Cardiac remodelling - Part 2: Clinical, imaging and laboratory findings. A review from the Study Group on Biomarkers of the Heart Failure Association of the European Society of Cardiology
Alberto Aimo 1 2, Giuseppe Vergaro 1 2, Arantxa González 3 4, Andrea Barison 1 2, Josep Lupón 5, Victoria Delgado 5, A Mark Richards 6, Rudolf A de Boer 7, Thomas Thum 8 9, Henrike Arfsten 8 9, Martin Hülsmann 8, Inês Falcao-Pires 10, Javier Díez 11, Roger S Y Foo 12, Mark Yan Yee Chan 12, Chukwuemeka G Anene-Nzelu 12, Magdy Abdelhamid 13, Stamatis Adamopoulos 14, Stefan D Anker 15, Yuri Belenkov 16, Tuvia Ben Gal 17, Alain Cohen-Solal 18, Michael Böhm 19, Ovidiu Chioncel 20, Ewa A Jankowska 21, Finn Gustafsson 22, Loreena Hill 23, Tiny Jaarsma 24, James L Januzzi 25, Pardeep Jhund 26, Yuri Lopatin 27, Lars H Lund 28, Marco Metra 29, Davor Milicic 30, Brenda Moura 10 31, Christian Mueller 32, Wilfried Mullens 33, Julio Núñez 34, Massimo F Piepoli 35, Amina Rakisheva 36, Arsen D Ristić 37 38, Patrick Rossignol 39, Gianluigi Savarese 28, Carlo G Tocchetti 40, Sophie van Linthout 41, Maurizio Volterrani 42, Petar Seferovic 38 43, Giuseppe Rosano 44, Andrew J S Coats 45, Michele Emdin 1 2, Antoni Bayes-Genis 4 5 46
In patients with heart failure, the beneficial effects of drug and device therapies counteract to some extent ongoing cardiac damage.
According to the net balance between these two factors, cardiac geometry and function may improve (reverse remodelling, RR) and even completely normalize (remission), or vice versa progressively deteriorate (adverse remodelling, AR). RR or remission predict a better prognosis, while AR has been associated with worsening clinical status and outcomes.
The remodelling process ultimately involves all cardiac chambers, but has been traditionally evaluated in terms of left ventricular volumes and ejection fraction. This is the second part of a review paper by the Study Group on Biomarkers of the Heart Failure Association of the European Society of Cardiology dedicated to ventricular remodelling. This document examines the proposed criteria to diagnose RR and AR, their prevalence and prognostic value, and the variables predicting remodelling in patients managed according to current guidelines.
Much attention will be devoted to RR in patients with heart failure with reduced ejection fraction because most studies on cardiac remodelling focused on this setting.
Keywords: Biomarkers; Ejection fraction; Heart failure; Imaging; Predictors; Remodelling; Therapies.
© 2022 European Society of Cardiology.