title: Approaches to Improving Cardiac Structure and Function During and After an Acute Myocardial Infarction: Acute and Chronic Phases.
abstract: While progress has been made in improving survival following myocardial infarction, this injury remains a major source of mortality and morbidity despite modern reperfusion therapy. While one approach has been to develop therapies to reduce lethal myocardial cell reperfusion injury, this concept has not translated to the clinics, and several recent negative clinical trials raise the question of whether reperfusion injury is important in humans undergoing reperfusion for acute ST segment elevation myocardial infarction. Therapy aimed at reducing myocardial cell death while the myocytes are still ischemic is more likely to further reduce myocardial infarct size. Developing new therapies to further reduce left ventricular remodeling after the acute event is another approach to preserving structure and function of the heart after infarction. Such therapy may include chronic administration of pharmacologic agents and/or therapies developed from the field of regenerative cardiology, including cellular or non-cellular materials such as extracellular matrix. The optimal therapy will be to administer agents that both reduce myocardial infarct size in the acute phase of infarction as well as reduce adverse left ventricular remodeling during the chronic or healing phase of myocardial infarction. Such a dual approach will help optimize the preservation of both cardiac structure and function.
authors.affiliation: HMRI Cardiovascular Research Institute, Huntington Medical Research Institutes, Pasadena, California, USA Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Guest Editor: Jonathan Leor kloner@hmri.org.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kloner
authors.affiliation: HMRI Cardiovascular Research Institute, Huntington Medical Research Institutes, Pasadena, California, USA Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Guest Editor: Jonathan Leor.
authors.forename: Wangde
authors.initials: W
authors.lastname: Dai
authors.affiliation: HMRI Cardiovascular Research Institute, Huntington Medical Research Institutes, Pasadena, California, USA.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Hale
authors.affiliation: HMRI Cardiovascular Research Institute, Huntington Medical Research Institutes, Pasadena, California, USA Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Guest Editor: Jonathan Leor.
authors.forename: Jianru
authors.initials: J
authors.lastname: Shi
mesh_terms: D000818:Animals; D016923:Cell Death; D006801:Humans; D009203:Myocardial Infarction / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D009206:Myocardium / Q000473:pathology*; D020127:Recovery of Function; D012038:Regeneration; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
keywords: Acute myocardial infarction; left ventricular remodeling; myocardial infarct size; reperfusion; reperfusion injury