Ischaemic cardiomyopathy: pathophysiology, assessment and the role of revascularisation

Ischaemic cardiomyopathy. Pathophysiological insights, diagnostic management and the roles of revascularisation and device treatment. Gaps and dilemmas in the era of advanced technology

“…Early remodelling involves wall thinning and dilatation, with irreversible late remodelling resulting from myocardial fibrosis and scar. 2 In addition, subsequent changes in the ventricular shape and geometry are often associated with valvular abnormalities such as functional MR that can further accelerate the deleterious structural changes in the left ventricle through volume overload. Annular enlargement secondary to LV dilatation, tenting of the of the mitral leaflets by LV remodelling, papillary muscle displacement and increased chordal traction are key components of the pathogenetic mechanisms underlying functional/ischaemic regurgitation.…”

“…Successful revascularisation in this context has lead to an improved survival of patients that have suffered an AMI but with an inevitable trade-off of an upsurge in the prevalence of ICM. 2 Although there is no general consensus regarding the definition of ICM, the latter is considered as a left ventricular (LV) dysfunction in the presence of severe coronary artery disease including at least one of the following characteristics: prior revascularisation or AMI; >75% stenosis in the left main stem or the left anterior descending artery; two or more coronary vessels with >75% luminal stenosis. 3 The pathophysiological milieu behind ICM involves a spectrum of metabolic, neurohumoral and inflammatory changes resulting in an adverse myocardial remodelling and contractile dysfunction in the context of significantly impaired myocardial blood flow and/or reduced coronary flow reserve.…”

Combining Nanomaterials and Developmental Pathways to Design New Treatments for Cardiac Regeneration: The Pulsing Heart of Advanced Therapies

“…The treatment options for MI range from anti-inflammatory, anti-coagulants and analgesic drugs to angioplasty, coronary bypass or electronic implants, up to heart transplantation in the most severe cases (Lu et al, 2015). However, if the ischemic event persists for prolonged period, the damage to the heart muscle can be irreversible, and cardiac remodeling, achieved by myocardial fibrosis, results in impaired cardiac function (Briceno et al, 2016). Non-ischemic cardiomyopathies refer, instead, to muscle diseases affecting heart size, shape and structure, that eventually reduce the pumping function of the organ (Chan et al, 2018).…”

Diastolic function of the left ventricle in patients with cardiomyopathy and low ejection fraction: the role of torsion in left bundle branch block

“…Всем боль-ным была выполнена коронаровентрикулография. Под ишемической кардиомиопатией понималась си-столическая дисфункция ЛЖ с развитием застойной сер-дечной недостаточности при наличии одного или бо-лее из перечисленных признаков: наличие в анамне-зе инфаркта миокарда или реваскуляризации миокарда, стеноз ствола левой коронарной артерии, передней нис-ходящей коронарной артерии или двух и более коро-нарных сосудов со стенозом более 75% [6]. Диагноз ди-латационной кардиомиопатии устанавливался на ос-новании критериев, предложенных Mestroni L. и соавт [7].…”