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Prevention of late postmyocardial infarction left ventricular remodeling: An update

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Abstract

Cardiac remodeling remains an important primary therapeutic target in patients with myocardial infarction (MI) and chronic heart failure. It also has utility as a reliable surrogate for clinical outcomes. The past three decades of research have demonstrated the importance of cardiac remodeling as a basic mechanism in the progression of heart failure. Novel therapeutic advances have allowed more patients to survive acute MI. Strategies to prevent or halt adverse left ventricular remodeling have included pharmacotherapy, percutaneous interventions, device-based therapies, and surgical procedures. More recently, experimental research has added opportunities for novel approaches to prevent and reverse cardiac remodeling. This review summarizes the effects of current and future therapeutic strategies on left ventricular remodeling and dysfunction after MI.

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References and Recommended Reading

  1. Sharpe N: Pharmacologic effects on cardiac remodeling. Curr Heart Fail Rep 2004, 1:9–13.

    Article  PubMed  Google Scholar 

  2. Pfeffer MA, Braunwald E: Ventricular remodeling after myocardial infarction. Experimental observations and clinical implications. Circulation 1990, 81:1161–1172.

    CAS  PubMed  Google Scholar 

  3. Cohn JN, Ferrari R, Sharpe N: Cardiac remodeling—concepts and clinical implications: a consensus paper from an international forum on cardiac remodeling. Behalf of an International Forum on Cardiac Remodeling. J Am Coll Cardiol 2000, 35:569–582.

    Article  CAS  PubMed  Google Scholar 

  4. Landmesser U, Wollert KC, Drexler H: Potential novel pharmacological therapies for myocardial remodelling. Cardiovasc Res 2009, 81:519–527.

    Article  CAS  PubMed  Google Scholar 

  5. Solomon SD, Glynn RJ, Greaves S, et al.: Recovery of ventricular function after myocardial infarction in the reperfusion era: the healing and early afterload reducing therapy study. Ann Intern Med 2001,134:451–458.

    CAS  PubMed  Google Scholar 

  6. St. John Sutton M, Lee D, Rouleau JL, et al.: Left ventricular remodeling and ventricular arrhythmias after myocardial infarction. Circulation 2003, 107:2577–2582.

    Article  PubMed  Google Scholar 

  7. Tiyyagura SR, Pinney SP: Left ventricular remodeling after myocardial infarction: past, present, and future. Mt Sinai J Med 2006, 73:840–851.

    PubMed  Google Scholar 

  8. Pfeffer JM, Pfeffer MA, Fletcher PJ, Braunwald E: Progressive ventricular remodeling in rat with myocardial infarction. Am J Physiol 1991, 260:H1406–H1414.

    CAS  PubMed  Google Scholar 

  9. Weisman HF, Bush DE, Mannisi JA, et al.: Cellular mechanisms of myocardial infarct expansion. Circulation 1988, 78:186–201.

    CAS  PubMed  Google Scholar 

  10. Mitchell GF, Lamas GA, Vaughan DE, Pfeffer MA: Left ventricular remodeling in the year after first anterior myocardial infarction: a quantitative analysis of contractile segment lengths and ventricular shape. J Am Coll Cardiol 1992, 19:1136–1144.

    CAS  PubMed  Google Scholar 

  11. Mitchell GF, Lamas GA, Pfeffer MA: Ventricular remodeling after myocardial infarction. Adv Exp Med Biol 1993, 346:265–276.

    CAS  PubMed  Google Scholar 

  12. Fu YC, Chi CS, Yin SC, et al.: Norepinephrine induces apoptosis in neonatal rat cardiomyocytes through a reactive oxygen species-TNF alpha-caspase signaling pathway. Cardiovasc Res 2004, 62:558–567.

    Article  CAS  PubMed  Google Scholar 

  13. Jugdutt BI, Warnica JW: Intravenous nitroglycerin therapy to limit myocardial infarct size, expansion, and complications. Effect of timing, dosage, and infarct location. Circulation 1988, 78:906–919.

