Fara A M
Methodist Hospital of Indiana, Inc., Indianapolis.
J Cardiovasc Nurs. 1993 Oct;8(1):32-48. doi: 10.1097/00005082-199310000-00006.
Ventricular remodeling is a pathologic change in the size and shape of the heart after myocardial infarction. Human and animal studies have described the mechanisms responsible for the thinning and enlargement that progresses for years beyond the initial infarction. As a result of elevations in preload and afterload, ventricular pressures increase, and changes occur in both the infarcted and uninfarcted regions of the ventricle, increasing overall heart size. Recent investigation has demonstrated that the initiation of angiotensin-converting enzyme (ACE) inhibitor drugs after myocardial infarction reduces both systolic and diastolic wall stresses, thereby averting changes in heart size. These findings are significant, as increases in heart size and ventricular volumes have proved to be powerful predictors of early mortality after myocardial infarction.
心室重构是心肌梗死后心脏大小和形状的病理性改变。人体和动物研究已经描述了导致心脏变薄和扩大的机制，这种变化在初始梗死数年之后仍会持续发展。由于前负荷和后负荷升高，心室压力增加，心室梗死区和未梗死区均发生改变，导致心脏整体增大。最近的研究表明，心肌梗死后开始使用血管紧张素转换酶（ACE）抑制剂药物可降低收缩期和舒张期壁应力，从而避免心脏大小改变。这些发现意义重大，因为心脏大小和心室容积增加已被证明是心肌梗死后早期死亡率的有力预测指标。
