Document Detail


First evidence of depressed contractility in the border zone of a human myocardial infarction.
MedLine Citation:
PMID:  22326127     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The temporal progression in extent and severity of regional myofiber contractile dysfunction in normally perfused border zone (BZ) myocardium adjacent to a myocardial infarction (MI) has been shown to be an important pathophysiologic feature of the adverse remodeling process in large animal models. We sought, for the first time, to document the presence of impaired contractility of the myofibers in the human BZ myocardium.
METHODS: A 62-year-old man who experienced an MI in 1985 and had recently had complete revascularization was studied. Myofiber systolic contractile stress developed in the normally perfused BZ adjacent to the MI (T(max_B)) and that developed in regions remote from the MI (T(max_R)) were quantified using cardiac catheterization, magnetic resonance imaging, and mathematical modeling.
RESULTS: The resulting finite element model of the patient's beating left ventricle was able to simulate the reduced systolic strains measured using magnetic resonance imaging at matching left ventricular pressures and volumes. The T(max_B) (73.1 kPa) was found to be greatly reduced relative to T(max_R) (109.5 kPa). These results were found to be independent of assumptions relating to BZ myofiber orientation.
CONCLUSIONS: The results of this study document the presence of impaired contractility of the myofibers in the BZ myocardium and support its role in the post-MI remodeling process in patients. To fully establish this important conclusion serial evaluations beginning at the time of the index MI will need to be performed in a cohort of patients. The current study supports the importance and demonstrates the feasibility of larger and longer-term studies.
Authors:
Jonathan F Wenk; Doron Klepach; Lik Chuan Lee; Zhihong Zhang; Liang Ge; Elaine E Tseng; Alastair Martin; Sebastian Kozerke; Joseph H Gorman; Robert C Gorman; Julius M Guccione
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-02-09
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  93     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-27     Completed Date:  2012-06-15     Revised Date:  2013-09-09    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1188-93     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Mechanical Engineering, University of Kentucky, Lexington, Kentucky, USA.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Catheterization
Coronary Artery Bypass
Finite Element Analysis
Heart Ventricles / pathology,  physiopathology
Humans
Imaging, Three-Dimensional
Magnetic Resonance Imaging
Male
Middle Aged
Models, Cardiovascular
Myocardial Contraction*
Myocardial Infarction / pathology*,  physiopathology*,  surgery
Ventricular Dysfunction, Left / diagnosis,  pathology,  physiopathology*
Ventricular Remodeling*
Grant Support
ID/Acronym/Agency:
R01 HL063954/HL/NHLBI NIH HHS; R01 HL077921/HL/NHLBI NIH HHS; R01 HL077921-05A1/HL/NHLBI NIH HHS; R01 HL077921-06/HL/NHLBI NIH HHS; R01 HL086400-02/HL/NHLBI NIH HHS; R01-HL063954/HL/NHLBI NIH HHS; R01-HL073021/HL/NHLBI NIH HHS; R01-HL077921/HL/NHLBI NIH HHS; R01-HL086400/HL/NHLBI NIH HHS; R01-HL103723/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Ann Thorac Surg. 2012 Apr;93(4):1193-4   [PMID:  22450072 ]

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