Document Detail


Myocardial Edema After Ischemia/Reperfusion Is Not Stable and Follows a Bimodal Pattern: Advanced Imaging and Histological Tissue Characterization.
MedLine Citation:
PMID:  25460833     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: It is widely accepted that after myocardial ischemia/reperfusion edema occurs early in the ischemic zone and persists in stable form for at least 1 week. However, there are no longitudinal studies covering from very early (minutes) to late (one week) reperfusion stages confirming this phenomenon.
OBJECTIVES: To perform a comprehensive longitudinal imaging and histological tissue characterization of the edematous reaction after experimental myocardial ischemia/reperfusion.
METHODS: The study population consisted of 25 instrumented Large-White pigs (30-40 Kg). Closed-chest 40min ischemia/reperfusion was performed in 20 pigs, which were sacrificed at 120 minutes (n=5), 24 hours (n=5), 4 days (n=5) and 7 days (n=5) after reperfusion and processed for histological quantification of myocardial water content. Cardiac magnetic resonance (CMR) scans with T2W-STIR and T2-mapping sequences were performed at every follow-up stage until sacrifice. Five additional pigs sacrificed after baseline CMR served as controls.
RESULTS: In all pigs, reperfusion was associated with a significant increase in T2 relaxation times in the ischemic region. On 24-hour CMR, ischemic myocardium T2 times returned to normal values (similar to those seen pre-infarction). Thereafter, there was a progressive systematic increase in ischemic myocardium-T2 times in CMR performed on days 4 and 7 after reperfusion. On day7-CMR T2 relaxation times were as high as those observed at reperfusion. Myocardial water content analysis in the ischemic region showed a parallel bimodal pattern: two high water content peaks at reperfusion and day 7, with a significant decrease at 24 hours.
CONCLUSIONS: Contrary to the accepted view, myocardial edema during the first week after ischemia/reperfusion follows a bimodal pattern. The initial wave appears abruptly upon reperfusion and dissipates at 24 hours. Conversely, the deferred wave of edema, appears progressively days after ischemia/reperfusion and is maximal around day 7 after reperfusion.
Authors:
Rodrigo Fernández-Jiménez; Javier Sánchez-González; Jaume Aguero; Jaime García-Prieto; Gonzalo J López-Martín; José M García-Ruiz; Antonio Molina-Iracheta; Xavier Rosselló; Leticia Fernández-Friera; Gonzalo Pizarro; Ana García-Álvarez; Erica Dall'Armellina; Carlos Macaya; Robin P Choudhury; Valentin Fuster; Borja Ibanez
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-17
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  -     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-12-2     Completed Date:  -     Revised Date:  2014-12-3    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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