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Related Experiment Videos

Regional differences in function within noninfarcted myocardium during left ventricular remodeling

C M Kramer1, J A Lima, N Reichek

  • 1Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia.

Circulation
|September 1, 1993
PubMed
Summary

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Persistent functional differences in noninfarcted heart muscle after myocardial infarction contribute to left ventricular remodeling. These regional variations in heart muscle function drive chamber enlargement and overall dysfunction post-infarction.

Area of Science:

  • Cardiovascular Research
  • Cardiac Mechanics
  • Myocardial Infarction

Background:

  • Mechanisms of ventricular enlargement and dysfunction post-myocardial infarction remodeling are unclear.
  • Global left ventricular changes are known, but regional functional differences in noninfarcted areas are unexplored.
  • These functional disparities may relate to regional wall stress and contribute to chamber enlargement and dysfunction.

Purpose of the Study:

  • Investigate functional differences between adjacent and remote noninfarcted myocardium during left ventricular remodeling.
  • Determine if these differences contribute to post-infarct chamber enlargement and global dysfunction.

Main Methods:

  • Created anteroapical infarcts in sheep.
  • Acquired cardiac magnetic resonance images at multiple time points post-infarction.

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  • Measured left ventricular volumes, mass, ejection fraction, and segmental function (circumferential and longitudinal shortening).
  • Assessed wall thickness and histopathology in infarcted and noninfarcted segments.

    • Main Results:

    • Functional differences in segmental shortening between adjacent and remote noninfarcted myocardium persisted for 6 months.
    • Adjacent regions showed partial functional improvement during infarct healing (1-8 weeks).
    • Left ventricular volume increased disproportionately, ejection fraction decreased, and late dilatation resulted from noninfarcted segment lengthening.

    Conclusions:

    • Persistent regional functional differences in noninfarcted myocardium are linked to left ventricular dilatation and eccentric hypertrophy.
    • These functional disparities may indicate increased wall stress in adjacent areas.
    • Such differences likely contribute to the global dilatation and dysfunction observed in post-infarct left ventricular remodeling.