Copyright © 1993 by the European Society of Cardiology.
© 1993 The European Society of Cardiology
Left ventricular systolic and diastolic dysfunction in the acute phases of myocardial ischaemia and infarction, and in the later phases of recovery. Function follows morphology
The Department of Medicine, School of Medicine, University of California at Los Angeles, and Cedars-Sinai Medical Center Los Angeles, California, U.S.A.
Correspondence: H. J. C. Swan, 1075 Wallace Ridge, Beverly Hills, CA, 90210, U.S.A.
Myocardial ischaemia and infarction result in major changes in myocardial function, due to the metabolic and structural cause. The observed morphological changes may be macroscopic—as in clinical myocardial infarction, microscopic—as in severe, prolonged ischaemia, or ultramicroscopic—in regard to the collagen matrix. Recognition of the vulnerability of these structures to the metabolic and mechanical stresses associated with severe ischaemia or infarction allows an understanding of the processes of acute dilatation, late adverse remodelling and compensatory hypertrophy, which determine both systolic and diastolic dysfunction and define the principal clinical complications. Morphology—‘Form’— is the primary determinant of function, while metabolic and other factors are secondary, variably dependent on the integrity of structure.
Key Words: Acute myocardial infarction • injury • ventricular dysfunction • cardiac volumes • collagen matrix