Aspects of Myocardial Infarction-induced Remodeling relevant to the Development of Heart Failure

Heart failure can be defined as the pathophysiological state in which the pump function of the heart is insufficient to meet the metabolic demands of the body (Guyton, 1986; Ruggie, 1986). Thus, heart failure is a pathophysiological condition (rather than a disease per se), and can occur in the course of a number of cardiovascular diseases. In Western countries, hypertension and coronary artery disease or a combination of both account for the majority of cases of heart failure (McKee & Castelli, 1971; Kannel & Castelli, 1972; Eriksson & Svardsudd, 1989). Cardiomyopathies (of genetic, viral, toxic or idiopathic origin) and congenital heart disease are other important etiological factors (Eriksson & Svardsudd, 1989). In developing countries, acquired abnormalities of heart valves due to the sequelae of streptococcal infection are a common cause of heart failure (Killip, 1985). The incidence of heart failure gradually increases with age, resulting in an incidence rate of 1011000 per year for men, and 8/1000 per year for women (McKee & Castelli, 1971; Kannel & Castelli, 1972; Ho el at., 1993) in the over·65 age group.

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