LEFT-VENTRICULAR REMODELING AFTER ACUTE MYOCARDIAL-INFARCTION

The loss of myocytes as a consequence of myocardial infarction results in a prompt reduction in regional wall motion and often leads to more protracted and progressive changes in ventricular architecture. The r ecognition that the process of ventricular enlargement following myoca rdial infarction is modifiable provided the initial rationale for the use of angiotensin-converting enzyme (ACE) inhibitors as therapy to pr event deterioration in ventricular size and function following infarct ion. Experimental and clinical studies have documented the effectivene ss of this therapy in preventing this late enlargement following infar ction. Increasing clinical evidence indicates that this new use of ACE inhibitor therapy in survivors of acute myocardial infarction will le ad to an improvement in clinical outcome.