Document Detail


Left ventricular dilatation after myocardial infarction: ACE inhibitors, beta-blockers, or both?
MedLine Citation:
PMID:  9731689     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Left ventricular (LV) dilatation after myocardial infarction (MI) is a major predictor of prognosis and identifies which patients will develop heart failure. Left ventricular dilatation or remodeling starts immediately after MI and progresses in the chronic phase of heart failure. Factors influencing remodeling, such as infarct size and neurohumoral activation, including the sympathetic and renin-angiotensin system, are discussed. Remodeling can be affected by reduction of infarct size and inhibition of neurohumoral activation. The effect of thrombolysis, beta-blockade, and angiotensin-converting enzyme (ACE) inhibition in the acute phase after MI and in the chronic phase of heart failure on remodeling are discussed. On the basis of beneficial effects of ACE inhibition and beta-blockade in acute MI and in chronic heart failure, a treatment strategy is proposed in which both ACE inhibition and beta-blockade are started early after MI. Depending on infarct size and ventricular function, continued treatment in the chronic phase of heart failure must be considered.
Authors:
R L Anthonio; D J van Veldhuisen; W H van Gilst
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of cardiovascular pharmacology     Volume:  32 Suppl 1     ISSN:  0160-2446     ISO Abbreviation:  J. Cardiovasc. Pharmacol.     Publication Date:  1998  
Date Detail:
Created Date:  1998-11-05     Completed Date:  1998-11-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7902492     Medline TA:  J Cardiovasc Pharmacol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  S1-8     Citation Subset:  IM    
Affiliation:
Institute of Clinical Pharmacology, University of Groningen, and Department of Cardiology/Thorax Center, University Hospital Groningen, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Dilatation, Pathologic / drug therapy,  etiology
Heart Failure
Humans
Myocardial Infarction / complications,  drug therapy*
Neurotransmitter Agents / physiology
Ventricular Function, Left / drug effects
Ventricular Remodeling / drug effects
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Neurotransmitter Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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