Postinfarction left ventricular remodelling: where are the theories and trials leading us?

While mortality from overt ischaemic heart disease is falling, that from heart failure is increasing and reaching epidemic proportions. Although an aging population is partly responsible for this trend, recent observations showing persistently high mortality and morbidity rates following myocardial infarction further compounds the issue. An understanding of the pathophysiological processes leading to heart failure, and in particular the mechanisms underlying postinfarction heart failure (postinfarction ventricular remodelling) is therefore fundamental and forms the basis of this review.