Neutrophils in human myocardial infarction with rupture of the free wall
Nina Zidar1, Jera Jeruc, Joze Balazic
1Institute of Pathology, Medical Faculty, 1000 Ljubljana, Slovenia. nina.zidar@mf.uni-lj.si
Introduction:
Experimental studies have shown that neutrophils might play an important role in the pathogenesis of ischemic and reperfusion injury in myocardial infarction (MI). Our aim was to compare histologic characteristics of MI with and without rupture of the free wall (RFW), with emphasis on the density of interstitial neutrophil infiltration.
Methods:
Autopsy samples of infarcted heart tissue from 110 patients with MI (50 with and 60 without RFW) were included. On the basis of histologic changes and clinical data, all cases were divided into three groups according to the duration of MI (
Results:
In MI that were less than 1 day or more than 7 days old, we did not observe any differences in histologic characteristics between cases with and those without RFW. In MI that were more than 1 day and less than 7 days old, we observed a significantly more intensive interstitial neutrophil infiltration in cases with RFW than in those without RFW. However, there were no significant differences in neutrophil infiltration between patients who received reperfusion treatment and those who did not.
Conclusions:
Our results suggest that intensive interstitial neutrophil infiltration in human MI might increase the risk of the RFW between the 2nd and the 7th days when the density of neutrophil infiltration is believed to reach a peak. We failed to confirm the hypothesis based on experimental studies that reperfusion treatment contributes significantly to the density of neutrophil infiltration.
Insights
Intensive neutrophil infiltration in myocardial infarction (MI) cases between days 2 and 7 may increase the risk of free wall rupture (RFW). Reperfusion treatment did not significantly affect neutrophil density in this study.
Area of Science:
- Cardiovascular Pathology
- Immunohistochemistry
- Myocardial Infarction Research
Background:
- Neutrophils are implicated in myocardial infarction (MI) pathogenesis and ischemic reperfusion injury.
- The role of neutrophil infiltration in the development of free wall rupture (RFW) in MI requires further investigation.
Purpose of the Study:
- To compare the histologic characteristics of MI with and without RFW.
- To specifically evaluate the density of interstitial neutrophil infiltration in relation to RFW.
Main Methods:
- Autopsy samples from 110 MI patients (50 with RFW, 60 without) were analyzed.
- Tissue samples were categorized by MI duration: <1 day, 1-7 days, and 1-4 weeks.
- Neutrophil infiltration was quantified using CD 15 immunohistochemistry and image analysis.
Main Results:
- No significant histologic differences were found in MI <1 day or >7 days old between RFW and non-RFW groups.
- MI aged 1-7 days showed significantly higher interstitial neutrophil infiltration in RFW cases compared to non-RFW cases.
- Neutrophil infiltration density did not differ significantly between patients who received reperfusion treatment and those who did not.
Conclusions:
- Intensive interstitial neutrophil infiltration during the 2-7 day period post-MI may elevate the risk of RFW.
- The study did not support the hypothesis that reperfusion treatment significantly increases neutrophil infiltration density in MI.
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