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Review
. 2016 Jun 1;310(11):H1402-22.
doi: 10.1152/ajpheart.00696.2015. Epub 2016 Mar 18.

Myocardial reverse remodeling: how far can we rewind?

Patrícia G Rodrigues  1 , Adelino F Leite-Moreira  1 , Inês Falcão-Pires  2
Affiliations
Free article
Review

Myocardial reverse remodeling: how far can we rewind?

Patrícia G Rodrigues et al. Am J Physiol Heart Circ Physiol. .
Free article

Abstract

Heart failure (HF) is a systemic disease that can be divided into HF with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). HFpEF accounts for over 50% of all HF patients and is typically associated with high prevalence of several comorbidities, including hypertension, diabetes mellitus, pulmonary hypertension, obesity, and atrial fibrillation. Myocardial remodeling occurs both in HFrEF and HFpEF and it involves changes in cardiac structure, myocardial composition, and myocyte deformation and multiple biochemical and molecular alterations that impact heart function and its reserve capacity. Understanding the features of myocardial remodeling has become a major objective for limiting or reversing its progression, the latter known as reverse remodeling (RR). Research on HFrEF RR process is broader and has delivered effective therapeutic strategies, which have been employed for some decades. However, the RR process in HFpEF is less clear partly due to the lack of information on HFpEF pathophysiology and to the long list of failed standard HF therapeutics strategies in these patient's outcomes. Nevertheless, new proteins, protein-protein interactions, and signaling pathways are being explored as potential new targets for HFpEF remodeling and RR. Here, we review recent translational and clinical research in HFpEF myocardial remodeling to provide an overview on the most important features of RR, comparing HFpEF with HFrEF conditions.

Keywords: diastolic dysfunction; heart failure with preserved ejection fraction; heart failure with reduced ejection fraction; left ventricle hypertrophy; myocardial reverse remodeling.

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