EDITORIAL

Left ventricular remodelling after myocardial infarction: importance of residual myocardial viability and ischaemia

C A Visser

Correspondence to:
Correspondence to:
Professor Cees A Visser, Department of Cardiology, VU medical Center, De Boelelaan 1117 Amsterdam, The Netherlands;
cardiol@vumc.nl

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Development of left ventricular remodelling after acute myocardial infarction is a complex process influenced by many factors, some of which are yet to be elucidated

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Keywords: left ventricular remodelling; myocardial infarction; myocardial viability; ischaemia

Abbreviations: AMI, acute myocardial infarction; APRICOT, anti-thrombotics in the prevention of reocclusion in coronary thrombolysis; IRA, infarct related artery; LV, left ventricle; TIMI, thrombolysis in myocardial infarction

The first 150 words of the full text of this article appear below.

During the past two decades, it has become increasingly well acknowledged that a large, transmural acute myocardial infarction (AMI) may result in complex alterations in the architecture and function of the left ventricle (LV), involving both the infarcted and non-infarcted zone. These alterations, usually referred to as "LV remodelling", can profoundly affect the patient’s prognosis.

From the clinical viewpoint LV remodelling is a dynamic process, starting in the acute phase with infarct expansion—that is, rearrangement of wall structure—leading to myocardial thinning and lengthening, and progressing to LV dilatation and hypertrophy.¹ The remodelling process has regional and global effects on wall thickness and chamber size, as well as on shape and function.² Patients who develop LV dilatation following AMI have significantly reduced survival. In fact, LV volume is the single most important predictor of survival in patients with coronary heart disease.³ Furthermore, Gaudron and colleagues demonstrated that LV dilatation following AMI . . . [Full text of this article]

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This article has been cited by other articles:

• Dwivedi, G., Janardhanan, R., Hayat, S. A., Lim, T. K., Senior, R. (2009). Improved prediction of outcome by contrast echocardiography determined left ventricular remodelling parameters compared to unenhanced echocardiography in patients following acute myocardial infarction. Eur J Echocardiogr 10: 933-940 [Abstract] [Full Text]