Left ventricular remodelling post-myocardial infarction: pathophysiology, imaging, and novel therapies

Area of Science:

• Cardiovascular Medicine
• Pathophysiology
• Translational Research

Background:

• While acute myocardial infarction (MI) survival rates have improved, there is a concerning rise in heart failure (HF) prevalence.
• Post-MI cardiac remodelling significantly impacts patient prognosis and contributes to increased comorbidities and healthcare costs.
• Existing HF therapies target general pathways, but specific treatments for MI-induced remodelling are lacking.

Purpose of the Study:

• To review the pathophysiological mechanisms of cardiac remodelling after MI.
• To discuss current diagnostic approaches for identifying cardiac remodelling.
• To outline existing and potential future therapeutic strategies for managing post-MI cardiac remodelling and HF.

Main Methods:

• Comprehensive literature review of pathophysiological processes in cardiac remodelling post-MI.
• Analysis of current diagnostic tools for assessing cardiac structure and function changes.
• Evaluation of existing and emerging pharmacological and interventional treatment options.

Main Results:

• Identified key risk factors (e.g., diabetes, COPD, female sex) that influence the progression from MI to HF.
• Highlighted the limitations of current HF treatments in addressing specific remodelling pathways.
• Emphasized the need for improved patient risk stratification and targeted therapies.

Conclusions:

• Cardiac remodelling is a critical determinant of long-term outcomes after MI, driving HF development.
• There is a significant unmet need for targeted therapies and refined risk stratification tools.
• This review provides a roadmap for developing novel interventions to mitigate adverse cardiac remodelling and improve HF management.