الفهرس | Only 14 pages are availabe for public view |
Abstract ST elevation acute myocardial infarction (STEMI) is a clinical syndrome defined by characteristic symptoms of myocardial ischemia in association with persistent electrocardiographic ST elevation and subsequent release of biomarkers of myocar¬dial necrosis. Ischemic heart disease is the leading cause of deaths worldwide. The primary goal of treatment during the acute phase of the disease is to preserve as much myocardium as possible while avoiding further complications. Patients with persistent ST-segment elevation are candidates for reperfusion therapy either primary percutaneous intervention (PPCI) or thrombolytic therapy to restore flow in the occluded epicardial infarct-related artery. Up to 50% of patients fail to achieve significant recovery of LVEF in the months following an acute MI despite revascularization and adequate medical treatment. Lack of cardiac functional recovery is moderated by the undergoing progressive adverse myocardial remodeling. Remodelling is ultimately a response to damage, even in the non-ischemic myocardium, to adjust for the increased workload. Long term cardiac remodelling distorts tissue structure, increases tissue stiffness, and accounts for systolic and diastolic ventricular dysfunction, heart failure and poor prognosis. |