Early predictors of left ventricular remodeling after acute myocardial infarction.

摘要: Ventricular remodeling after acute myocardial infarction is characterized by alteration in left ventricular (LV) size, shape, and wall thickness involves both the infarcted noninfarcted regions of ventricle. These structural changes are result several distinct pathologic processes that contribute to progressive LV dilation: rearrangement structure, myocyte hypertrophy, increasing muscle mass without an increase (eccentric hypertrophy). The pathogenesis multifactorial. Multiple factors may fact at different stages from time coronary occlusion until development include magnitude loss contractile elements, abrupt systolic diastolic loading conditions, activation circulating neurohormones local autocrine trophic factors, patency infarct-related artery. Although occurring early be appropriate compensatory response preserve function, recent observations have suggested this long process has a deleterious effect on function prognosis. Thus attempts inhibit these been focus experimental clinical studies. This review focuses interactive influence postinfarction remodeling, emphasizing role some new emerging determinants such as extent surviving myocardium within zones. (Am Heart J 1999;138:S79-S83.)