Cardiac remodeling in coronary artery disease

Cardiac remodeling is a central mechanism of heart failure progression in patients with coronary artery disease (CAD). The remodeling effect of β-blockade with carvedilol has been studied in patients with left ventricular dysfunction after myocardial infarction and in patients with chronic heart failure of ischemic etiology. Carvedilol has been found to prevent progressive adverse ventricular remodeling in both conditions. This effect is concordant with the improvement in long-term clinical outcomes established for carvedilol in such patients. Thus, ventricular remodeling appears to be an important treatment target in patients with CAD and is likely to mediate at least part of the clinical improvement achieved with carvedilol.