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Cardiac remodeling—concepts and clinical implications: a consensus paper from an international forum on cardiac remodeling

Jay N. Cohn, MD^*, Roberto Ferrari, MD, Norman Sharpe, MD on Behalf of an International Forum on Cardiac Remodeling

^* Department of Medicine, Cardiovascular Division, University of Minnesota Medical School, Minneapolis, Minnesota, USA
Cattedra di Cardiologia, Universita degli Studi di Ferrara, Ferrara, Italy
Department of Medicine and Health Sciences, University of Auckland School of Medicine, Auckland, New Zealand

View larger version (26K): [in a new window]   Figure 1 Late ventricular enlargement in a patients with anterior myocardial infarction. Marked increase in volume results from increased circumference and sphericity. The late change in circumference is due to lengthening of contractile tissue rather than further expansion of the infarcted, noncontractile segment. The increased sphericity results from a rounding out of the sharp abnormalities in contour at the margins of the infarct (reproduced with permission from reference 31).

View larger version (29K): [in a new window]   Figure 2 Cumulative benefit of beta-blockade in addition to angiotensin-converting enzyme inhibition in heart failure (5,7).

View larger version (12K): [in a new window]   Figure 3 Effect of angiotensin-converting enzyme inhibition with enalapril and beta-blockade with carvedilol on left ventricular ejection fraction (13,16). ANZ = Australia/New Zealand Collaborative Group Study; LV = left ventricular dysfunction; SOLVD = Studies of Left Ventricular Dysfunction. Solid circle = ANZ substudy (placebo); Open circle = ANZ substudy (carvedilol); solid square = SOLVD substudy (enalapril); Open square = SOLVD substudy (placebo).