    CAS  PubMed  Google Scholar 

  14. Six-month effects of early treatment with lisinopril and transdermal glyceryl trinitrate singly and together withdrawn six weeks after acute myocardial infarction: the GISSI-3 trial. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico. J Am Coll Cardiol 1996, 27:337–344.

  15. ISIS-4: a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group. Lancet 1995, 345:669–685.

  16. The SOLVD Investigators: Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 1991, 325:293–302.

    Article  Google Scholar 

  17. Pfeffer MA, Braunwald E, Moy LA, et al.: Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction: results of the survival and ventricular enlargement trial. N Engl J Med 1992, 327:669–677.

    CAS  PubMed  Google Scholar 

  18. Køber L, Torp-Pedersen C, Carlsen JE, et al.: A clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 1995, 333:1670–1676.

    Article  PubMed  Google Scholar 

  19. Pfeffer MA, Swedberg K, Granger CB, et al.: Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programme. Lancet 2003, 362:759–766.

    Article  CAS  PubMed  Google Scholar 

  20. Abraham WT, Greenberg BH, Yancy CW: Pharmacologic therapies across the continuum of left ventricular dysfunction. Am J Cardiol 2008, 102:21G–28G.

    Article  CAS  PubMed  Google Scholar 

  21. Cohn JN, Tognoni G: A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med 2001, 345:1667–1675.

    Article  CAS  PubMed  Google Scholar 

  22. Hunt SA: ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2005, 46:e1–e82.

    Article  PubMed  Google Scholar 

  23. Dickstein K, Kjekshus J: Effects of losartan and captopril on mortality and morbidity in high-risk patients after acute myocardial infarction: the OPTIMAAL randomised trial. Lancet 2002, 360:752–760.

    Article  CAS  PubMed  Google Scholar 

  24. Pfeffer MA, McMurray JJ, Velazquez EJ, et al.: Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both. N Engl J Med 2003, 349:1893–1906.

    Article  CAS  PubMed  Google Scholar 

  25. MERIT-HF Study Group: Effect of metoprolol CR/XL in chronic heart failure: metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERITHF). Lancet 1999, 353:2001–2007.

    Article  Google Scholar 

  26. The CIBIS-II Investigators: The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet 1999, 353:9–13.

    Article  Google Scholar 

  27. The CAPRICORN Investigators: Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomised trial. Lancet 2001, 357:1385–1390.

    Article  Google Scholar 

  28. Packer M, Coats AJS, Fowler MB, et al.: Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med 2001, 344:1651–1658.

    Article  CAS  PubMed  Google Scholar 

  29. Pitt B, Zannad F, Remme WJ, et al.: The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N Engl J Med 1999, 341:709–717.

    Article  CAS  PubMed  Google Scholar 

  30. Pitt B, Remme W, Zannad F, et al.: Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 2003, 348:1309–1321.

    Article  CAS  PubMed  Google Scholar 

  31. Scherrer-Crosbie M, Ullrich R, Bloch KD, et al.: Endothelial nitric oxide synthase limits left ventricular remodeling after myocardial infarction in mice. Circulation 2001, 104:1286–1291.

    Article  CAS  PubMed  Google Scholar 

  32. Massion PB, Balligand JL: Relevance of nitric oxide for myocardial remodeling. Curr Heart Fail Rep 2007, 4:18–25.

    Article  CAS  PubMed  Google Scholar 

  33. Timmers L, Sluijter JP, van Keulen JK, et al.: Toll-like receptor 4 mediates maladaptive left ventricular remodeling and impairs cardiac function after myocardial infarction. Circ Res 2008, 102:257–264.

