Abstract
Introduction.Currently, there are different approaches to assessing changes that occur in ischemic myocardium in patients with chronic coronary artery disease (CAD). Researchers argue about the timing and completeness of the restoration of myocardial dysfunction areas. We aimed to assess hibernating myocardium in the zones of hypokinesia in patients with CAD. Materials and methods. We performed a morphological and immunohistochemical study of left ventricular myocardial biopsies of 25 patients who underwent surgical reconstruction of the left ventricle with surgical revascularization. Results. Morphological and immunohistochemical studies revealed violated morphological structure of cardiomyocytes. It correlates with the accumulation of MMP9 in the cytoplasm of cardiomyocytes in the areas of affected myocardium in ischemia against the background of partial or complete destruction of CM basement membranes formed by type IV collagen. It also correlates with long-term consequences of treatment. Conclusion. As a result of the destructed structure of sarcomeres and cardiac basement membrane hibernating myocardium is unable to provide a contractile function in the future. Morphological examination showed that viable cells were likely to function only as a protective mechanism in early scar formation. Keywords: left ventricular remodeling, hibernating myocardium, basement membrane, cardiomyocytes, matrix metalloproteinase 9, type IV collagen
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