor-antagonists (ARB), and use of beta-blockers (Filho et al, 2015).
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ACE inhibitors have been shown to reduce the rate of cardiac dilation, as well as progression of heart remodeling. ACE inhibitors prevent ventricular dilation and at the same time stimulate small elevations in ejection fraction. Beta-blockers can also be used to minimize heart remodeling. Beta-blockers have been shown to promote a powerful reversal of cardiac dilation and also promote the reduction of ventricular diameter and also elevations in ejection fraction. A study conducted by Azevedo et al (2016) demonstrated remarkable improvement in the ejection fraction as well as the reversal of heart remodeling. ARB treatment has also been shown to reduce remodeling. A study conducted by Kloner et al (2015) indicated that ARBs are beneficial in preventing ventricular remodeling and preventing cardiac dilation. Cardiac dilation is a major factor contributing to heart remodeling and hence its prevention minimizes remodeling.
Heart remodeling can be assessed by measuring the internal measurements of the left ventricle during systole and diastole. Additionally, the proportion of the blood within the LV ejected into circulation following a contraction can also be used to assess heart remodeling. A healthy individual has an ejection fraction of more than 50%. Close monitoring and assessment of the heart remodeling will ensure that the appropriate measures are implemented to prevent it (Filho et al, 2015). Cardiac Remodeling Assignment Essay
The overall goal of minimizing remodeling is to have a better prognosis because heart remodeling is associated with poor outcomes and higher mortality (Filho et al, 2015).
Azevedo P, Bertha P, Marcos M, Paiya S & Leornardo Z. (2016). Cardiac Remodeling: Concepts, Clinical Impact, Pathophysiological Mechanisms and Pharmacologic Treatment. Arq Bras Cardiol. 106(1): 62–69.
Filho J, Cardoso J, Cardoso C. & Carlos A. (2015). Reverse Cardiac Remodeling: A Marker of Better Prognosis in Heart Failure. Arq Bras Cardiol. 104(6): 502–506.
Kloner R, Shi J & Dai W. (2015). New therapies for reducing post-myocardial left ventricular remodeling. Ann Transl Med. 3(2): 20.
Cardiac Remodeling Assignment Essay
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