    Article  CAS  PubMed  Google Scholar 

  34. Abbate A, Salloum FN, Vecile E, et al.: Anakinra, a recombinant human interleukin-1 receptor antagonist, inhibits apoptosis in experimental acute myocardial infarction. Circulation 2008, 117:2670–2683.

    Article  CAS  PubMed  Google Scholar 

  35. Kelly D, Cockerill G, Ng LL, et al.: Plasma matrix metalloproteinase-9 and left ventricular remodelling after acute myocardial infarction in man: a prospective cohort study. Eur Heart J 2007, 28:711–718.

    Article  CAS  PubMed  Google Scholar 

  36. GUSTO (Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries): Comparison of four therapeutic strategies in acute myocardial infarction. Washington, 30 April 1993 [in German]. Internist (Berl) 1993, 34(7 Suppl):1–12.

    Google Scholar 

  37. Centurión OA: The open artery hypothesis: beneficial effects and long-term prognostic importance of patency of the infarct-related coronary artery. Angiology 2007, 58:34–44.

    Article  PubMed  Google Scholar 

  38. Kennedy JW, Ritchie JL, Davis KB, et al.: The Western Washington Randomized Trial of intracoronary streptokinase in acute myocardial infarction: a 12-months follow-up report. N Engl J Med 1985, 312:1073–1078.

    Article  CAS  PubMed  Google Scholar 

  39. Randomized trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Lancet 1988, 2:349–360.

  40. Dzavik V, Beanlands DS, Davies RF, et al.: Effects of late percutaneous transluminal coronary angioplasty of an occluded infarct-related coronary artery on left ventricular function in patients with a recent (< 6 weeks) Q-wave acute myocardial infarction (Total Occlusion Post-Myocardial Infarction Interventional Study [TOMIIS]-a pilot study). Am J Cardiol 1994, 73:856–861.

    Article  CAS  PubMed  Google Scholar 

  41. Steg PG, Thuaire C, Himbert D, et al.: DECOPI (DEsobstruction COronaire en Post-Infarctus): a randomized multi-centre trial of occluded artery angioplasty after acute myocardial infarction. Eur Heart J 2004, 25:2187–2194.

    Article  PubMed  Google Scholar 

  42. Dzavik V, Buller CE, Lamas GA, et al.: Randomized trial of percutaneous coronary intervention for subacute infarctrelated coronary artery occlusion to achieve long-term patency and improve ventricular function. The Total Occlusion Study of Canada (TOSCA)-2 Trial. Circulation 2006, 114:2449–2457.

    Article  PubMed  Google Scholar 

  43. Hochman JS, Lamas GA, Buller CE, et al.: Coronary intervention for persistent occlusion after myocardial infarction. N Engl J Med 2006, 355:2395–2407.

    Article  CAS  PubMed  Google Scholar 

  44. Appleton DL, Abbate A, Biondi-Zoccai GG: Late percutaneous coronary intervention for the totally occluded infarct-related artery: a meta-analysis of the effects on cardiac function and remodeling. Catheter Cardiovasc Interv 2008, 71:772–781.

    Article  PubMed  Google Scholar 

  45. Leacche M, Balaguer JM, Byrne JG: Role of cardiac surgery in the post-myocardial infarction patient with heart failure. Curr Heart Fail Rep 2008, 5:204–210.

    Article  PubMed  Google Scholar 

  46. Alderman EL, Bourassa MG, Cohen LS, et al.: Ten-year follow-up of survival and myocardial infarction in the randomized Coronary Artery Surgery Study. Circulation 1990, 82:1629–1646.

    CAS  PubMed  Google Scholar 

  47. Yusuf S, Zucker D, Peduzzi P, et al.: Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration. Lancet 1994, 344:563–570.

    Article  CAS  PubMed  Google Scholar 

  48. Jones RH, Velazquez EJ, Michler RE, et al.: Coronary bypass surgery with or without surgical ventricular reconstruction. N Engl J Med 2009, 360:1705–1717.

