Left ventricular remodelling post-myocardial infarction: pathophysiology, imaging, and novel therapies.
Stefan FrantzMoritz Jens HundertmarkJeanette Schulz-MengerFrank Michael BengelJohann BauersachsPublished in: European heart journal (2022)
Most patients survive acute myocardial infarction (MI). Yet this encouraging development has certain drawbacks: heart failure (HF) prevalence is increasing and patients affected tend to have more comorbidities worsening economic strain on healthcare systems and impeding effective medical management. The heart's pathological changes in structure and/or function, termed myocardial remodelling, significantly impact on patient outcomes. Risk factors like diabetes, chronic obstructive pulmonary disease, female sex, and others distinctly shape disease progression on the 'road to HF'. Despite the availability of HF drugs that interact with general pathways involved in myocardial remodelling, targeted drugs remain absent, and patient risk stratification is poor. Hence, in this review, we highlight the pathophysiological basis, current diagnostic methods and available treatments for cardiac remodelling following MI. We further aim to provide a roadmap for developing improved risk stratification and novel medical and interventional therapies.
Keyphrases
- left ventricular
- heart failure
- healthcare
- end stage renal disease
- acute myocardial infarction
- risk factors
- chronic obstructive pulmonary disease
- newly diagnosed
- chronic kidney disease
- type diabetes
- ejection fraction
- cardiovascular disease
- cardiac resynchronization therapy
- acute heart failure
- peritoneal dialysis
- prognostic factors
- hypertrophic cardiomyopathy
- aortic stenosis
- high resolution
- metabolic syndrome
- mitral valve
- adipose tissue
- photodynamic therapy
- health information
- social media
- transcatheter aortic valve replacement
- health insurance
- cancer therapy
- glycemic control