| Autor: |
Rodrigo, Fernández-Jiménez, Javier, Sánchez-González, Jaume, Agüero, Jaime, García-Prieto, Gonzalo J, López-Martín, José M, García-Ruiz, Antonio, Molina-Iracheta, Xavier, Rosselló, Leticia, Fernández-Friera, Gonzalo, Pizarro, Ana, García-Álvarez, Erica, Dall'Armellina, Carlos, Macaya, Robin P, Choudhury, Valentin, Fuster, Borja, Ibáñez |
| Rok vydání: |
2014 |
| Předmět: |
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| Zdroj: |
Journal of the American College of Cardiology. 65(4) |
| ISSN: |
1558-3597 |
| Popis: |
It is widely accepted that edema occurs early in the ischemic zone and persists in stable form for at least 1 week after myocardial ischemia/reperfusion. However, there are no longitudinal studies covering from very early (minutes) to late (1 week) reperfusion stages confirming this phenomenon.This study sought to perform a comprehensive longitudinal imaging and histological characterization of the edematous reaction after experimental myocardial ischemia/reperfusion.The study population consisted of 25 instrumented Large-White pigs (30 kg to 40 kg). Closed-chest 40-min ischemia/reperfusion was performed in 20 pigs, which were sacrificed at 120 min (n = 5), 24 h (n = 5), 4 days (n = 5), and 7 days (n = 5) after reperfusion and processed for histological quantification of myocardial water content. Cardiac magnetic resonance (CMR) scans with T2-weighted short-tau inversion recovery and T2-mapping sequences were performed at every follow-up stage until sacrifice. Five additional pigs sacrificed after baseline CMR served as controls.In all pigs, reperfusion was associated with a significant increase in T2 relaxation times in the ischemic region. On 24-h CMR, ischemic myocardium T2 times returned to normal values (similar to those seen pre-infarction). Thereafter, ischemic myocardium-T2 times in CMR performed on days 4 and 7 after reperfusion progressively and systematically increased. On day 7 CMR, T2 relaxation times were as high as those observed at reperfusion. Myocardial water content analysis in the ischemic region showed a parallel bimodal pattern: 2 high water content peaks at reperfusion and at day 7, and a significant decrease at 24 h.Contrary to the accepted view, myocardial edema during the first week after ischemia/reperfusion follows a bimodal pattern. The initial wave appears abruptly upon reperfusion and dissipates at 24 h. Conversely, the deferred wave of edema appears progressively days after ischemia/reperfusion and is maximal around day 7 after reperfusion. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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