Left ventricular remodeling after acute myocardial infarction [AMI] affects the prognosis of patients. It involves infarct expansion, dilatation [or hypertrophy] of the non-infarcted myocardium.
To assess the early topographic changes after transmural AMI, 20 patients were studied during the first 2 weeks after infarction by serial 2D echo. Studies were done on day 5 and day 12 post-infarction. With the use of the papillary muscles as internal LV l and marks, anterior and posterior segments dilatation in each patient were assessed. Ten patients received captopril to assess its effect on remodeling, six normal persons were studied as a control group. Expansion of infarction occurred in 70% of patients, those who developed expansion were older patients, heavy smokers, with a history of hypertension. Those who received captopril had less incidence of infarct expansion and less dilatation of the non-infarcted myocardium. Patients who had infarct expansion had more incidence of congestive heart failure. It is concluded that if patients with infarct expansion could be identified early by sequential 2D echo, it is likely that captopril therapy could attenuate this process, limit progression of ventricular dilatation and improves cardiac function
M. Sobhy ,
Left ventricular expansion and remodeling of the myocardium in patients with acute myocardial infarction: effect of angiotensin converting enzyme inhibitor,
Bull. Alex. Fac. Med. 1994;
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