Left ventricular remodelling post-myocardial infarction: pathophysiology, imaging, and novel therapies

Author:

Frantz Stefan1ORCID,Hundertmark Moritz Jens2,Schulz-Menger Jeanette3,Bengel Frank Michael4ORCID,Bauersachs Johann5ORCID

Affiliation:

1. Department of Internal Medicine I, Universitätsklinikum Würzburg, University Hospital Würzburg, University of Würzburg , Oberdürrbacher Str. 6, 97080 Würzburg , Germany

2. Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital , Oxford , UK

3. Department of Cardiology and Nephrology, Experimental and Clinical Research Center, a Joint Cooperation between the Charité Medical Faculty and the Max-Delbrueck Center for Molecular Medicine and HELIOS Hospital Berlin Buch , Berlin , Germany

4. Department of Nuclear Medicine, Hannover Medical School , Hannover , Germany

5. Department of Cardiology and Angiology, Hannover Medical School , Hannover , Germany

Abstract

Abstract 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.

Funder

CRC1525

DFG

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

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