Vaughan D E, Pfeffer M A
Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts.
Cardiovasc Res. 1994 Feb;28(2):159-65. doi: 10.1093/cvr/28.2.159.
Regional alterations in left ventricular function are generally present in patients who sustain an acute myocardial infarction. Segmental wall motion abnormalities in left ventricular systolic function can be identified in the hyperacute period and generally persist in patients with myocardial infarction. Through the process of infarct expansion, the infarcted territory may thin and lengthen in the short term following a myocardial infarction. Some infarct survivors are also prone to further progressive alterations in the shape and size of the left ventricle, a process that has been termed "postinfarction ventricular remodelling". Although a component of left ventricular remodelling appears to represent an adaptive process serving to preserve stroke volume and cardiac output following myocardial injury, the enlargement process may have undesirable long term effects on global left ventricular function and on clinical prognosis. Fortunately, recent experimental and clinical evidence shows that ventricular remodelling and its deleterious consequences may be preventable.
急性心肌梗死患者通常存在左心室功能的局部改变。在超急性期即可识别出左心室收缩功能的节段性室壁运动异常，并且在心肌梗死患者中一般会持续存在。通过梗死扩展过程，梗死区域在心肌梗死后短期内可能会变薄并拉长。一些梗死幸存者还容易出现左心室形状和大小的进一步渐进性改变，这一过程被称为“梗死后心室重构”。虽然左心室重构的一部分似乎代表了一种适应性过程，有助于在心肌损伤后维持每搏输出量和心输出量，但扩大过程可能会对整体左心室功能和临床预后产生不良的长期影响。幸运的是，最近的实验和临床证据表明，心室重构及其有害后果可能是可以预防的。
