Impact of endothelial dysfunction and myocardial fibrosis on prognosis in patients with chronic heart failure after myocardial infarction

Today, a promising direction for determining the prognosis of chronic heart failure (CHF) and its further clinical course is the study of predictors that reflect the pathogenesis of heart failure. Endothelial dysfunction is an independent predictor of the risk of cardiovascular events. Today, it is becoming more obvious that myocardial fibrosis plays a significant role in the pathogenesis of CHF in patients with myocardial infarction. Myocardial fibrosis is correlated with increased arrhythmias, hospitalization, and mortality in heart failure. The author searched for publications in the electronic databases PubMed, Web of Science, Google Scholar and ELibrary. The review article analyzes the prognostic value of endothelial dysfunction and myocardial fibrosis in patients with CHF who have had a myocardial infarction. There are two main histological forms of reactive fibrosis, interstitial and perivascular, which often coexist. Interstitial fibrosis is associated with chronic stressors. Perivascular fibrotic tissue is rich in inflammatory cell infiltrate and is more pronounced in conditions with predominant endothelial damage. Differentiating the effects of interstitial and perivascular fibrosis is difficult because these processes usually coexist.