EDITORIAL Plasma MicroRNA Clusters in Human Left Ventricular Remodeling A Biomarker and Discovery Platform See Article by Shah et al Arun Padmanabhan, MD, PhD Saptarsi M. Haldar, MD mpaired cardiac function results in increased neurohormonal activity, a stress response initially mounted to augment cardiac output. However, chronic or ex- Icessive activity of the neurohormonal response contributes to progressive myo- cardial damage and the clinical manifestations of the heart failure (HF) syndrome. This myocardial injury leads to a vicious cycle of organ remodeling, wherein the shape, thickness, volume of the ventricular cavity, and the functional state of the cells populating the stressed heart are adversely altered in a manner that further 1,2 compromises cardiac performance. Early work in animal models of myocardial infarction demonstrated the pathophysiologic significance of cardiac remodeling and a role for neurohormonal blockade in its prevention and reversal. These find- ings were subsequently extended to humans with myocardial infarction–associated HF and cardiac dilation in the absence of HF, with the severity of remodeling serv- 3,4 ing as a poor prognostic indicator. Current guideline-directed medical therapy for HF is associated with regression of ventricular dilation and improvement of ejection fraction in a subset of patients, a process called left ventricular
Circulation: Heart Failure – Wolters Kluwer Health
Published: Feb 1, 2018
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