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Review

Managing the Post-Myocardial Infarction Patient with Asymptomatic Left Ventricular Dysfunction

Philippides G.J.

Author affiliations

Department of Clinical Cardiology, Boston University School of Medicine, Coronary Care Unit, Boston Medical Center, Boston, Mass., USA

Related Articles for ""

Cardiology 2006;105:95–107

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Article / Publication Details

First-Page Preview
Abstract of Review

Received: June 10, 2005
Accepted: July 26, 2005
Published online: February 10, 2006
Issue release date: February 2006

Number of Print Pages: 13
Number of Figures: 9
Number of Tables: 0

ISSN: 0008-6312 (Print)
eISSN: 1421-9751 (Online)

For additional information: http://www.karger.com/CRD

Abstract

The percentage of post-myocardial infarction (MI) patients with asymptomatic left ventricular dysfunction (ALVD) is now estimated at 10%, and that number is expected to grow as reperfusion procedures increasingly become routine. Since average all-cause mortality risk in these patients is high (up to 27%), definitive diagnostics are recommended to screen all post-MI patients for ALVD, defined as left ventricular systolic dysfunction in the absence of heart failure symptoms. Post-MI management strategies for patients with ALVD target the two routes of progression to heart failure: (1) cardiac remodeling mediated by neurohormonal activation, and (2) continued and recurrent myocardial ischemic events. Clinical trials of neurohormonal antagonists in post-MI ALVD patients have shown that angiotensin-converting enzyme inhibitors attenuate left ventircular remodeling and that β-blocker therapy reverses remodeling for patients already on angiotensin-converting enzyme inhibitor therapy. Neurohormonal antagonist therapy is also associated with significant reductions in sudden death in post-MI ALVD patients.

© 2006 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Review

Received: June 10, 2005
Accepted: July 26, 2005
Published online: February 10, 2006
Issue release date: February 2006

Number of Print Pages: 13
Number of Figures: 9
Number of Tables: 0

ISSN: 0008-6312 (Print)
eISSN: 1421-9751 (Online)

For additional information: http://www.karger.com/CRD


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