    Article  CAS  PubMed  Google Scholar 

  49. Allman KC, Shaw LJ, Hachamovitch R, Udelson JE: Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: a meta-analysis. J Am Coll Cardiol 2002, 39:1151–1158.

    Article  PubMed  Google Scholar 

  50. Elefteriades J, Edwards R: Coronary bypass in left heart failure. Semin Thorac Cardiovasc Surg 2002, 14:125–132.

    Article  PubMed  Google Scholar 

  51. Borger MA, Alam A, Murphy PM, et al.: Chronic ischemic mitral regurgitation: repair, replace or rethink? Ann Thorac Surg 2006, 81:1153–1161.

    Article  PubMed  Google Scholar 

  52. Grossi EA, Goldberg JD, LaPietra A, et al.: Ischemic mitral valve reconstruction and replacement: comparison of longterm survival and complications. J Thorac Cardiovasc Surg 2001, 122:1107–1124.

    Article  CAS  PubMed  Google Scholar 

  53. Badhwar V, Bolling SF: Mitral valve surgery in the patient with left ventricular dysfunction. Semin Thorac Cardiovasc Surg 2002, 14:133–136.

    Article  PubMed  Google Scholar 

  54. Bax JJ, Braun J, Somer ST, et al.: Restrictive annuloplasty and coronary revascularization in ischemic mitral regurgitation results in reverse left ventricular remodeling. Circulation 2004, 110(11 Suppl 1):II103–II108.

    PubMed  Google Scholar 

  55. Parolari A, Naliato M, Loardi C, et al.: Surgery of left ventricular aneurysm: a meta analysis of early outcomes following different reconstruction techniques. Ann Thorac Surg 2007, 83:2009–2016.

    Article  PubMed  Google Scholar 

  56. Menicanti L, Castelvecchio S, Ranucci M, et al.: Surgical therapy for ischemic heart failure: single-center experience with surgical anterior ventricular restoration. J Thorac Cardiovasc Surg 2007, 134:433–441.

    Article  PubMed  Google Scholar 

  57. Dor V, Sabatier M, Montiglio F, et al.: Endoventricular patch reconstruction of ischemic failing ventricle: a single center with 20 years experience. Advantages of magnetic resonance imaging assessment. Heart Fail Rev 2004, 9:269–286.

    Article  CAS  PubMed  Google Scholar 

  58. Athanasuleas CL, Buckberg GD, Stanley AW, et al.: Surgical ventricular restoration in the treatment of congestive heart failure due to post-infarction ventricular dilation. J Am Coll Cardiol 2004, 44:1439–1445.

    Article  PubMed  Google Scholar 

  59. Maxey TS, Reece TB, Ellman PI, et al.: Coronary artery bypass with ventricular restoration is superior to coronary artery bypass alone in patients with ischemic cardiomyopathy. J Thorac Cardiovasc Surg 2004, 127:428–434.

    Article  PubMed  Google Scholar 

  60. Acker MA, Bolling S, Shemin R, et al.: Mitral valve surgery in heart failure: insights from the Acorn Clinical Trial. J Thorac Cardiovasc Surg 2006, 132:568–577.

    Article  PubMed  Google Scholar 

  61. Rahmouni HW, Kirkpatrick JN, St John Sutton MG: Effects of cardiac resynchronization therapy on ventricular remodeling. Curr Heart Fail Rep 2008, 5:25–30.

    Article  PubMed  Google Scholar 

  62. Cleland JG, Daubert JC, Erdmann E, et al.: Baseline characteristics of patients recruited into the CARE-HF study. Eur J Heart Fail 2005, 7:205–214.

    Article  CAS  PubMed  Google Scholar 

  63. Mollema SA, Liem SS, Suffoletto MS, et al.: Left ventricular dyssynchrony acutely after myocardial infarction predicts left ventricular remodeling. Am Coll Cardiol 2007, 50:1532–1540.

