Takemura G, Fujiwara H, Yoshida H, Wu D J, Matsuda M, Ishida M, Kawamura A, Fujiwara T, Kawai C
Department of Internal Medicine, Kyoto University, Japan.
Am J Pathol. 1989 Dec;135(6):989-99.
To determine whether or not male (NZWXBXSB)F1 [WXB)F1) mice exhibiting a lupus-like syndrome died of acute myocardial infarction (MI), and whether acute MI is directly related to small coronary artery disease, acute and old MIs were examined histologically in 55 dead (WXB)F1 male mice and 30 age-matched, surviving (WXB)F1 male mice used as a control group. In each heart from the 15 dead mice with MI and the five surviving mice without MI, 300 to 400 5-microns-thick serial sections were made; every fourth section was stained. Acute MI was found in 35 (64%) dead mice and in one (3%) survivors, whereas old MI was found in 50 (91%) dead mice and 17 (57%) survivors: a significant difference between the dead and surviving mice. The MIs were numerous, scattered, and small in most mice. Quantitative analysis revealed that the percentage of acute MI and old MI in the left ventricular (LV) wall was 6% +/- 11% and 3% +/- 3% in the dead group, and 0.4% and 2% +/- 3% in the control group. This indicated that recurrent acute MI is a major factor in the death of the mice. Although all the epicardial major coronary arteries of the (WXB)F1 male mice were intact, significant stenoses were noted in the intramyocardial small arteries. The serial sections in the 15 dead mice with MI revealed 1) segmental occlusive thrombi in the infarct-related small coronary artery in 14 of the 20 foci of acute anemic MIs, two of the 18 foci of acute hemorrhagic MIs, and four of the 58 foci of old MIs; and 2) segmental intimal thickenings in the infarct-related small artery in six of the 20 foci of acute anemic MIs, two of the 18 foci of acute hemorrhagic MIs, and 56 of the 58 foci of old MIs. There was no evidence of small coronary artery disease in the surviving mice without MI. The thrombus would result in thickened intima as MI progresses from the acute to the old stage. Because it was established that acute MI of hemorrhagic type follows reperfusion after transient occlusion of the coronary artery, hemorrhagic acute MI with rare incidence of thrombi in this mouse suggests that thrombolysis occurs after occlusion due to thrombus formation. Thus, the pathogenesis of multiple MIs is occlusive thrombi, recanalization in small coronary arteries or both. Some of the mice had dilated cardiomyopathy (DCM)-like features (marked LV dilatation).(ABSTRACT TRUNCATED AT 400 WORDS)
为了确定表现出狼疮样综合征的雄性(NZWXBXSB)F1[WXB)F1]小鼠是否死于急性心肌梗死(MI),以及急性心肌梗死是否与小冠状动脉疾病直接相关,对55只死亡的(WXB)F1雄性小鼠和30只年龄匹配的存活(WXB)F1雄性小鼠(作为对照组)进行了急性和陈旧性心肌梗死的组织学检查。在15只死于心肌梗死的小鼠和5只未患心肌梗死的存活小鼠的每颗心脏中,制作了300至400张5微米厚的连续切片;每隔四张切片进行染色。在35只(64%)死亡小鼠和1只(3%)存活小鼠中发现急性心肌梗死,而在50只(91%)死亡小鼠和17只(57%)存活小鼠中发现陈旧性心肌梗死:死亡小鼠和存活小鼠之间存在显著差异。大多数小鼠的心肌梗死数量多、分布散且面积小。定量分析显示,死亡组左心室壁急性心肌梗死和陈旧性心肌梗死的百分比分别为6%±11%和3%±3%,对照组为0.4%和2%±3%。这表明复发性急性心肌梗死是小鼠死亡的主要因素。尽管(WXB)F1雄性小鼠的心外膜主要冠状动脉均完整,但心肌内小动脉出现了明显狭窄。15只死于心肌梗死的小鼠的连续切片显示:1)在20个急性贫血性心肌梗死病灶中的14个、18个急性出血性心肌梗死病灶中的2个以及58个陈旧性心肌梗死病灶中的4个,梗死相关小冠状动脉内有节段性闭塞血栓;2)在20个急性贫血性心肌梗死病灶中的6个、18个急性出血性心肌梗死病灶中的2个以及58个陈旧性心肌梗死病灶中的56个,梗死相关小动脉有节段性内膜增厚。未患心肌梗死的存活小鼠没有小冠状动脉疾病的证据。随着心肌梗死从急性期发展到陈旧期,血栓会导致内膜增厚。因为已经确定出血型急性心肌梗死是在冠状动脉短暂闭塞后再灌注所致,在这种小鼠中罕见血栓的出血性急性心肌梗死表明,血栓形成导致闭塞后发生了溶栓。因此,多发性心肌梗死的发病机制是闭塞性血栓、小冠状动脉再通或两者皆有。一些小鼠具有扩张型心肌病(DCM)样特征(左心室明显扩张)。(摘要截断于400字)