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RESEARCH PRODUCT

Microvascular obstruction in the right ventricle in reperfused anterior myocardial infarction. Macroscopic and pathologic evidence in a swine model.

Fabian ChaustreAna DíazClara BonanadCristina GomezJuan SanchisGema MiñanaFrancisco J. ChorroMaria J. FortezaLuis MainarElena De DiosInmaculada NogueraJulio NúñezDaniel MonleonAmparo Ruiz-sauriJosé Manuel MoralesVicente Bodi

subject

medicine.medical_specialtySwineHeart VentriclesMyocardial InfarctionInfarctionContext (language use)chemistry.chemical_compoundEdemaInternal medicinemedicineAnimalsMyocardial infarctionbusiness.industryHematologymedicine.diseaseCoronary VesselsMagnetic Resonance ImagingPathophysiologyStainingmedicine.anatomical_structurechemistryVentricleMicrovesselsCardiologyThioflavinFemalemedicine.symptombusinesshuman activities

description

article i nfo Introduction: Data on right ventricular (RV) involvement in anterior myocardial infarction are scarce. The presence of RV microvascular obstruction (MVO) in this context has not been analyzed yet. The aim of the present study was to characterize the presence of MVO in the RV in a controlled experimental swine model of reperfused anterior myocardial infarction. Materials and Methods: Left anterior descending (LAD) artery-perfused area (thioflavin-S staining after selective infusioninLADartery),infarctsize(lackof triphenyltetrazolium-chloride staining) andMVO (lack of thioflavin-S staininginthe core oftheinfarctedarea) inthe RVwere studied.A quantitative(%of theventricularvolume)and semiquantitative (number of segments involved) analysis was carried out both in the RV and LV in a 90-min left anterior descending balloon occlusion and 3-day reperfusion model in swine (n = 15). Results: RV infarction and RV MVO (N1 segment) were detected in 9 (60%) and 6 (40%) cases respectively. Mean LAD-perfused area, infarct size and MVO in the RV were 33.8 ± 13%, 13.53 ± 11.7% and 3.4 ± 4.5%. Haematoxylin and eosin stains and electron microscopy of the RV-MVO areas demonstrated generalized cardiomyocyte necrosis and inflammatory infiltration along with patched hemorrhagic areas. Ex-vivo nuclear magnetic resonance (T2* sequences) microimaging of RV-MVO showed, in comparison with remote non-infarctedterritories, markedhypointensezones(corresponding tonecrosis, inflammation andhemorrhage) in the core of hyperintense regions (corresponding to edema). Conclusions: In reperfused anterior myocardial infarction, MVO is frequently present in the RV. It is associated with severe histologic repercussion on the RV wall. Nuclear magnetic resonance appears as a promising technique for the noninvasive detection of this phenomenon. Further studies are warranted to evaluate the pathophysiological and clinical implications.

10.1016/j.thromres.2013.08.009https://pubmed.ncbi.nlm.nih.gov/24007796