The clinical understanding of the determinants of mechanical function and oxygen requirements of the myocardium have now been applied to the patient with acute myocardial infarction. Invasive and noninvasive techniques to quantitate afterload, contractile state, preload, and heart rate as well as to assess the metabolic state and infarct size are now available to evaluate a growing list of therapeutic interventions. Thus, the availability of pharmacologic and metabolic agents to support ischemic myocardium and to reduce the eventual loss of contracting myocardium appears promising to the patient with acute myocardial infarction.
