First evidence of depressed contractility in the border zone of a human myocardial infarction

Jonathan F. Wenk, Doron Klepach, Lik Chuan Lee, Zhihong Zhang, Liang Ge, Elaine E. Tseng, Alastair Martin, Sebastian Kozerke, Joseph H. Gorman, Robert C. Gorman, Julius M. Guccione

Research output: Contribution to journalArticlepeer-review

47 Scopus citations

Abstract

Background: The temporal progression in extent and severity of regional myofiber contractile dysfunction in normally perfused border zone (BZ) myocardium adjacent to a myocardial infarction (MI) has been shown to be an important pathophysiologic feature of the adverse remodeling process in large animal models. We sought, for the first time, to document the presence of impaired contractility of the myofibers in the human BZ myocardium. Methods: A 62-year-old man who experienced an MI in 1985 and had recently had complete revascularization was studied. Myofiber systolic contractile stress developed in the normally perfused BZ adjacent to the MI (T max-B) and that developed in regions remote from the MI (T max-R) were quantified using cardiac catheterization, magnetic resonance imaging, and mathematical modeling. Results: The resulting finite element model of the patient's beating left ventricle was able to simulate the reduced systolic strains measured using magnetic resonance imaging at matching left ventricular pressures and volumes. The T max-B (73.1 kPa) was found to be greatly reduced relative to T max-R (109.5 kPa). These results were found to be independent of assumptions relating to BZ myofiber orientation. Conclusions: The results of this study document the presence of impaired contractility of the myofibers in the BZ myocardium and support its role in the post-MI remodeling process in patients. To fully establish this important conclusion serial evaluations beginning at the time of the index MI will need to be performed in a cohort of patients. The current study supports the importance and demonstrates the feasibility of larger and longer-term studies.

Original languageEnglish
Pages (from-to)1188-1193
Number of pages6
JournalAnnals of Thoracic Surgery
Volume93
Issue number4
DOIs
StatePublished - Apr 2012

Bibliographical note

Funding Information:
This study was supported by NIH grants R01-HL063954 (RCG), R01-HL103723 (RCG), R01-HL073021 (JHG), R01-HL077921 (JMG), and R01-HL086400 (JMG). This support is gratefully acknowledged. Doctors R.C. Gorman and J.H. Gorman are supported by individual American Heart Association Established Investigator Awards.

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'First evidence of depressed contractility in the border zone of a human myocardial infarction'. Together they form a unique fingerprint.

Cite this