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J Am Coll Cardiol. 2014 Apr 29;63(16):1593-603. doi: 10.1016/j.jacc.2014.01.014. Epub 2014 Feb 13.

Anti-inflammatory strategies for ventricular remodeling following ST-segment elevation acute myocardial infarction.

Author information

1
Cardiology Department, FLENI Foundation, Buenos Aires, Argentina.
2
VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia; Victoria Johnson Research Laboratory, Virginia Commonwealth University, Richmond, Virginia.
3
VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia; Victoria Johnson Research Laboratory, Virginia Commonwealth University, Richmond, Virginia; School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia.
4
VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia; Victoria Johnson Research Laboratory, Virginia Commonwealth University, Richmond, Virginia. Electronic address: aabbate@mchv-vcu.edu.

Abstract

Acute myocardial infarction (AMI) leads to molecular, structural, geometric, and functional changes in the heart in a process known as ventricular remodeling. An intense organized inflammatory response is triggered after myocardial ischemia and necrosis and involves all components of the innate immunity, affecting both cardiomyocytes and noncardiomyocyte cells. Inflammation is triggered by tissue injury; it mediates wound healing and scar formation and affects ventricular remodeling. Many therapeutic attempts aimed at reducing inflammation in AMI during the past 3 decades presented issues of impaired healing or increased risk of cardiac rupture or failed to show any additional benefit in addition to standard therapies. More recent strategies aimed at selectively blocking one of the key factors upstream rather than globally suppressing the response downstream have shown some promising results in pilot trials. We herein review the pathophysiological mechanisms of inflammation and ventricular remodeling after AMI and the results of clinical trials with anti-inflammatory strategies.

KEYWORDS:

acute myocardial infarction; inflammation; ventricular remodeling

PMID:
24530674
DOI:
10.1016/j.jacc.2014.01.014
[Indexed for MEDLINE]
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