Reverse ventricular remodelling – characterized by a reduction of left ventricular end-systolic volume indexed to body surface area (LVESVI) or an increase of left ventricular ejection fraction (LVEF) – is associated with better clinical outcomes in patients with heart failure with reduced ejection fraction (HFrEF). Little is known about the central pathophysiological mechanisms associated with this process in HFrEF patients, and for this reason, a recently published echocardiographic substudy from the VICTORIA trial examined the relationship between protein biomarker profiles and reverse ventricular remodelling in 419 patients with HFrEF.
The researchers analyzed echocardiograms in parallel with measurements of 92 biomarkers at study start and after 8 months. Reverse ventricular remodelling was defined as a greater than 5% LVEF increase or a greater than 15% LVESVI relative decrease between study start and 8 months.
There were two central findings from the study. First, none of the 92 biomarkers at study start were associated with decreased LVESVI or increased LVEF, suggesting they are poor predictors for future reverse ventricular remodelling. Second, there was a substantial decrease in biomarkers associated with inflammation and cardiac metabolism between study start and 8 months in patients with reverse remodelling.
This research was published in the European Journal of Heart Failure, and conducted on behalf of the VICTORIA study group. CVC co-authors include Wendimagegn Alemayehu, PhD, Cindy Westerhout, PhD, and Paul W. Armstrong, MD.
