EXPANSION OF ACUTE MYOCARDIAL-INFARCTION - AN EXPERIMENTAL-STUDY
EXPANSION OF ACUTE MYOCARDIAL-INFARCTION - AN EXPERIMENTAL-STUDY
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DOI：
10.1161/01.cir.65.7.1446
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发表时间：
1982-01-01
期刊：
影响因子：
37.8
通讯作者：
BULKLEY, BH
中科院分区：
文献类型：
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作者：
HOCHMAN, JS;BULKLEY, BH
已证明人类急性梗死心肌的扩张（局部扩张和变薄）与总体心脏扩张和破裂相关。在大鼠中研究了大体和组织病理学特征以及扩张的时间过程。在84只大鼠中通过结扎左冠状动脉来产生血栓，并在1、2、3、4、5和7天进行研究。所有心脏均通过K舒张期停搏、凝胶扩张和固定来准备。扩张分级为0至4+：1+，梗死壁轻度变薄; 2+，轻度变薄和扩张; 3+，中度变薄和扩张; 4+，显著变薄和扩张。有80例透壁性梗死，66%显示扩张; 80例中有36例（45%）为1-2+级，80例中有17例（21%）为3-4+级。4例完全非透壁性梗死均无扩张。61%的透壁性梗死在1-2天出现扩张，65%在3-4天出现扩张，80%在5-7天出现扩张。在此期间，严重（3-4+）扩张的大鼠百分比显著增加，从1-2天的0%增加到3-4天的23%，再到5-7天的65%。组织学梗死进展速度大约是人类的两倍; 5至7天的梗死显示出发育良好的肉芽组织。因此，可以在动物模型中产生扩增。17%的临界梗死面积似乎是显著（> 1+）扩张所必需的，扩张程度与梗死面积相关。虽然这种现象在梗死后早期就开始了，但其程度会在几天内发展，因此可以进行干预以中断其发展。
Expansion (regional dilatation and thinning) of acutely infarcted myocardium in man has been shown to correlate with overall cardiac dilatation and rupture. Gross and histopathologic features and the time course of expansion were studied in rats. Infarcts were produced in 84 rats by ligation of the left coronary artery and studied at 1, 2, 3, 4, 5 and 7 days. All hearts were prepared by K diastolic arrest, gel distention and fixation. Expansion was graded 0 to 4+:1+, mild thinning of infarcted wall; 2+, mild thinning and dilatation; 3+, moderate thinning and dilatation; and 4+, marked thinning and dilatation. There were 80 transmural infarcts, and 66% showed expansion; 36 of 80 (45%) were graded 1-2+ and 17 of 80 (21%) 3-4+. None of the 4 exclusively nontransmural infarcts showed expansion. Expansion was present in 61% of transmural infarcts at 1-2 days, in 65% at 3-4 days and in 80% at 5-7 days. The percentage of rats with severe (3-4+) expansion increased markedly over this period, from 0% at 1-2 days to 23% at 3-4 days to 65% at 5-7 days. Histopathologic infarct evolution was roughly twice as rapid as that of humans; 5 to 7 day-old infarcts showed well-developed granulation tissue. Thus, expansion can be produced in an animal model. A critical infarct size of 17% appeared necessary for significant (> 1+) expansion, and the degree of expansion correlated with infarct size. Although this phenomenon begins early after infarction, its extent progresses over days, making interventions to interrupt its development feasible.