Left Ventricular Dysfunction in Ischemic Heart Disease

Ischemic heart disease is a growing cause of heart failure owing to the increasing prevalence of diabetes, hypertension, and obesity. It is important to understand the concepts of myocardial stunning and hibernation so we as physicians can order appropriate testing on patients with ischemic heart disease, such as myocardial viability studies. Ventricular remodeling is associated with an elevated risk of death after myocardial infarction. The extent of myocardial viability determines the clinical outcome of patients after myocardial infarction. Multiple impactful clinical trials have changed the way we manage ischemic cardiomyopathy over the past few decades, and medications such as angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, beta-blockers, and aldosterone antagonists have improved outcomes in this patient population. Similarly, much has been reported on the effect of coronary artery bypass surgery on outcomes in patients with ischemic heart disease and heart failure, but further research studies are needed on the role of percutaneous coronary intervention.