[Neurohumoral activation and remodeling after acute myocardial infarct and the effect of angiotensin-converting enzyme inhibitors].
Neuroendocrine activation, which begins early after myocardial injury, participates significantly in the pathogenesis of acute myocardial infarction and its complications. Plasma concentrations of catecholamines, arginine vasopressin and atrial natriuretic factor were highest on admission. Activation of the renin-angiotensin-aldosterone system reached its peak after 72 hours. In patients with acute myocardial infarction and heart failure the neuroendocrine activation was more intensively expressed. This study presents clinical consequences of neuroendocrine activation. Its relation to ventricular remodeling, as a potentially maladaptive mechanism is especially discussed. Angiotensin-converting-enzyme inhibitors influence favourably both neuro-endocrine activation and ventricular remodeling after myocardial infarction. At present 7 ongoing extensive multicenter trials are to determine if such a therapy would lead to a better survival and attenuate the progressive deterioration of heart function after myocardial infarction. (Fig. 2, Ref. 24.)
Dúbrava
J
J
IV. interná klinika NsP, Bratislava, Slovakía.
Cagán
S
S
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D000818:Animals; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000503:physiopathology*; D009203:Myocardial Infarction / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D018377:Neurotransmitter Agents / Q000378:metabolism*
D000806:Angiotensin-Converting Enzyme Inhibitors; D018377:Neurotransmitter Agents
Neurohumorálna aktivácia a remodelácia po akútnom infarkte myokardu a ich ovplyvnenie inhibítormi angiotenzín-konvertujúceho enzýmu.