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Infarct Scar. Living Tissue

2003; Springer Nature; Linguagem: Inglês

10.1007/978-1-4419-9262-8_23

1389-1774

Karl T. Weber,

Cardiac electrophysiology and arrhythmias

Heart failure, a worldwide health problem, is most commonly due to ischemic cardiomyopathy (ICM) with previous myocardial infarction(s). Herein, insights into the infarct scar as living tissue (and which resembles heart valve leaflets) are reviewed. This includes: a) its population of persistent, metabolically active myofibroblasts, whose elaboration of angiotensin II regulates (via AT1 receptor-ligand binding) their production of TGF-β1 and, in turn, type I fibrillar collagen; b) its neovasculature, which nourishes these fibroblast-like cells; and c) its contractile tonus. Scar tissue myofibroblasts regulate the accumulation of collagen found at sites remote to the infarct and it is this interstitial fibrosis that represents a major component to the adverse structural remodeling seen in ICM. The management of heart failure due to ICM therefore needs to take into account the behavior of infarct scar myofibroblasts.