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"Targeting the Heart" in Heart Failure: Myocardial Recovery in Heart Failure With Reduced Ejection Fraction.

Publication ,  Journal Article
Wilcox, JE; Fonarow, GC; Ardehali, H; Bonow, RO; Butler, J; Sauer, AJ; Epstein, SE; Khan, SS; Kim, RJ; Sabbah, HN; Díez, J; Gheorghiade, M
Published in: JACC Heart Fail
September 2015

Myocardial recovery in heart failure (HF) is possible, but its determinants are not fully defined. At least partial functional improvement is possible with current evidence-based therapies. However, once significant HF symptoms develop, patients have varied trajectories, including: 1) structural and functional recovery; 2) stabilization (remission); and 3) acceleration to end-stage HF/death. All 3 trajectories may be interrupted by sudden death. These trajectories may represent the interplay of heterogeneous causality, genetic predeterminants, and disease phenotypes. Enhanced phenotypic description with cardiac magnetic resonance imaging, molecular imaging, or circulating biomarkers of the heterogeneous HF population may provide insights regarding specific biological targets amenable to existing and novel therapeutic strategies. The identification of patients in "remission," before progression to the end stage of predominantly nonviable tissue (e.g., fibrosis), has implications for clinical practice and future trials because such patients may be more likely to experience myocardial recovery (cardiac reserve). The identification of dysfunctional but viable myocardium and its diverse pathophysiological causes may provide opportunities to investigate existing and novel therapeutics aimed at enhancing myocardial recovery.

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Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

September 2015

Volume

3

Issue

9

Start / End Page

661 / 669

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Stroke Volume
  • Recovery of Function
  • Myocardium
  • Myocardial Contraction
  • Magnetic Resonance Imaging, Cine
  • Humans
  • Heart Failure
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

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Wilcox, J. E., Fonarow, G. C., Ardehali, H., Bonow, R. O., Butler, J., Sauer, A. J., … Gheorghiade, M. (2015). "Targeting the Heart" in Heart Failure: Myocardial Recovery in Heart Failure With Reduced Ejection Fraction. JACC Heart Fail, 3(9), 661–669. https://doi.org/10.1016/j.jchf.2015.04.011
Wilcox, Jane E., Gregg C. Fonarow, Hossein Ardehali, Robert O. Bonow, Javed Butler, Andrew J. Sauer, Stephen E. Epstein, et al. “"Targeting the Heart" in Heart Failure: Myocardial Recovery in Heart Failure With Reduced Ejection Fraction.JACC Heart Fail 3, no. 9 (September 2015): 661–69. https://doi.org/10.1016/j.jchf.2015.04.011.
Wilcox JE, Fonarow GC, Ardehali H, Bonow RO, Butler J, Sauer AJ, et al. "Targeting the Heart" in Heart Failure: Myocardial Recovery in Heart Failure With Reduced Ejection Fraction. JACC Heart Fail. 2015 Sep;3(9):661–9.
Wilcox, Jane E., et al. “"Targeting the Heart" in Heart Failure: Myocardial Recovery in Heart Failure With Reduced Ejection Fraction.JACC Heart Fail, vol. 3, no. 9, Sept. 2015, pp. 661–69. Pubmed, doi:10.1016/j.jchf.2015.04.011.
Wilcox JE, Fonarow GC, Ardehali H, Bonow RO, Butler J, Sauer AJ, Epstein SE, Khan SS, Kim RJ, Sabbah HN, Díez J, Gheorghiade M. "Targeting the Heart" in Heart Failure: Myocardial Recovery in Heart Failure With Reduced Ejection Fraction. JACC Heart Fail. 2015 Sep;3(9):661–669.

Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

September 2015

Volume

3

Issue

9

Start / End Page

661 / 669

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Stroke Volume
  • Recovery of Function
  • Myocardium
  • Myocardial Contraction
  • Magnetic Resonance Imaging, Cine
  • Humans
  • Heart Failure
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology