Document Detail

Relevance of apoptosis in influencing recovery of hibernating myocardium.
MedLine Citation:
PMID:  17127093     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Hibernating myocardium (HM) is viable but dysfunctional myocardium which can recover following revascularization. Myocyte necrosis is virtually absent in HM; however, cellular loss may take place by apoptosis, although this is controversial.
AIM: To assess the presence of apoptosis and its relevance in HM.
METHODS: During coronary artery by-pass surgery (CABG), 21 patients underwent transmural biopsy in the dysfunctional left anterior descending artery tributary area of the left ventricle (LV), with kinetic recovery at follow-up, thus fulfilling the HM criteria. All patients underwent echocardiographic follow-up at 12 months. All biopsies were evaluated by light microscopy, electron microscopy (EM), and molecular analysis.
RESULTS: All biopsies were structurally altered, showing increased fibrosis and myocytes with variable size. Myocyte dedifferentiation was not detected by immunohistochemistry or EM. On stepwise linear regression, 1 year LVEF was predicted by the apoptotic index (beta=-0.973, p=0.002), the normotrophic cell percentage (beta=0.449, p=0.038), and mean fibrosis (beta=-0.412, p=0.51).
CONCLUSIONS: Our biopsy study detected a wide range of morphological substrate heterogeneity in HM with degenerative features. We have demonstrated for the first time in humans that myocyte apoptosis is an important phenomenon in HM, negatively influencing LV functional recovery after CABG.
Annalisa Angelini; Giuseppe Maiolino; Giovanni La Canna; Claudio Ceconi; Fiorella Calabrese; Elena Pettenazzo; Marialuisa Valente; Ottavio Alfieri; Gaetano Thiene; Roberto Ferrari
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Publication Detail:
Type:  Journal Article     Date:  2006-11-28
Journal Detail:
Title:  European journal of heart failure     Volume:  9     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-26     Completed Date:  2007-11-13     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  377-83     Citation Subset:  IM    
Department of Pathological Anatomy, University of Padua, Via Gabelli, 61, 35121 Padova, and Department of Non-invasive Diagnostic Cardiology, San Raffaele Foundation Institute and University Hospital, Milan, Italy.
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MeSH Terms
Cardiomyopathies / physiopathology*,  ultrasonography
Fibrosis / physiopathology
Heart Ventricles / physiopathology*
Hypertrophy, Left Ventricular / physiopathology
Middle Aged
Muscle Cells
Myocardium / cytology,  pathology*
Prospective Studies
Stroke Volume

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