VENTRICULAR REMODELING OF THE HEART

Published clinical data has emphasized the importance of reperfusion in limiting ventricular remodeling and has shown that patients with anterior infarcts are at greater risk of infarct expansion. However, some doubts have been cast on the benefits of late reperfusion, as analysis suggests that it may be associated with increased incidence of myocardial rupture. A great deal of evidence has been published to suggest that changes to the myocardial collagen matrix play an important role in ventricular remodeling. Connections between such disparate studies have been provided by a recent review of the clinical and basic science literature which identified three factors that might limit ventricular remodeling: limitation of infarct size, reduction of ventricular wall stress, and enhancement of scar healing. Consideration of these factors in current and future experiments is likely to enhance our understanding of ventricular remodeling.