Ventricular remodeling

Ventricular remodeling (or cardiac remodeling) refers to the changes in size, shape, structure and physiology of the heart. This can happen as a result of exercise (physiological remodelling) or after injury to the heart muscle (pathological remodelling). The injury is typically due to acute myocardial infarction (usually transmural or ST segment elevation infarction), but may be from a number of causes that result in increased pressure or volume overload (forms of strain) on the heart. Chronic hypertension, congenital heart disease with intracardiac shunting, and valvular heart disease may also lead to remodeling. After the insult occurs, a series of histopathological and structural changes occur in the left ventricular myocardium that lead to progressive decline in left ventricular performance. Ultimately, ventricular remodeling may result in diminished contractile (systolic) function and reduced stroke volume.