[The role of the myocardial interstitium in left ventricular remodeling after acute myocardial infarction].

An acute myocardial infarction (MI) is characterized by a change in the protein composition not only in the infarct area but, also, in the area not involved; the remodelling of cardiac tissue is the consequence of synthesis of qualitatively and quantitatively different collagenous and non-collagenous proteins. The authors discuss the biochemical and structural characteristics of extracellular space proteins (the main types of cardiac collagen include collagens I, III, IV and V, with an important role played by glycoproteins). The mechanisms involved in the alteration of the architecture of a left ventricle affected by an MI include the changed ratios of these proteins along with an effect on the structure and enzymatic activity of contractile proteins and myocyte slippage; these factors largely affect not only myocardial function but, also, the patient's prognosis. Despite a number of published data (mainly on the effect of ACE inhibitors), it is evident that the issue of controlling the quality and scar formation following an MI requires further study by clinical and experimental cardiologists.