Molecular and cellular mechanisms of myocardial remodeling

Myocardial remodeling is inextricably intertwined with the development and progression of heart failure. It is characterized by alterations in ventricular geometry and function. At the cellular level, ventricular remodeling consists of myocyte hypertrophy, neurohumoral activation, matrix remodeling, altered gene expression, immune system activation, and apoptosis. Many factors, including neurohormones, cytokines, growth factors, oxidative stress, and mechanical strain, can trigger the molecular and cellular events observed in remodeling, thus suggesting that they may play a role in myocardial remodeling. A thorough understanding of the cellular and molecular mechanisms involved in myocardial remodeling may lead to novel pharmacologic or genetic therapies for the treatment and prevention of heart failure.