Preocclusive perfusion area as a determinant of infarct size in a canine model

The extent of myocardial infarction related to the pre-occlusive perfusion are was quantitatively evaluated in a canine model. The perfusion area was determined preocclusively by selective injection of tracer microspheres into the coronary artery in question, then the main trunk and a small lateral branch of the left circumflex coronary artery was occluded in group 1 (10 dogs) and group 2 (10 dogs), respectively. Rapid freezing was used to prepare autoradiographic samples for determination of the perfusion are along with samples for dehydrogenase staining in order to delineate the extent of myocardial infarction. The relationship between perfusion area and infarct size was examined in 50 micrometers thick samples from base, middle and apex of the ventricle and a direct linear correlation between the perfused (P) and infarcted area (I) in the left ventricle (LV) was noted regardless of the perfusion size or the location in the ventricle. The linear relationship I = 0.93P - 4.9 (r = 0.95, P less than 0.001) was obtained in all 20 dogs. Transmural extent of necrosis was larger in the endocardium than in the epicardium, thereby representing a more salvageable myocardium in the epicardium. It is concluded that the preocclusive determination of perfusion are by high resolution autoradiography is a useful method of obtaining physiological perfusion not affected by ischaemia. Also the infarct size when standardized by the perfusion area is mainly influenced by transmural location but not by the spacial geometry or the size of the occluded area.