Influence of methods of pharmacotherapy in myocardial remodeling of the left ventricle in patients with acute myocardial infarction after reperfusion in the prevention of the formation of CHF (review of literature)

Author(s):  L.V. Shekhovtsova, Belgorod National Research University, Belgorod, Russia

O.A. Osipova, Dr., Prof., Belgorod National Research University, Belgorod, Russia, osipova_75@inbox.ru

A.I. Golovin, Belgorod National Research University, Belgorod, Russia

K.G. Plaksina, Belgorod National Research University, Belgorod, Russia

A.A. Dolzhikov, Dr., Prof., Belgorod National Research University, Belgorod, Russia

Issue:  Volume 41, № 4

Rubric:  Clinical Medicine

Annotation:  In this literature review, we studied the influence of left ventricular (LV) myocardial remodeling on the progression of chronic heart failure (CHF) against the background of acute myocardial infarction with ST-segment elevation (STEMI). Myocardial remodeling with the organization of fibrosis is a process that combines pathological changes occurring at the level of the interstitial space of the myocardium and macromorphological structures as a whole. Myocardial fibrosis is one of the leading markers of LV systolic-diastolic dysfunction in patients with STEMI, even after myocardial reperfusion. The article analyzes the literature of new clinical studies confirming the role of the mineralocorticoid receptor antagonist (MRA) is a blocker of aldosterone after suffering STEMI, a decrease in the synthesis of markers involved in the formation of fibrosis in viable myocardium. Describes new mechanisms of influence on systolo-diastolic dysfunction of the LV, methods of pharmacotherapy involved in the prevention of the formation of CHF in patients with STEMI after myocardial reperfusion.

Keywords:  acute coronary syndrome, remodeling of myocardium of the left ventricle, chronic heart failure, postinfarction cardiosclerosis, mineralocorticoid receptor antagonist

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