Circulation, Vol 62, 945-952, Copyright © 1980 by American Heart Association
RA Kloner, RE Rude, N Carlson, PR Maroko, LW DeBoer and E Braunwald
Both microvascular damage and myocardial cell injury occur after coronary
occlusion, but the relationship of these two events is unclear;
specifically, it is unknown whether microvascular damage causes myocardial
cell injury. Dogs were subjected to coronary occlusion for 20, 40, 60, 90
or 180 minutes, after which subendocardial and subepicardial biopsies were
obtained for electron and light microscopy of 1-mu sections. Of 312
biopsies of ischemic myocadium, 181 showed myocardial cell injury with no
microvascular damage; 131 showed myocardial cell injury and microvascular
damage; but none showed microvascular damage without myocardial cell
injury. Although ultrastructural evidence of myocardial cell damage was
present in the subendocardium after 20-40 minutes of ischemia,
ultrastructural evidence of microvascular damage was not prominent until
60-90 minutes after coronary artery occlusion. Morphologic ultrastructural
evidence of microvascular damage lagged behind myocardial cell injury,
suggesting that ultrastructural microvascular damage is not a primary cause
of ultrastructural myocardial cell injury.
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Ultrastructural evidence of microvascular damage and myocardial cell injury after coronary artery occlusion: which comes first?
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