Ischemic Cardiomyopathy and Heart Failure After Acute Myocardial Infarction

被引:138
作者
Del Buono, Marco Giuseppe [1 ,2 ]
Moroni, Francesco [3 ]
Montone, Rocco Antonio [1 ]
Azzalini, Lorenzo [4 ]
Sanna, Tommaso [1 ,2 ]
Abbate, Antonio [3 ]
机构
[1] Fdn Policlin Univ A Gemelli IRCCS, Dept Cardiovasc Med, Largo Agostino Gemelli 1, I-00168 Rome, Italy
[2] Univ Cattolica Sacro Cuore, Dept Cardiovasc & Pulm Sci, Rome, Italy
[3] Univ Virginia, Berne Cardiovasc Res Ctr, Charlottesville, VA USA
[4] Univ Washington, Dept Med, Div Cardiol, Seattle, WA USA
关键词
Ischemic cardiomyopathy; Coronary artery disease; Myocardial infarction; Heart failure; Remodeling; HFrEF; ST-SEGMENT ELEVATION; PERCUTANEOUS CORONARY INTERVENTION; ARTERY-BYPASS SURGERY; SYSTOLIC FUNCTION; TASK-FORCE; SIZE; DYSFUNCTION; REPERFUSION; IMPACT; SACUBITRIL/VALSARTAN;
D O I
10.1007/s11886-022-01766-6
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of Review Ischemic cardiomyopathy refers to systolic left ventricular dysfunction in the setting of obstructive coronary artery disease and represents the most common cause of heart failure worldwide. It is often the combination of an irreversible loss of viable mass following an acute myocardial infarction (AMI) with a dysfunctional, but still viable, myocardium in the context of a chronically reduced myocardial blood flow and reduced coronary reserve. Medical treatments aiming at modulating neurohumoral response and restoring blood flow to the ischemic cardiomyocytes were shown to dramatically abate the occurrence of ventricular dysfunction and adverse remodeling in ischemic cardiomyopathy. Recent Findings Novel therapeutic approaches, such as mechanical unloading and modulation of the inflammatory response, appear to be promising. Furthermore, the understanding of the mechanisms by which, despite optimal treatment, heart failure ensues after AMI, with or without adverse remodeling and systolic dysfunction, is a critical step in the search for novel ways to tackle heart failure risk beyond preservation of left ventricular volumes and systolic function. In this review article, we explore the principal pathophysiological mechanisms and pathways of heart failure in ischemic cardiomyopathy, therapeutic opportunities, and knowledge gaps in this area.
引用
收藏
页码:1505 / 1515
页数:11
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