[Pathophysiology and therapeutic aspects of left ventricular "remodeling" in the post-infarct phase].
Left ventricular remodeling is the process by which ventricular size, shape, and function are regulated by mechanical, neurohormonal, and genetic factors. Remodeling may be physiological and adaptive during normal growth or pathological due to myocardial infarction, cardiomyopathy, hypertension, or valvular heart disease. Postinfarction remodeling has been divided into an early phase within 72 hours and a late phase beyond 72 hours. The early phase involves expansion of the infarct zone, which may result in early ventricular rupture or aneurysm formation. Late remodeling involves the left ventricle globally and is associated with time-dependent dilatation, the distortion of ventricular shape, and mural hypertrophy. Hypertrophy and collagen degradation are adaptive responses during postinfarction remodeling. Myocardial repair is triggered by cytokines released from injured myocytes. Ventricular remodeling is influenced most by infarct artery patency. Once infarct evolution has occurred, pharmacological intervention, like ACE inhibition and beta-adrenoreceptor blocking agents, may minimize infarct expansion and ventricular dilatation and improve the long-term prognosis.
Auer
J
J
II. Interne Abteilung mit Kardiologie und Internistischer Intensivmedizin, A. ö. Krankenhaus Wels, Grieskirchnerstrasse 42, A-4600 Wels. johann.auer@khwels.at
Berent
R
R
Eber
B
B
D006801:Humans; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy; D020257:Ventricular Remodeling / Q000502:physiology*
Pathophysiologische und therapeutische Aspekte des linksventrikulären "Remodelings" in der Postinfarktphase.