Myocardial infarction remodeling that progresses to heart failure: a signaling misunderstanding

After myocardial infarction, remodeling of the left ventricle involves a wound-healing orchestra involving a variety of cell types. In order for wound healing to be optimal, appropriate communication must occur; these cells all need to come in at the right time, be activated at the right time in the...

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Bibliographic Details
Published in:American journal of physiology. Heart and circulatory physiology 2018-07, Vol.315 (1), p.H71-H79
Main Authors: Mouton, Alan J, Rivera, Osvaldo J, Lindsey, Merry L
Format: Article
Language:English
Subjects:
Animals
Bioindicators
Biomarkers
Cell interactions
Extracellular matrix
Extracellular Matrix - metabolism
Extracellular Matrix - pathology
Heart attacks
Heart diseases
Heart failure
Heart Failure - etiology
Heart Failure - metabolism
Heart Failure - pathology
Homeostasis
Humans
Inflammation
Macrophages
Myocardial infarction
Myocardial Infarction - complications
Myocardial Infarction - metabolism
Myocardial Infarction - pathology
Myocardium - metabolism
Myocardium - pathology
Organs
Review
Signal Transduction
Ventricle
Wound healing
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Summary:After myocardial infarction, remodeling of the left ventricle involves a wound-healing orchestra involving a variety of cell types. In order for wound healing to be optimal, appropriate communication must occur; these cells all need to come in at the right time, be activated at the right time in the right amount, and know when to exit at the right time. When this occurs, a new homeostasis is obtained within the infarct, such that infarct scar size and quality are sufficient to maintain left ventricular size and shape. The ideal scenario does not always occur in reality. Often, miscommunication can occur between infarct and remote spaces, across the temporal wound-healing spectrum, and across organs. When miscommunication occurs, adverse remodeling can progress to heart failure. This review discusses current knowledge gaps and recent development of the roles of inflammation and the extracellular matrix in myocardial infarction remodeling. In particular, the macrophage is one cell type that provides direct and indirect regulation of both the inflammatory and scar-forming responses. We summarize current research efforts focused on identifying biomarker indicators that reflect the status of each component of the wound-healing process to better predict outcomes.
ISSN:0363-6135
1522-1539
DOI:10.1152/ajpheart.00131.2018