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Doctoral Thesis
DOI
10.11606/T.5.2006.tde-23112006-124950
Document
Author
Full name
Marcia Kiyomi Koike
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2006
Supervisor
Committee
Frimm, Clovis de Carvalho (President)
Heimann, Joel Claudio
Okoshi, Katashi
Soriano, Francisco Garcia
Tucci, Paulo José Ferreira
Title in Portuguese
A queda da pressão de perfusão coronariana implica em dano subendocárdico da região do miocárdio remota ao infarto e em disfunção do ventrículo esquerdo
Keywords in Portuguese
Endocárdio
Fibrose
Glicosaminoglicanos
Infarto do miocárdio
Inflamação
Necrose
Remodelação ventricular
Abstract in Portuguese
No infarto, o remodelamento da região ventricular remota tem sido pouco examinado. Previamente, observamos que a redução da pressão de perfusão coronariana (PPC) associa-se ao aparecimento de fibrose subendocárdica. O objetivo do presente estudo foi investigar o papel da PPC no remodelamento e na função ventricular esquerda após o infarto. Medidas hemodinâmicas foram determinadas em ratos Wistar imediatamente após o infarto (IM) ou cirurgia fictícia (SH) e ao final dos seguimentos de 1, 3, 7, e 28 dias. Cortes teciduais do coração foram submetidos a coloração com HE, Sirius red, e a imunohistoquímica para a-actina. Duas regiões distintas do ventrículo esquerdo remotas ao infarto foram examinadas: subendocárdio (SE) e interstício (INT). A necrose de miócitos, a infiltração leucocitária e de miofibroblastos, e a fração de volume do colágeno foram determinadas. Comparados com SH, os grupos IM apresentaram menor PPC e disfunção sistólica e diastólica do ventrículo esquerdo. A necrose foi evidente em SE no dia 1. A inflamação e a fibroplasia ocorreram predominantemente em SE até o dia 7. A fibrose foi restrita a SE e evidente desde o dia 3. Em INT, a inflamação ocorreu predominantemente nos dias 1 e 3, mas em menor grau comparada a SE. A queda da PPC associou-se à dilatação progressiva do ventrículo esquerdo. Em SE, a PPC relacionou-se inversamente com a necrose (r =- 0,65, p = 0,003, no dia 1), com a inflamação (r = -0,76, p < 0,001, no dia 1), com a fibroplasia (r = -0,47, p = 0,04, no dia 7) e com a fibrose (r = -0,83, p < 0,001, no dia 28). A necrose no dia 1, a inflamação nos dias 3 e 7 e a fibroplasia no dia 7 relacionaram-se inversamente com a função do ventrículo esquerdo. A PPC é um fator determinante da integridade de SE e interfere com o remodelamento e a função do ventrículo esquerdo.
Title in English
Low coronary driving pressure early in the course of myocardial infarction determines subendocardial remodeling and left ventricular dysfunction
Keywords in English
Endocardium
Fibrosis
Glycosaminoglycans
Inflammation
Myocardial infarction
Necrosis
Ventricular remodeling
Abstract in English
Left ventricular (LV) subendocardial remodeling has been poorly investigated after myocardial infarction. Previously, we have demonstrated that low coronary driving pressure (CDP) early in the course of infarction was associated with the subsequent development of subendocardial fibrosis. The present study aimed at the investigation of the role of CDP in LV remodeling and function following infarction. Hemodynamics were determined in Wistar rats immediately after infarct surgery (MI group) or sham (SH group) and at days 1, 3, 7, and 28. Heart tissue sections were stained with HE, Sirius red and immunostained for a- actin. Two distinct LV regions remote to MI were examined: subendocardium (SE) and interstitium (INT). Myocyte necrosis, leukocyte and myofibroblast infiltration, and collagen volume fraction were determined. Compared with SH, MI groups showed lower CDP and LV systolic and diastolic dysfunction. Necrosis was evident in SE at day 1. Inflammation and fibroplasia occurred predominantly in SE as far as day 7. Fibrosis was restricted to SE and was evident beginning from day 3. Inflammation occurred predominantly at days 1 and 3 in INT, but at a lower extent than in SE. CDP fall was associated with progressive LV dilatation. In SE, CDP correlated inversely with necrosis (r = -0.65, p=0.003, at day 1), inflammation (r = -0.76, p < 0.001, at day 1), fibroplasia (r = -0.47, p = 0.04, at day 7) and fibrosis (r = -0.83, p < 0.001, at day 28). Necrosis at day 1, inflammation at days 3 and 7, and fibroplasia at day 7 correlated inversely with LV function. CDP is a key factor to SE integrity following infarction and interferes with LV remodeling and function.
 
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marciakkoike.pdf (390.38 Kbytes)
Publishing Date
2006-12-18
 
WARNING: The material described below relates to works resulting from this thesis or dissertation. The contents of these works are the author's responsibility.
  • DE CARVALHO FRIMM, Clovis, KOIKE, Marcia Kiyomi, e CURI, Mariana. Subendocardial fibrosis in remote myocardium results from reduction of coronary driving pressure... : ...during acute infarction in rats. Arquivos Brasileiros de Cardiologia [online], 2003, vol. 80, n. 5, p. 509-520. [acesso 2011-11-02]. Disponível em : <http://www.scielo.br/scielo.php?script=sci_pdf&pid=S0066-782X2003000500004&lng=en&nrm=iso&tlng=en>
  • KOIKE, Marcia Kiyomi, DE CARVALHO FRIMM, Clovis, and CURI, Mariana. Low coronary driving pressure early in the course of myocardial infarction is associated with... : ...subendocardial remodelling and left ventricular dysfunction. International Journal of experimental pathology [online], 2007, vol. 88, n. 4, p. 279-290. [cited 2011-11-02]. Available from : <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2517313/?tool=pubmed>
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