Heart rhythm disorders and myocardial remodeling in patients with ST-segment elevation acute myocardial infarction

Contact address: Razvan O Mada, MD, „Niculae Stancioiu” Heart Institute, 19-21 Motilor Street, 400001, Cluj-Napoca, Romania. E-mail: mada_razvan@yahoo.com 1 „Niculae Stancioiu” Heart Institute, Cluj-Napoca, Romania ACUTE MYOCARDIAL INFARCTION According to the Fourth Universal Defi nition, type I ST-segment elevation acute myocardial infarction results from a complicated atherosclerotic coronary plaque leading to occlusion or subocclusion of the involved artery1. The subsequent ischemia leads to myocardial interstitial edema and even necrosis whenever the coronary blood fl ow is not timely restored. However, even effective percutaneous coronary intervention (PCI) performed in the therapeutic window with complete blood fl ow restoration has the potential to induce myocardial damage due to the reperfusion injury4,5. Recent data have shown that large epicardial vessels are not the only responsible for the tissue injury in STEMI. A microvascular obstruction (MVO) is found INTRODUCTION ST-segment elevation acute myocardial infarction (STEMI), the most severe form of ischemic heart disease, is one of the leading causes of mortality in the world. This patient population usually dies from either heart rhythm disorders or heart failure1,2. The exact underlying pathophysiology of the acute myocardial infarction (AMI) has not been fully understood yet. However, recent data have brought to the spotlight the role of infl ammation in the development and further evolution of this severe pathology3. This review synthesizes the current knowledge in what concerns the pathophysiology of AMI and the subsequent heart rhythm disorders, as well as possible future perspectives. Abstract: Acute myocardial infarction is a potential life threatening disease spread all over the world. The continuing progress of medical and interventional therapies requires a comprehensive understanding of the underlying pathophysiology. Moreover, the potential development of heart failure or/and arrhythmias in either acute or chronic setting, demand a deep knowledge of their molecular mechanisms in order to provide adequate treatments. This review aims to summarize the current data regarding the etiopathogenesis of acute myocardial infarction and the heart rhythm disorders associated with this clinical condition.