[Myocardial necrosis in chronic course of ischemic heart disease]

The possibility of myocardial necrosis occurrence in coronary failure proceeding as atypical myocardial infarction was examined in 176 patients with chronic types of coronary heart disease and in experiments with 16 dogs with reversible coronary failure simulated in chronic tests. 99mTe-labeled pyrophosphate myocardial scintigraphy was used in the clinical studies. Myocardial pyrophosphate accumulation was recorded in 37% of patients with angina pectoris without a history of myocardial infarction and 73% myocardial infarction survivals. Histological evidence for small myocardial necroses at various stages of their development was found in 12 dogs. Recurrent transient myocardial ischemias were shown to be able to lead to myocardial necroses that are not always followed by a typical course of acute myocardial infarction.