Mechanisms of myocardial reverse remodelling and its clinical significance: A scientific statement of the ESC Working Group on Myocardial Function.

Adverse remodelling Heart failure Myocardial remodelling Physiologic remodelling Reverse remodelling

Journal

European journal of heart failure
ISSN: 1879-0844
Titre abrégé: Eur J Heart Fail
Pays: England
ID NLM: 100887595

Informations de publication

Date de publication:
04 Jun 2024
Historique:
revised: 22 03 2024
received: 20 09 2023
accepted: 18 04 2024
medline: 5 6 2024
pubmed: 5 6 2024
entrez: 5 6 2024
Statut: aheadofprint

Résumé

Cardiovascular disease (CVD) is the leading cause of morbimortality in Europe and worldwide. CVD imposes a heterogeneous spectrum of cardiac remodelling, depending on the insult nature, that is, pressure or volume overload, ischaemia, arrhythmias, infection, pathogenic gene variant, or cardiotoxicity. Moreover, the progression of CVD-induced remodelling is influenced by sex, age, genetic background and comorbidities, impacting patients' outcomes and prognosis. Cardiac reverse remodelling (RR) is defined as any normative improvement in cardiac geometry and function, driven by therapeutic interventions and rarely occurring spontaneously. While RR is the outcome desired for most CVD treatments, they often only slow/halt its progression or modify risk factors, calling for novel and more timely RR approaches. Interventions triggering RR depend on the myocardial insult and include drugs (renin-angiotensin-aldosterone system inhibitors, beta-blockers, diuretics and sodium-glucose cotransporter 2 inhibitors), devices (cardiac resynchronization therapy, ventricular assist devices), surgeries (valve replacement, coronary artery bypass graft), or physiological responses (deconditioning, postpartum). Subsequently, cardiac RR is inferred from the degree of normalization of left ventricular mass, ejection fraction and end-diastolic/end-systolic volumes, whose extent often correlates with patients' prognosis. However, strategies aimed at achieving sustained cardiac improvement, predictive models assessing the extent of RR, or even clinical endpoints that allow for distinguishing complete from incomplete RR or adverse remodelling objectively, remain limited and controversial. This scientific statement aims to define RR, clarify its underlying (patho)physiologic mechanisms and address (non)pharmacological options and promising strategies to promote RR, focusing on the left heart. We highlight the predictors of the extent of RR and review the prognostic significance/impact of incomplete RR/adverse remodelling. Lastly, we present an overview of RR animal models and potential future strategies under pre-clinical evaluation.

Identifiants

pubmed: 38837573
doi: 10.1002/ejhf.3264
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Foundation for Science and Technology
ID : SFRH/BD/138925/2018
Organisme : UnIC
ID : UIDP/00051/2020
Organisme : Fonds National de la Recherche Scientifique (FNRS) et Médicale, Belgium
Organisme : Walloon Excellence in Life Sciences and Biotechnology WELBIO, Belgium
Organisme : University of Salerno
ID : FARB 2021-2022
Organisme : Italian Ministry of Economic Development (SOLOMAX)
Organisme : Italian Ministry of Health (SMARTCARE)
Organisme : Netherlands Heart Foundation
Organisme : Dekker Senior Clinical Scientist 2019
ID : 2019T056
Organisme : Health-Holland, Top Sector Life Sciences & Health
Organisme : LVAD-LVAD
ID : LSHM19035
Organisme : German Research Foundation
ID : SFB1002-TPA08
Organisme : German Research Foundation
ID : Li690/14-1
Organisme : ERA-CVD
ID : I4168-B
Organisme : ERA-PerMed
ID : I5898-B
Organisme : Austrian Science Fund
Organisme : BioTechMed Graz (INTERACD+ consortium)
Organisme : Medical University of Graz (VASC-HEALTH consortium)
Organisme : AIRC
ID : IG 24529
Organisme : TiiLT Horizon RIA
ID : 101080897
Organisme : Ministry of Health
ID : RF GR-2019-12370197
Organisme : Ministry of Health
ID : PNRR-MAD-2022-12376295
Organisme : Deutsche Forschungsgemeinschaft
Organisme : European Union
ID : GA 101058103
Organisme : Italian Ministry of Health
ID : PNRR-MAD-2022-12376632
Organisme : Italian Ministry of Health
ID : RF-2016-02362988

Informations de copyright

© 2024 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

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Auteurs

Inês Falcão-Pires (I)

UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal.

Ana Filipa Ferreira (AF)

UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal.

Fábio Trindade (F)

UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal.

Luc Bertrand (L)

Université Catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Pôle of Cardiovascular Research, Brussels, Belgium.
WELBIO, Department, WEL Research Institute, Wavre, Belgium.

Michele Ciccarelli (M)

Cardiovascular Research Unit, Department of Medicine and Surgery, University of Salerno, Baronissi, Italy.

Valeria Visco (V)

Cardiovascular Research Unit, Department of Medicine and Surgery, University of Salerno, Baronissi, Italy.

Dana Dawson (D)

Aberdeen Cardiovascular and Diabetes Centre, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.

Nazha Hamdani (N)

Department of Cellular and Translational Physiology, Institute of Physiology, Ruhr University Bochum, Bochum, Germany.
Institut für Forschung und Lehre (IFL), Molecular and Experimental Cardiology, Ruhr University Bochum, Bochum, Germany.
HCEMM-SU Cardiovascular Comorbidities Research Group, Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary.
Department of Physiology, Cardiovascular Research Institute Maastricht University Maastricht, Maastricht, the Netherlands.

Linda W Van Laake (LW)

Division Heart and Lungs, Department of Cardiology and Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands.

Frank Lezoualc'h (F)

Institut des Maladies Métaboliques et Cardiovasculaires, Inserm, Université Paul Sabatier, UMR 1297-I2MC, Toulouse, France.

Wolfgang A Linke (WA)

Institute of Physiology II, University Hospital Münster, Münster, Germany.

Ida G Lunde (IG)

Oslo Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevaal, Oslo, Norway.
KG Jebsen Center for Cardiac Biomarkers, Campus Ahus, University of Oslo, Oslo, Norway.

Peter P Rainer (PP)

Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
BioTechMed Graz, Graz, Austria.
St. Johann in Tirol General Hospital, St. Johann in Tirol, Austria.

Mahmoud Abdellatif (M)

Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
BioTechMed Graz, Graz, Austria.

Jolanda Van der Velden (J)

Department of Physiology, Amsterdam UMC, Amsterdam, The Netherlands.

Nicola Cosentino (N)

Centro Cardiologico Monzino IRCCS, Milan, Italy.
Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.

Alessia Paldino (A)

Cardiovascular Biology Laboratory, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy.
Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.

Giulio Pompilio (G)

Centro Cardiologico Monzino IRCCS, Milan, Italy.
Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.

Serena Zacchigna (S)

Cardiovascular Biology Laboratory, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy.
Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.

Stephane Heymans (S)

Department of Cardiology, CARIM Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.
Centre of Cardiovascular Research, University of Leuven, Leuven, Belgium.

Thomas Thum (T)

Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany.

Carlo Gabriele Tocchetti (CG)

Department of Translational Medical Sciences (DISMET), Center for Basic and Clinical Immunology Research (CISI), Interdepartmental Center of Clinical and Translational Sciences (CIRCET), Interdepartmental Hypertension Research Center (CIRIAPA), Federico II University, Naples, Italy.

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