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Cardiology TrialsReview of Survival and Ventricular Enlargement (SAVE) TrialNEJM 1992;327:669-77 Background After a large heart attack, cardiac hemodynamics are altered, which leads to a series of changes in the heart muscle itself. The immediate consequence of a large heart attack is decreased myocardial contractility. This leads to a reduction in stroke volume and cardiac output. Compensatory mechanisms governed by the renin-angiotensin-aldosterone system and sympathetic nervous system become activated and may lead to ventricular dilation or “remodeling”, which has negative short and long-term consequence for the heart muscle.By the mid-1980’s, angiotensin converting enzyme inhibitors (ACEi) were commonly used for patients with chronic systol...2024-01-3009 min
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