IKBFU's Vestnik

2016 Issue № 2

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Heart and blood vessels remodeling and the estimation of residual risk in patients with myocardial infarction



The author uses the notion of residual risk for the assessment of myocardial infarction (MI). In the acute phase of myocardial infarction, the majority of patients have remodelling of the myocardium with a predominant combination of cavity dilatation and hypertrophic left ventricle. One third of patients having endothelial dysfunction have remodelling of the myocardium. It explains a greater frequency of angina pectoris and the development of heart failure symptoms. Persistent remodelling is associated with impaired endothelium-dependent vasodilation; a significant number of patients develop paradoxical vasoconstriction. A combination of these factors largely determines the degree of residual risk after myocardial infarction. In addition to standard therapy, post-MI therapy should be aimed at correcting the remodelling of blood vessels and the myocardium. It will prevent the development of delayed complications.


1. Mendis S., Thygesen K., Kuulasmaa K. et al. World Health Organization definition of myocardial infarction: 2008—09 revisio // International Journal of Epidemiology. 2011. Vol. 40. Р. 139—146.
2. Thygesen K., Alpert J. S., White H. D. Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction. Universal definition of myocardial infarction // Circulation. 2007. Vol. 116. P. 2634—2653.
3. Rodriguez-Granillo G. A. Long-term effect of perindopril on coronariaterosclerosis progression (from the perindopril/ s Prospective Effect on Coronariaterosclerosis bу Angiographу and Intravascular Ultrasound Evaluation [PERSPECTIVE] // The American Journal of Cardiology. 2007. Vol. 100. P. 159—163.
4. Трухан Д. И., Тарасова Л. В. Оптимизация лекарственной терапии ишемической болезни сердца и артериальной гипертензии: выбор ингибитора ангиотензинпревращающего фермента // Системные гипертензии. 2014. Т. 11, № 1. С. 73—77.
5. Чернявская Т. К. Современные подходы к диагностике и коррекции эндотелиальной дисфункции у пациентов с артериальной гипертонией // Лечебное дело. 2013. № 2. С. 118—130.