Category Archives: Ventricular Remodeling

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A ventricular remodeling procedure, which involves reshaping of an abnormal heart muscle, is often performed along with coronary artery bypass graft (CABG) or mitral valve repair or replacement. Conditions that my require ventricular remodeling including cardiomyopathy, aortic disease, heart attack and heart failure. People who have had a heart attack, for example, may develop scar tissue that causes the hearts left ventricle to become enlarged and weak. Continue reading →

LEADERSHIP Marc S. Sabatine, MD, MPHis Chairman of the Thrombolysis in Myocardial Infarction (TIMI) Study Group, the Lewis Dexter, MD, Distinguished Chair in Cardiovascular Medicine at Brigham and Womens Hospital (BWH), and a Professor of Medicine at Harvard Medical School (HMS). Dr. Continue reading →

Ventricular dysfunction in heart failure The major role of the ventricles in pumping blood to the lungs and body means that even a slight decrease in ventricular efficiency can have a significant impact on heart function. If the left ventricle encounters either absolute or relative functional insufficiency (called left ventricular heart failure, or left-sided heart failure), a series of compensatory reactions are initiated that may temporarily provide a return to sufficient ventricular function. Continue reading →

Ventricular remodeling, first described in animal models of left ventricular (LV) stress and injury, occurs progressively in untreated patients after large myocardial infarction and in those with dilated forms of cardiomyopathy. The gross pathologic changes of increased LV volume and perturbation in the normal elliptical LV chamber configuration is driven, on a histologic level, by myocyte hypertrophy and apoptosis and by increased interstitial collagen. Each of the techniques used for tracking this processechocardiography, radionuclide ventriculography, and cardiac magnetic resonancecarries advantages and disadvantages. Numerous investigations have demonstrated the value of LV volume measurement at a single time-point and over time in predicting clinical outcomes in patients with heart failure and in those after myocardial infarction. The structural pattern of LV remodeling and evidence of scarring on cardiac magnetic resonance have additional prognostic value. Beyond the impact of abnormal cardiac structure on cardiovascular events, the relationship between LV remodeling and clinical outcomes is likely linked through common local and systemic factors driving vascular as well as myocardial pathology. As demonstrated by a recent meta-analysis of heart failure trials, LV volume stands out among surrogate markers as strongly correlating with the impact of a particular drug or device therapy on patient survival. These … Continue reading →

Surgical Ventricular Reconstruction (SVR) Surgical ventricular reconstruction (SVR) reduces the size of a patient's failing, enlarged heart to ensure that blood is pumped out of the heart, and through the body efficiently enough to allow them to participate in a full, active life. In a healthy patient, oxygen-rich blood returning from the lungs is pumped through the heart and to the body. In 25 percent of heart attack patients, the left ventricle dilates from its natural football shape into a rounder, basketball shape. This new shape interferes with the heart's ability to contract strongly enough to push the returning blood through the heart. Instead, blood pools in the lungs causing a variety of symptoms that typically compromise quality of life: During the SVR procedure, the cardiothoracic surgeon will reshape the patient's heart so that it can contract more effectively and restore a free flow of oxygen-rich blood throughout the body. Following the procedure, patients who were once winded by their favorite activities, from gardening to golf, can return to these activities free from chest pain and shortness of breath. Montefiore Einstein Center for Heart and Vascular Care is a national leader in surgical ventricular reconstruction. SVR has a greater than … Continue reading →

Left ventricular hypertrophy (LVH) is thickening of the heart muscle of the left ventricle of the heart, that is, left-sided ventricular hypertrophy. While ventricular hypertrophy occurs naturally as a reaction to aerobic exercise and strength training, it is most frequently referred to as a pathological reaction to cardiovascular disease, or high blood pressure.[1] It is one aspect of ventricular remodeling. While LVH itself is not a disease, it is usually a marker for disease involving the heart.[2] Disease processes that can cause LVH include any disease that increases the afterload that the heart has to contract against, and some primary diseases of the muscle of the heart. Causes of increased afterload that can cause LVH include aortic stenosis, aortic insufficiency and hypertension. Primary disease of the muscle of the heart that cause LVH are known as hypertrophic cardiomyopathies, which can lead into heart failure. Long-standing mitral insufficiency also leads to LVH as a compensatory mechanism. Associated genes include OGN, osteoglycin.[3] The principal method to diagnose LVH is echocardiography, with which the thickness of the muscle of the heart can be measured. The electrocardiogram (ECG) often shows signs of increased voltage from the heart in individuals with LVH, so this is … Continue reading →