Ventricular Dilatation and Remodeling After Myocardial Infarction JOHN A. RUMBERGER, PH.D., M.D.  Mayo Clinic Proceedings  Volume 69, Issue 7, Pages 664-674 (July 1994) DOI: 10.1016/S0025-6196(12)61345-7 Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 1 Interactive and progressive factors that influence physiologic responses and prognosis after myocardial infarction. LV = left ventricular. Mayo Clinic Proceedings 1994 69, 664-674DOI: (10.1016/S0025-6196(12)61345-7) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 2 Ultrafast computed tomographic scan of 35-year-old woman at end-diastole (A) and end-systole (B) 1 year after transmural lateral wall myocardial infarction. Circular area is left ventricle, and crescentic-shaped right ventricle is to the left. Note, in particular, thin infarcted myocardium surrounding contrast-filled left ventricular chamber in lateral-inferior myocardial wall (right and inferior to center of left ventricular chamber). Mayo Clinic Proceedings 1994 69, 664-674DOI: (10.1016/S0025-6196(12)61345-7) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 3 Electron photomicrograph of normal (A) and acutely infarcted (B) myocardium. Myocytes are uniform in shape and site in normal myocardium but are in disarray with myocyte bundle rearrangement (“slippage”) evident in acutely infarcted myocardium. Mayo Clinic Proceedings 1994 69, 664-674DOI: (10.1016/S0025-6196(12)61345-7) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 4 Serial changes in absolute left ventricular end-diastolic volume (LVEDV), left ventricular muscle mass (LVM), and volume/mass (V/M) ratio during first year after anterior wall myocardial infarction, d/c = discharge; * = P<0.05 versus discharge. (From Rumberger and associates.18 By permission of The American College of Cardiology.) Mayo Clinic Proceedings 1994 69, 664-674DOI: (10.1016/S0025-6196(12)61345-7) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 5 Schematic drawing of serial adaptations related to cardiac remodeling in infarct and noninfarct regions after initial transmural infarction. (See text for details.) Mayo Clinic Proceedings 1994 69, 664-674DOI: (10.1016/S0025-6196(12)61345-7) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 6 Cumulative mortality from all causes in Survival and Ventricular Enlargement study groups. (See text for details.) (From Pfeffer and associates.48 By permission of The New England Journal of Medicine.) Mayo Clinic Proceedings 1994 69, 664-674DOI: (10.1016/S0025-6196(12)61345-7) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 7 Schematic illustration of proposed “natural history” of postinfarction cardiac remodeling. (See text for details.) CHF = congestive heart failure; m O2 = minute venous oxygen consumption; V/M = volume/mass ratio. Mayo Clinic Proceedings 1994 69, 664-674DOI: (10.1016/S0025-6196(12)61345-7) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions