Document Detail


Prevention of left ventricular remodelling after acute myocardial infarction: an update.
MedLine Citation:
PMID:  20874671     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Left ventricular remodelling is a progressive process, which starts immediately after acute myocardial infarction and evolves in the chronic phase of heart failure. It is characterized by left ventricular chamber dilatation and increased wall stress, which results in alteration of the contractile properties of the non-infarct zone and impairment of the systolic and diastolic performances of the left ventricle. Neurohormonal activation and increased sympathetic stimulation are among the factors that have been linked to the development and progression of left ventricular dysfunction after acute myocardial infarction. The present review will address recent insights from new patents and experimental studies of drugs, which ought to prevent left ventricular remodelling. Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers and Beta-Blockers have been proven effective in modulating the process of remodelling and in reducing the occurrence of adverse events. However, in most of the trials high risk patients have been excluded, and uncertainty still exists regarding a number of clinically relevant questions. Data from experimental studies have identified new targets for interventions to prevent reverse left ventricular remodelling, i.e. stem cell transfer, activation of cardiac and leukocyte-dependent oxidant stress pathways, inflammatory pathway activation, matrix-metalloproteinase activation.
Authors:
Roberta Rossini; Michele Senni; Giuseppe Musumeci; Paolo Ferrazzi; Antonello Gavazzi
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Recent patents on cardiovascular drug discovery     Volume:  5     ISSN:  2212-3962     ISO Abbreviation:  Recent Pat Cardiovasc Drug Discov     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-15     Completed Date:  2011-02-22     Revised Date:  2011-11-10    
Medline Journal Info:
Nlm Unique ID:  101263805     Medline TA:  Recent Pat Cardiovasc Drug Discov     Country:  United Arab Emirates    
Other Details:
Languages:  eng     Pagination:  196-207     Citation Subset:  IM    
Affiliation:
Dipartimento Cardiovascolare, Ospedali Riuniti di Bergamo, Bergamo, Italy. roberta_rossini@yahoo.it
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / pharmacology,  therapeutic use
Aldosterone Antagonists / therapeutic use
Angiotensin Receptor Antagonists / pharmacology,  therapeutic use
Angiotensin-Converting Enzyme Inhibitors / pharmacology,  therapeutic use
Antioxidants / therapeutic use
Enzyme Activators / pharmacology,  therapeutic use
Heart Failure / physiopathology,  prevention & control
Humans
Hypertrophy, Left Ventricular / etiology*,  physiopathology,  prevention & control*
Matrix Metalloproteinases / metabolism
Myocardial Infarction / complications*,  drug therapy*,  physiopathology,  prevention & control
Stem Cell Transplantation
Ventricular Function, Left / drug effects
Ventricular Remodeling / drug effects*
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Aldosterone Antagonists; 0/Angiotensin Receptor Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antioxidants; 0/Enzyme Activators; EC 3.4.24.-/Matrix Metalloproteinases

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


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