Concept of myocardial fatigue in reversible severe left ventricular systolic dysfunction from afterload mismatch: a case series.

ABSTRACT:

Background

There is already extensive literature on the natural history of hypertensive heart disease (HHD) and aortic stenosis (AS). Once these patients develop severe left ventricular systolic dysfunction (LVSD) despite guideline-directed therapy for heart failure (HF), it is often thought to be end-stage from irreversible adverse remodelling. Our case series challenges this traditional paradigm. A more holistic model that factors in the interactions between the ventricle and vasculature is required. Based on a novel hypothetical concept of myocardial fatigue, we propose that occasionally LVSD is not an inherent myocardial or valvular disease but a consequence of an arterial afterload mismatch. By addressing this, the ventricle may recover and contract efficiently in unison with

SUBMITTER: Tran P 

PROVIDER: S-EPMC8186914 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature