Remodelação ventricular pós-infarto do miocárdio: conceitos e implicações clínicas

Leonardo A. M. Zornoff, Sergio A. R. Paiva, Daniella R. Duarte, Joel Spadaro
2009 Arquivos Brasileiros de Cardiologia  
Remodeling process after acute myocardial infarction (AMI) is clinically characterized by ventricular cavity increase. In the acute phase, ventricular dilation is a result of infarction expansion process, whereas late cavity dilation is the result of the eccentric hypertrophy process. Ventricular remodeling plays a key role in the pathology of post-infarction ventricular dysfunction. When reacting to aggression, the genetic, structural, and biochemical changes arising from that process will
more » ... at process will result in the deterioration of the functional ability of the heart in the long run. Signs and symptoms of the onset of heart failure and/or sudden death will result. The mechanisms that have been proposed for the onset of ventricular dysfunction are complex, but the ones to be pointed out are changes in: calcium transit; betaadrenergic pathway; contractile proteins; increased cell death; collagen accumulation; methaloproteases; higher oxidative stress; energy deficit; cytoskeletal, membrane and matrix proteins; and ventricular geometry. Additionally, remodeling is associated to higher prevalence of cardiac rupture, arrhythmia, and aneurysm formation after infarction. Remodeling is therefore associated to impaired postinfarction prognosis. As a result, a better understanding of such process is critical since remodeling course can be modified through a number of therapeutic interventions. Review Article Zornoff et al Post-infarction remodeling Arq Bras Cardiol 2009;92(2):150-156
doi:10.1590/s0066-782x2009000200013 pmid:19360249 fatcat:daw5wm75lfb25iqhc3q2d7r4jy