The elderly are particularly vulnerable to the consequences of cardiac remodeling as, in this population, the incidence of myocardial infarction is higher and remodeling precipitates overt heart failure more rapidly than in younger patients. Furthermore, thrombolytic therapy is less effective and has more contraindications in this age-group. Although no studies have specifically addressed remodeling in the elderly, the findings of large trials suggest that thrombolytic therapy and early initiation of angiotensin-converting enzyme (ACE) inhibition, especially following extensive anterior myocardial infarction, may prevent or reduce the dilation of the left ventricle. Recent reports show that the ß-blockers improve survival and functional capacity in patients with severe left ventricular dysfunction, but whether this beneficial effect, which is additive to that of the ACE inhibitors, is correlated with regression of remodeling remains to be determined...