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Ventricular Remodelling

Cardiac remodelling refers to adverse changes that occur in the heart’s size and shape in response to the body’s demand for oxygen-rich blood. It can also occur as a complication of certain heart diseases. This remodelling usually occurs in the left ventricle (heart’s lower chamber that distributes blood to the entire body), and is hence termed as ventricular remodelling. With this condition the ventricle enlarges, its shape changes to become more globular and the walls become thinner causing deterioration of the heart’s functions.

Causes

Remodelling can occur due various heart diseases or from cardiac damage such as occurs with a heart attack. The initial remodelling occurs immediately after a heart attack to compensate for the damage and enable the heart to pump sufficient amount of blood to the body. However, if remodelling persists for a long time the heart stops functioning, which can lead to heart failure.

Remodelling can be of 2 types based on its cause:

  • Physiological remodelling: caused when the body requires more blood. For example during exercises and pregnancy.
  • Pathological remodelling: occurs due to certain heart problems that cause an overload of pressure or volume of blood flowing through the heart’s chambers

Diagnosis

The extent of damage caused by ventricular remodelling can be measured using imaging studies including MRI scans and echocardiography to assess the shape and size of the ventricles. The other technique used to measure remodelling is the left ventricular ejection fraction (LVEF), which measures the amount of blood pumped out of the left ventricle.

Treatment

Ventricular remodelling can be treated by the following methods:

  • Medication
  • Bypass surgery: Blood flow is rerouted to reduce the increased pressure that occurs when blood flows through a blocked or narrowed blood vessel.
  • Stenting: A stent, a small mesh like tube, is placed in a blood vessel to prevent the weakened blood vessel walls from bursting.
  • Cardiac resynchronization: A special pacemaker is inserted to coordinate the beating of the right and left ventricles of the heart.

Your doctor will discuss the best treatment option with you depending on your individual condition and severity of the ventricular remodelling.