Document Detail

Medical Management Is The Way To Go For Ventricular Reconstruction Post STICH?
MedLine Citation:
PMID:  23518375     Owner:  NLM     Status:  In-Data-Review    
Ventricular remodeling is a complex process mediated by pathogenic factors all of which interact at the cellular, ventricular and systemic levels to cause progressive left ventricular dilation and subsequently a heart failure syndrome. Remodeling is a well-characterized response to insult or injury and is initiated early on by neurohormonal activation. Neurohormonal antagonists have formed the foundation of therapy to alter the progression of remodeling and concomitantly improve outcomes. Surgical ventricular reconstruction was designed as a surgical means to reduce the ventricular radius and in principal decrease ventricular wall stress as defined by the Law of Laplace. Despite optimistic initial results from case series, the Surgical Treatment for Ischemic Heart Failure Trial (STICH) trial, a large randomized trial of ventricular reconstruction in addition to coronary artery bypass surgery (CABG) therapy for management of patients with heart failure with a reduced ejection fraction showed no clinical benefit. We will summarize the evidence that demonstrates the foundational role of neurohormonal blockade in improving outcomes in patients with heart failure with a reduced ejection and the evidence behind its role in "medical ventricular reconstruction".
Brisham Harchandani; Alex Reyentovich
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Progress in cardiovascular diseases     Volume:  55     ISSN:  1532-8643     ISO Abbreviation:  Prog Cardiovasc Dis     Publication Date:    2013 Mar-Apr
Date Detail:
Created Date:  2013-03-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376442     Medline TA:  Prog Cardiovasc Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  476-80     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013. Published by Elsevier Inc.
The Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY.
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