Document Detail

Does reperfusion extend necrosis? A study in a single territory of myocardial ischemia--half reperfused and half not reperfused.
MedLine Citation:
PMID:  2393986     Owner:  NLM     Status:  MEDLINE    
The purpose of this study was to confirm or disprove the existence of reperfusion-induced extension of necrosis. To avoid the effect of the variability of collateral circulation when groups of dogs are compared, we compared the effect of reperfusion and nonreperfusion on myocardial necrosis in a single ischemic territory, half of which was reperfused and half of which was not. The left anterior descending coronary artery (LAD) territory between its last diagonal branch and the apex was studied because it was found to have uniform collateral blood flow. In 20 dogs, the LAD was occluded for 90-240 minutes to produce necrosis of different degrees of transmurality. Before release of this occlusion, the LAD was occluded distally halfway to the apex to keep the distal half nonreperfused. After 5 minutes of proximal reperfusion. Monastral blue dye was injected into the left atrium for demarcation of the reperfused region, and the heart was arrested, excised, cut parallel to the LAD, and placed into triphenyl tetrazolium chloride (TTC) solution for delineation of the region of necrosis. The validity of TTC staining under the conditions of this study was confirmed by light and electron microscopy. The transmurality of necrosis, measured within 1 or 0.5 cm on either side of the boundary, ranged from 30% to 88% of wall thickness and was not different in the reperfused compared with the nonreperfused region (paired t test). Reperfusion did not advance the epicardial edge of necrosis compared with the nonreperfused region. In conclusion, at 5 minutes after reperfusion, comparison of necrosis in the reperfused and nonreperfused halves of a single ischemic territory could not demonstrate an extension of necrosis by reperfusion.
W Ganz; I Watanabe; K Kanamasa; J Yano; D S Han; M C Fishbein
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  82     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1990 Sep 
Date Detail:
Created Date:  1990-10-09     Completed Date:  1990-10-09     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1020-33     Citation Subset:  AIM; IM    
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, Calif.
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MeSH Terms
Coronary Disease / pathology*
Microscopy, Electron
Myocardial Reperfusion*
Myocardial Reperfusion Injury / pathology*
Myocardium / pathology*,  ultrastructure
Grant Support
Comment In:
Circulation. 1991 Apr;83(4):1459-60   [PMID:  2013164 ]
Circulation. 1990 Sep;82(3):1070-2   [PMID:  2136248 ]

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