Left Ventricular Remodeling After Myocardial Infarction—Pathophysiology, Diagnostic Approach and Management During Cardiac Rehabilitation
Víctor Marcos‐Garcés, Carlos Bertolín‐Boronat, H Merenciano-Gonzalez, María Luz Martínez Mas, Josefa Inés Climent Alberola, Laura López, Alfonso Payá Rubio, Nerea Pérez-Solé, César Ríos‐Navarro, Elena de Dios, José Gavara, David Moratal, José F. Rodríguez‐Palomares, Jose T. Ortiz‐Pérez, Juan Sanchís, Vicente Bodı́
Abstract
Despite the improvement in prognosis in patients with acute myocardial infarction (AMI), a significant proportion of survivors still experience heart failure (HF)-related adverse outcomes. Adverse left ventricular remodeling (LVR), which refers to a progressive dilation of left ventricular (LV) end-diastolic and end-systolic volumes, usually accompanied by a deterioration in LV systolic function, occurs frequently and underlies most cases of HF development after AMI. In this review, we discuss the current definitions of post-AMI LVR, the most appropriate imaging modalities for its detection, and the pathophysiological mechanisms by which Cardiac Rehabilitation (CR) can improve LVR-including exercise interventions, cardiovascular risk factors control, and pharmacological therapy optimization. Finally, we provide up-to-date recommendations for the follow-up and management of LVR in post-AMI patients enrolled in CR and outline future prospects on this topic.