Ischemic Cardiomyopathy and Heart Failure After Acute Myocardial Infarction

Marco Giuseppe Del Buono, Francesco Moroni, Rocco Antonio Montone, Lorenzo Azzalini, Tommaso Sanna, Antonio Abbate

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of Review: Ischemic cardiomyopathy refers to systolic left ventricular dysfunction in the setting of obstructive coronary artery disease and represents the most common cause of heart failure worldwide. It is often the combination of an irreversible loss of viable mass following an acute myocardial infarction (AMI) with a dysfunctional, but still viable, myocardium in the context of a chronically reduced myocardial blood flow and reduced coronary reserve. Medical treatments aiming at modulating neurohumoral response and restoring blood flow to the ischemic cardiomyocytes were shown to dramatically abate the occurrence of ventricular dysfunction and adverse remodeling in ischemic cardiomyopathy. Recent Findings: Novel therapeutic approaches, such as mechanical unloading and modulation of the inflammatory response, appear to be promising. Furthermore, the understanding of the mechanisms by which, despite optimal treatment, heart failure ensues after AMI, with or without adverse remodeling and systolic dysfunction, is a critical step in the search for novel ways to tackle heart failure risk beyond preservation of left ventricular volumes and systolic function. Summary: In this review article, we explore the principal pathophysiological mechanisms and pathways of heart failure in ischemic cardiomyopathy, therapeutic opportunities, and knowledge gaps in this area.

Original languageEnglish
Pages (from-to)1505-1515
Number of pages11
JournalCurrent Cardiology Reports
Volume24
Issue number10
DOIs
StatePublished - Oct 2022
Externally publishedYes

Keywords

  • Coronary artery disease
  • HFrEF
  • Heart failure
  • Ischemic cardiomyopathy
  • Myocardial infarction
  • Remodeling

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