Collagen and ventricular remodeling after acute myocardial infarction: concepts and hypotheses

Most attention in the treatment of acute myocardial infarction has focussed on methods to limit muscle injury. In contrast, little attention has been paid to another important component of the myocardium; namely the collagen. In this article, I will propose three hypothetical methods of manipulating collagen that all have the potential to limit the amount of ventricular expansion that occurs after myocardial infarction. These methods are: 1) limitation of the amount of damage to the myocardial collagen matrix, 2) enhancement of collagen production in the scar, and 3) promotion of scar shrinkage.