POSTMYOCARDIAL INFARCTION VENTRICULAR REMODELING - ANIMAL AND HUMAN STUDIES

Segmental alterations in left ventricular function are generally prese nt in patients who suffer an acute myocardial infarction. Regional wal l motion abnormalities in left ventricular systolic function can be id entified in the hyperacute period and generally persist in patients wh o complete a myocardial infarction. Through the process of infarct exp ansion, the infarcted territory may thin and lengthen in the short ter m following a myocardial infarction. Some infarct survivors are also p rone to further progressive alterations in the shape and size of the l eft ventricle, a process that has been termed postinfarction ventricul ar remodeling. Although left ventricular remodeling appears to represe nt an adaptive process serving to preserve stroke volume (and cardiac output) following myocardial injury, the enlargement process may have undesirable long-term effects on global left ventricular function and on clinical prognosis. Fortunately, recent experimental and clinical e vidence demonstrates that ventricular remodeling and its deleterious c onsequences may be preventable.