[Post-infarct cardiac remodelling: A problem in quest of prevention and therapy]

Cardiac remodelling (REM) is the most important cause of heart failure after myocardial itifarct. It is characterised by cardiac dilation and an evolution towards the fetal phenotype and myocardial fibrosis. The " primum movens " is cardiac cell death caused by necrosis andlor apoptosis. Therapeutic approaches include early reperfusion by primary angioplasty or thrombolysis. Pharmaceutical interventions are completed by cardiac resynchronization. LVAD placement, stem cell infusion and gene therapy, i.e. transfer of SERCA-2 or protein phosphatase 1 inhibition, and exercise, a simple and inexpensive modality.