Hervas Arantxa, Ruiz-Sauri Amparo, de Dios Elena, Forteza Maria Jose, Minana Gema, Nunez Julio, Gomez Cristina, Bonanad Clara, Perez-Sole Nerea, Gavara Jose, Chorro Francisco Javier, Bodi Vicente
Cardiology Department, Hospital Clinico Universitario, INCLIVA, University of Valencia, Valencia, Spain.
INCLIVA, University of Valencia, Valencia, Spain.
J Anat. 2016 Jan;228(1):47-58. doi: 10.1111/joa.12395. Epub 2015 Oct 29.
We aimed to characterize the organization of collagen within a fibrotic scar in swine and human samples from patients with chronic infarctions. Swine were subjected to occlusion of the left anterior descending artery followed by reperfusion 1 week (acute myocardial infarction group) or 1 month (chronic myocardial infarction group) after infarction. The organization of the collagen fibers (Fast Fourier Transform of samples after picrosirius staining; higher values indicate more disorganization) was studied in 100 swine and 95 human samples. No differences in collagen organization were found between the acute and chronic groups in the core area of the scar in the experimental model. In the chronic group, the endocardium [0.90 (0.84-0.94); median (interquartile range)], epicardium [0.84 (0.79-0.91)] and peripheral area [0.73 (0.63-0.83)] displayed a much more disorganized pattern than the core area of the fibrotic scar [0.56 (0.45-0.64)]. Similarly, in human samples, the collagen fibers were more disorganized in all of the outer areas than in the core of the fibrotic scar (P < 0.0001). Both in a highly controlled experimental model and in patient samples, collagen fibers exhibited an organized pattern in the core of the infarction, whereas the outer areas displayed a high level of inhomogeneity. This finding contributes pathophysiological information regarding the healing process and may lead to a clearer understanding of the genesis and invasive treatment of arrhythmias after acute myocardial infarction.
我们旨在描述猪和慢性梗死患者人体样本中纤维化瘢痕内胶原蛋白的组织结构。对猪进行左前降支动脉闭塞，然后在梗死1周（急性心肌梗死组）或1个月（慢性心肌梗死组）后再灌注。在100个猪样本和95个人体样本中研究了胶原纤维的组织结构（天狼星红染色后样本的快速傅里叶变换；值越高表明越紊乱）。在实验模型中，瘢痕核心区域的急性和慢性组之间未发现胶原组织结构的差异。在慢性组中，心内膜[0.90（0.84 - 0.94）；中位数（四分位间距）]、心外膜[0.84（0.79 - 0.91）]和周边区域[0.73（0.63 - 0.83）]的紊乱模式比纤维化瘢痕的核心区域[0.56（0.45 - 0.64）]更为明显。同样，在人体样本中，纤维化瘢痕所有外部区域的胶原纤维比核心区域更紊乱（P < 0.0001）。在高度可控的实验模型和患者样本中，梗死核心区域的胶原纤维均呈现有序模式，而外部区域则表现出高度的不均匀性。这一发现为愈合过程提供了病理生理学信息，并可能有助于更清楚地理解急性心肌梗死后心律失常的发生机制和侵入性治疗。
