Читать книгу Practical Cardiovascular Medicine - Elias B. Hanna - Страница 119
XII. LV remodeling and infarct expansion after MI (see Figure 2.5) XIII. Discharge, EF improvement, ICD A. Discharge medications
ОглавлениеSee Chapter 1, Section VI.
B.EF improves 1–3 months after discharge and justifies follow-up echocardiography for risk assessment. There are two explanations for EF improvement:
LV dysfunction that occurs immediately after MI is partly due to post-ischemic stunning rather than necrosis. When an artery occludes transiently, necrosis occurs in part of the myocardium, while dysfunction without necrosis, called stunning, occurs in other parts. The stunned myocardium recovers over the course of days to weeks after arterial recanalization.
ACE-Is, β-blockers, and aldosterone antagonists reduce LV remodeling and LV size, allowing an increase in EF for the same amount of necrotic myocardium (Figure 2.5). Each one of these drugs allows an EF improvement of up to 5%.
