ABSTRACT
Structural and biochemical modifications of the myocardium (remodeling) occur after acute myocardial infarction. An important part of this process of myocardial remodeling takes place in the intersticial compartment which is comjposed mainly of fibrillar collagen. These remodeling changes are associated with modifications in left ventricular geometry and function that could be deletereous and have significant clinical manifestations. Some salutatory effects of the treatment are related to modifications of the process of intersticial remodeling. Clinical studies with calcium channel antagonists, nitrtes and, specially converting enzyme inhibitors have shown significant in the degree of ventricular dilation, hemodynamics and exercise tolerance as a comapred to palcebo treated patients. Ongoing clinical studies will provide us with more definite information on the effects of converting enzyme inhibitors on long term prongnosis as vell as on myocardial remodeling after acute myocardial infarction