    Article  Google Scholar 

  64. Zhang Y, Yip GW, Chan AK, et al.: Left ventricular systolic dyssynchrony is a predictor of cardiac remodeling after myocardial infarction. Am Heart J 2008,156:1124–1132.

    Article  PubMed  Google Scholar 

  65. Meyer GP, Wollert KC, Drexler H: The role of stem cells in the post-MI patient. Curr Heart Fail Rep 2007, 4:198–203.

    Article  PubMed  Google Scholar 

  66. Wollert KC, Meyer GP, Lotz J, et al.: Intracoronary autologous bone-marrow cell transfer after myocardial infarction: the BOOST randomised controlled clinical trial. Lancet 2004, 364:141–148.

    Article  PubMed  Google Scholar 

  67. Schachinger V, Erbs S, Elsasser A, et al.: Intracoronary bone marrow-derived progenitor cells in acute myocardial infarction. N Engl J Med 2006, 355:1210–1221.

    Article  CAS  PubMed  Google Scholar 

  68. Janssens S, Dubois C, Bogaert J, et al.: Autologous bone marrow-derived stem-cell transfer in patients with ST segment elevation myocardial infarction: double-blind, randomised controlled trial. Lancet 2006, 367:113–121.

    Article  PubMed  Google Scholar 

  69. Lunde K, Solheim S, Aakhus S, et al.: Intracoronary injection of mononuclear bone marrow cells in acute myocardial infarction. N Engl J Med 2006, 355:1199–1209.

    Article  CAS  PubMed  Google Scholar 

  70. Schaefer A, Meyer GP, Fuchs M, et al.: Impact of intracoronary bone marrow cell transfer on diastolic function in patients after acute myocardial infarction: results from the BOOST trial. Eur Heart J 2006, 27:929–935.

    Article  PubMed  Google Scholar 

  71. Schachinger V, Assmus B, Britten MB, et al.: Transplantation of progenitor cells and regeneration enhancement in acute myocardial infarction: final one-year results of the TOPCARE-AMI Trial. J Am Coll Cardiol 2004, 44:1690–1699.

    Article  PubMed  Google Scholar 

  72. Assmus B, Honold J, Schachinger V, et al.: Transcoronary transplantation of progenitor cells after myocardial infarction. N Engl J Med 2006, 355:1222–1232.

    Article  CAS  PubMed  Google Scholar 

  73. Ince H, Petzsch M, Kleine HD, et al.: Preservation from left ventricular remodeling by front-integrated revascularization and stem cell liberation in evolving acute myocardial infarction by use of granulocyte-colony-stimulating factor (FIRSTLINE-AMI). Circulation 2005, 112:3097–3106.

    Article  CAS  PubMed  Google Scholar 

  74. Yu CM, Bleeker CB, Fung JWH, et al.: Left ventricular reverse remodeling but not clinical improvement predicts long-term survival after cardiac resynchronisation therapy. Circulation 2005, 112:1580–1586.

    Article  PubMed  Google Scholar 

  75. Funaro S, La Torre G, Madonna M, et al.: Incidence, determinants, and prognostic value of reverse left ventricular remodelling after primary percutaneous coronary intervention: results of the Acute Myocardial Infarction Contrast Imaging (AMICI) multicenter study. Eur Heart J 2009, 30:566–575.

    Article  PubMed  Google Scholar 

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  1. Department of Cardiovascular Diseases, Mayo College of Medicine, Mayo Clinic Arizona, 13400 East Shea Boulevard, Scottsdale, AZ, 85259, USA

    Farouk Mookadam

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  1. Farouk Mookadam
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  2. Sherif E. Moustafa
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Mookadam, F., Moustafa, S.E. Prevention of late postmyocardial infarction left ventricular remodeling: An update. Curr Heart Fail Rep 6, 245–253 (2009). https://doi.org/10.1007/s11897-009-0034-4

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