[Ventricular "remodeling" after myocardial infarction].
Cardiac failure is the principal medium-term complication of myocardial infarction. Changes in left ventricular geometry are observed after infarction, called ventricular remodeling, which, though compensatory initially, cause ventricular failure in the long-term. Experimental and clinical studies suggest that early treatment by coronary recanalisation, trinitrin and angiotensin converting enzyme inhibitors may prevent or limit the expansion and left ventricular dilatation after infarction, so improving ventricular function, and, at least in the animal, reduce mortality. Large scale trials with converting enzyme inhibitors are currently under way to determine the effects of this new therapeutic option. It would seem possible at present, independently of any reduction in the size of the infarction, to reduce or delay left ventricular dysfunction by interfering with the natural process of dilatation and ventricular modeling after infarction.
Cohen-Solal
A
A
Service de cardiologie, hôpital Bichat, Paris.
Himbert
D
D
Guéret
P
P
Gourgon
R
R
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D006333:Heart Failure / Q000209:etiology* / Q000503:physiopathology; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications* / Q000628:therapy; D015425:Myocardial Reperfusion; D005996:Nitroglycerin / Q000627:therapeutic use; D016277:Ventricular Function, Left
D000806:Angiotensin-Converting Enzyme Inhibitors; D005996:Nitroglycerin
Le "remodelage" ventriculaire après infarctus du myocarde.