Cardiac Remodelling

Our specialist helpline nurse Jayne Partridge discusses cardiac remodelling and how this applies to cardiomyopathy.

Cardiac remodelling is a term that refers to changes in the heart’s size and shape that occur in response to cardiac disease or cardiac damage. When doctors talk about “remodelling,” they are usually talking about the left ventricle, though occasionally this term is applied to other cardiac chambers. Doctors can assess whether cardiac remodelling is present, and can follow the extent of remodelling over time, with imaging studies that allow them to assess the size, shape, and function of the left ventricle.

The most common studies used to measure remodelling are:

  • echocardiography; and
  • MRI.

These tests are non-invasive and do not expose the patient to radiation, so they can be repeated as often as necessary.

Beta blockers tend to reduce the force of contraction of cardiac muscle, and for this reason, for a long time it was thought these drugs ought to be absolutely avoided in anyone with heart failure. But beta blockers also improve the geometry of the left ventricle, and in patients with heart failure it turns out that these drugs reliably increase the LVEF, improve symptoms, and prolong survival.

The best treatments for heart failure appear to be those that reduce or reverse ventricular remodelling. The therapies below can help and improve Cardiac remodelling:

  • beta blockers;
  • ACE inhibitors and angiotensin II receptor blockers;
  • hydralazine plus nitrates;
  • aldosterone inhibition with spironolactone; and 
  • Cardiac Resynchronization Therapy (a type of implanted device).

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© Cardiomyopathy UK. January 2018.