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Early infarct expansion: structural or functional?

J A Erlebacher, R C Richter, D R Alonso

    Journal of the American College of Cardiology
    |October 1, 1985
    PubMed
    Summary
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    Early myocardial infarction causes segment lengthening, which appears reversible postmortem. However, histological analysis reveals persistent thinning and sarcomere lengthening in infarct zones, indicating underlying structural changes.

    Area of Science:

    • Cardiology
    • Pathology
    • Biomedical Engineering

    Background:

    • Myocardial infarction leads to rapid increases in segment length, distorting ventricular geometry.
    • Infarct expansion, characterized by permanent stretching and thinning of infarcted zones, is a known complication.
    • The apparent reversal of early infarct expansion postmortem raises questions about its functional reversibility versus artifact.

    Purpose of the Study:

    • To investigate the reversibility of early infarct expansion after myocardial infarction.
    • To differentiate between functional and structural changes contributing to infarct expansion.

    Main Methods:

    • Myocardial infarction was induced in dogs by occluding the left anterior descending coronary artery.
    • Ultrasound sonomicrometers measured myocardial segment end-diastolic length in infarct and normal zones.

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  • Histological analysis measured sarcomere length and myofiber width from biopsy specimens.

    • Main Results:

    • After 3 hours of ischemia, infarct zone segment length significantly increased compared to normal zones (116% vs 103%).
    • Following cardiac arrest, segment lengths returned to pre-ischemic values, suggesting apparent reversibility.
    • Histology showed significantly thinner infarct zone myofibers (7.9 vs 9.4 microns) and longer sarcomeres (1.9 vs 1.5 microns) in the infarct zone.

    Conclusions:

    • Early infarct expansion appears reversible due to functional changes immediately after cardiac arrest.
    • Underlying structural abnormalities, including myofiber thinning and sarcomere lengthening, persist despite the apparent reversal.
    • These structural changes are crucial for understanding long-term infarct remodeling and cardiac function.