Carter G, Gavin J B
Basic Res Cardiol. 1986 Sep-Oct;81(5):465-72. doi: 10.1007/BF01907752.
To provide insight into the effects of severe ischaemia on endocardium, the sequence of morphological changes which develop in the endocardium of the isolated rat heart subjected to 0-12 hours of global ischaemia at 37 degrees C was examined. A progression of changes occurred. Following one or more hours of ischaemia crater-like depressions and blebs appeared on the luminal surfaces of ventricular endothelial cells, with margination and clumping of nuclear chromatin, loss of glycogen granules, swelling of mitochondria, and the development of subendothelial membrane-bound dilatations of myocytes. Following two or more hours of ischaemia there was progressive separation of endothelial cells along their intercellular boundaries and desquamation of an increasing proportion of these cells. In regions of desquamation the surface was initially smooth due to persistence of the lamina densa of the basal lamina, but after longer periods of ischaemia the surface became rough with exposure first of the subendothelial connective tissue fibres (4 hours) and eventually of cardiac muscle cells (12 hours).
为深入了解严重缺血对心内膜的影响，研究了在37℃下对离体大鼠心脏进行0至12小时全心缺血时心内膜发生的形态学变化序列。变化呈渐进性。缺血1小时或更长时间后，心室内皮细胞腔面出现火山口样凹陷和小泡，核染色质边缘化和聚集，糖原颗粒丢失，线粒体肿胀，心肌细胞内皮下膜结合性扩张形成。缺血2小时或更长时间后，内皮细胞沿细胞间边界逐渐分离，越来越多的细胞发生脱落。在细胞脱落区域，由于基膜致密层的持续存在，表面最初是光滑的，但缺血时间较长后，表面变得粗糙，首先暴露内皮下结缔组织纤维（4小时），最终暴露心肌细胞（12小时）。
