Abstract
This study assesses the relation between qualitative and quantitative findings of myocytes and interstitial connective tissue in the ischemic heart disease. Qualitative and quantitative changes of myocytes and interstitial connective tissue were studied on the serial cross myocardial sections from 20 autopsied hearts with ischemic lesions, stained by immunohistochemistry using a monoclonal antibody (von Willebrand factor) and with hematoxylin-eosin method. Myocardial sections included proximal and distal part of occlusion and area of occlusion of coronary vessels. The volume densities (V V) of the cardiac myocytes and interstitial fibrosis in the group with coronary occlusion were examined stereologically and compared with control group. The findings showed a significant reduction in the volume density of myocytes and an increase in the volume density of interstitial fibrosis in patients with coronary occlusion compared with control group. Significant reduction in the volume density of myocytes and an increase in volume density of interstitial fibrosis were greater in the distal part of occlusion and area of occlusion, than in the proximal part of the occlusion. Our stereological results give useful quantitative information's of changes in myocardium parts during coronary occlusion as well as in normal conditions, and represent objective proof of significant changes in ischemic myocardium described by qualitative analyses.
Highlights
Ischemic heart disease is a complex and diverse clinical syndrome in which an imbalance between blood supply and demand is created by complete or partial occlusion of a major epicardial coronary artery, resulting in myocardial infarction or multiple isolated sites of tissue injury
The results shows the qualitative changes in the myocardium with coronary occlusion: hypertrophy, atrophy and myocytes necrosis with proliferation of interstitially connective tissue (Figure )
Some fibrosis was found in the control hearts (Figure ), the density of fibrosis was greater in patients with coronary occlusion
Summary
Ischemic heart disease is a complex and diverse clinical syndrome in which an imbalance between blood supply and demand is created by complete or partial occlusion of a major epicardial coronary artery, resulting in myocardial infarction or multiple isolated sites of tissue injury. AIDA HASANOVIĆ ET AL.: MORPHOLOGIC FINDINGS OF THE ISCHEMIC MYOCARDIUM branches of the coronary vasculature or defects of the microcirculation may generate varying degrees of ischemia, with reflect the characteristics of myocytes loss in myocardium. On this basis, interstitial fibrosis have recently been as quantitative definitions of those aspects of myocyte loss ( , , ). Morphometric studies in animal models and in human hearts have suggested that inadequate growth of the coronary microvascular bed is one factor limiting myocardial perfusion with consecutive reduction of myocytes and an increase of interstitial connective tissue ( , , , , ). Morphologic changes of the myocardium myocytes and interstitially connective tissue, as a constituents of myocardium, in a various pathological conditions have been studied by many authors ( , , )
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