Fenoglio J J, Albala A, Silva F G, Friedman P L, Wit A L
Hum Pathol. 1976 Sep;7(5):547-63. doi: 10.1016/s0046-8177(76)80102-5.
The present study was undertaken using light and electron microscopic techniques to determine whether Purkinje fibers survive in the subendocardial region of anteroseptal infarcts in humans. Tissue was obtained for this purpose from 11 patients with 12 documented infarctions at the time of autopsy; six patients died within 72 hours of the infarction and five had healed infarcts. Seven of the 11 patients had ventricular arrhythmias. Light microscopic study indicated that intact cells with a normal appearance remained on the subendocardial surface, although the underlying ventricular muscle either was necrotic or was replaced by fibrous tissue. Electron microscopy demonstrated that these intact surviving cells over the surface of the infarct had few randomly oriented myofibrils, abundant glycogen, and other characteristics of Purkinje fibers. These cells could be readily distinguished from normal or infarcted ventricular muscle cells. Purkinje fibers, the most peripheral part of the conduction system, survive in extensive anteroseptal infarcts and may be the site of origin of ventricular arrhythmias.
本研究采用光镜和电镜技术，以确定人类前间隔梗死灶心内膜下区域的浦肯野纤维是否存活。为此，在尸检时从11例有12处记录梗死灶的患者获取组织；6例患者在梗死72小时内死亡，5例为陈旧性梗死。11例患者中有7例发生室性心律失常。光镜研究表明，尽管其下的心室肌已坏死或被纤维组织取代，但心内膜表面仍保留外观正常的完整细胞。电镜显示，梗死灶表面这些存活的完整细胞有少量随机排列的肌原纤维、丰富的糖原以及浦肯野纤维的其他特征。这些细胞可轻易与正常或梗死的心室肌细胞区分开来。传导系统最外周部分的浦肯野纤维在广泛的前间隔梗死灶中存活，可能是室性心律失常的起源部位。
