Title: Structural correlates of electrical remodeling in ventricular hypertrophy
Abstract: Time for primary review 26 days.
See article by Peschar et al. [2] (pages 510–517) in this issue.
Ventricular remodeling is an adaptive change in cardiac chamber structure and function in response to volume and/or pressure overload. In the last few years, it became clear that this process also involves the electrical system of the ventricular chambers. Electrical remodeling associated with left ventricular hypertrophy and heart failure causes an increased frequency of ventricular ectopy and a high risk of cardiac arrest. The degree of electrical remodeling and arrhythmic risk is not directly proportional to the severity of left ventricular (LV) dysfunction. For example, in the VHeFT study (Veterans Administration Heart Failure Trial), the risk of sudden cardiac death was greater in patients with modest LV dysfunction [1]. It has been shown that there is a temporal relationship between the progression of structural and electrical remodeling of the left ventricle in response to various pressure and volume overload states. Concurrent regression of structural and electrical remodeling in pressure overload hypertrophy is seen, but there seems to be a dissociation in these processes in certain types of volume overload hypertrophy (Fig. 1). Such an interesting dissociation is shown in this issue of Cardiovascular Research by Peschar et al. [2]. The findings of this paper underscore the independent nature of electrical remodeling in volume overload hypertrophy in contrast to pressure overload hypertrophy. …
*Corresponding author. 318 McHaney Hall, University of Missouri Hospital, 1 Hospital Drive, Columbia, MO, USA. Fax: +1-573-884-7743.