Coronary occlusion and reperfusion: effects on subendocardial cardiac fibers

Coronary flow and transmembrane potentials of Purkinje and muscle fibers in reperfused infarcts and infarcts caused by permanent coronary occlusion were compared. Purkinje fibers in permanently occluded infarcts at 24 h had markedly reduced resting potentials. Action potential amplitudes, and Vmax were reduced and duration markedly prolonged. In reperfused infarcts, changes in Purkinje fiber transmembrane potentials were not as marked. Action potential duration in 3-day-old permanently occluded infarcts were longer than at 24 h, but in reperfused infarcts durations had returned to normal. Premature impulses conducted more rapidly in the reperfused infarct Purkinje system than in the permanently occluded. Other transmembrane potential parameters of Purkinje fibers in 3-day-old and 9- to 10-day-old reperfused and permanently occluded infarcts were not significantly different from each other. The ventricular muscle cells that survived in reperfused infarcts at all times also had reduced resting potentials and action potentials with decreased amplitudes, reduced Vmax, and prolonged durations. Almost no muscle cells survived in permanently occluded infarcts. Therefore, reperfusion salvages subendocardial fibers and prevents some but not all of the electrophysiological abnormalities.