LEFT-VENTRICULAR REMODELING AFTER MYOCARDIAL-INFARCTION - PATHOPHYSIOLOGY AND PREVENTION

The degree of left ventricular dilatation occurring after myocardial infarction is a major prognostic factor. Left ventricular remodeling is characterized by early expansion of the infarcted region and predominantly excentric hypertrophy of the noninfarcted myocardium, resulting in left ventricular cavity dilatation. Remodeling is most pronounced in large anterior infarctions. Recent evidence indicates that remodeling is amenable to treatment. Several randomized studies have demonstrated that long-term administration of converting enzyme inhibitors not only reduces left ventricular enlargement but also lowers morbidity and mortality after myocardial infarction.