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Reperfusion injury after temporary coronary occlusion
J Vinten-Johansen1, W E Johnston, S A Mills
1Department of Surgery, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, N.C. 27103.
The Journal of Thoracic and Cardiovascular Surgery
|June 1, 1988
Summary
Unmodified blood reperfusion significantly worsens myocardial injury after temporary coronary artery occlusion. Reperfusion increases tissue water, muscle stiffness, and cellular damage, extending heart damage.
Area of Science:
- Cardiovascular Physiology
- Myocardial Pathophysiology
Background:
- Temporary coronary artery occlusion leads to myocardial ischemia.
- Understanding the effects of reperfusion on myocardial injury is critical.
Purpose of the Study:
- To investigate the time course of changes in myocardial function, stiffness, and structure after coronary occlusion and reperfusion.
- To determine the impact of unmodified blood reperfusion on myocardial injury.
Main Methods:
- Anesthetized open-chest dogs underwent 1-hour left anterior descending coronary artery occlusion followed by 2 hours of reperfusion.
- Measurements included contractile function, diastolic muscle stiffness (sonomicrometry), tissue water content, and ultrastructure.
Main Results:
- Occlusion caused passive bulging and mild ultrastructural changes, with no significant increase in water content or stiffness.
- Reperfusion led to a significant increase in subendocardial water content and diastolic muscle stiffness.
- Reperfusion also resulted in more severe ultrastructural damage, indicating extended myocardial injury.
Conclusions:
- Myocardial injury is significantly exacerbated by unmodified blood reperfusion following temporary coronary artery occlusion.
- Reperfusion-induced edema and increased stiffness contribute to worsened myocardial damage.