[Possibilities of early surgical correction of postinfarction remodeling of the heart].

Postinfarction remodeling of the heart (PIRH) has unfavorable prognostic value because is associated with elevated risk of fatal arrhythmias, emergence and progression of heart failure. Reversibility of PIRH in early period after myocardial infarction causes interest. We followed dynamics of echocardiographical parameters in a patient who had undergone myocardial infarction with subsequent aorto-coronary bypass operation. Values of left ventricular end diastolic and end-systolic volumes were as follows: baseline - 147 and 70, in the process of infarction - 281 and 141, in 1 month after infarction - 298 and 194, in 10 days after surgery - 194 and 88, in 1 year after surgery - 194 and 83 ml, respectively. Thus PIRH is substantially reversible in the early period after myocardial infarction followed by adequate cardiac muscle revascularization. In can be supposed that at the moment of infarction an abrupt progression of stenotic atherosclerosis of the coronary arteries occurs due to complete or subtotal occlusion of vessels, what aggravates myocardial ischemia and predominantly determines course of subsequent PIRH.