Preview

Russian Journal of Cardiology

Advanced search

THE MORPHOLOGY OF ELECTROPHYSIOLOGICAL DISORDERS OF MYOCARDIUM IN POSTINFARCTION ANEURYSM AND VENTRICULAR TACHICARDIA

https://doi.org/10.15829/1560-4071-2015-11-18-22

Abstract

Aim. To study morphology of the left ventricle (LV) myocardium in zones with disordered conduction of electrical potential in patients with post infarction aneurysm of the heart and ventricular tachycardia.

Material and methods. The microscopic and morphometric investigations performed of 78 fragments of LV myocardium, obtained during LV reconstruction from zones with different electrical conductivity, from 19 patients with post infarction LV remodeling and chronic heart failure. For electrical conductivity all patients underwent electrophysiological study of the heart. In the zones with normal conduction (1 group) the value of electrical potential was more than 1,5 mV, in transient zone (2 group) — 0,5-1,5 mV, in “electrical scar” zone — less than 0,5 mV (3 group). The zone with zero value of electrical potential got to the 4th group.

Results. In transient zone of myocardium pieces and “electrical scar” zone, comparing to those from normal electrical potential, there were more significant sclerosis of endocardium and myocardium, atrophy and degeneration of cardiomyocytes. In “electrical scar” zone there was more significant value of these
changes than in transitory zone. Areas of myocardium with zero value of the potential differed from the zones with normal and low values of electrical potential by more significant replacement of myocardium by fat tissue.

Conclusion. Transition from normal electrical potential to electrical scar do determine the severity of endocardial fibrosis, and myocardial lipomathosis, degeneration of cardiomyocytes

About the Authors

V. E. Babokin
Moscow Regional Research and Clinical Institute (MONIKI), Moscow
Russian Federation


Yu. V. Rogovskaya
RI Cardiology, Tomsk National Research Tomsk State University, Tomsk, Russia
Russian Federation


V. M. Shipulin
RI Cardiology, Tomsk
Russian Federation


R. E. Batalov
RI Cardiology, Tomsk National Research Tomsk State University, Tomsk, Russia
Russian Federation


S. V. Popov
RI Cardiology, Tomsk
Russian Federation


References

1. Dor V, Civaia F, Alexandrescu C, et al. Favorable effects of left ventricular reconstruction in patients excluded from the Surgical Treatments for Ischemic Heart Failure (STICH) trial. J Thorac Cardiovasc Surg 2011; 141 (4): 905-16.

2. Babokin V, Shipulin V, Batalov R, et al. Surgical ventricular reconstruction with endocardectomy along radiofrequency ablation-induced markings. J Thorac Cardiovasc Surg 2013; 146 (5): 1133-8.

3. Aminova HK, Mitrofanova LB. Nomenclature and histopathology atlas of myocardium: Manual. SPb., 1994. 16 p. Russian. (Аминова Х. К., Митрофанова Л. Б. Номенклатура и атлас гистопатологии миокарда: методическое пособие. СПб., 1994. 16 с.).

4. Dor V, Di Donato M, Civaia F. Post myocardial infarct left ventricular remodeling: Role of magnetic resonance imaging for the assessment of its patho-physiology and of its regression after ventricular reconstruction. Thoracic and cardiovascular surgery 2014; 3: 14-27. Russian (Дор В, Ди Донато М, Сивая Ф. Постинфарктное ремоделирование левого желудочка: магнитно-резонансная томография для оценки патофизиологии после реконструкции левого желудочка. Грудная и сердечно-сосудистая хирургия. 2014; 3: 14-27).

5. Rogovskaya JV, Pavlukova EN, Paderov JM, et al. Relationship between the morphological condition of left ventricle and degree of abnormality contracting walls in patient with IHD with left ventricular heavy dysfunction. Sibirian medical journal 2011; 26 (3) V.1: 115-8. Russian (Роговская Ю. В., Павлюкова Е. Н., Падеров Ю. М. и др. Морфологическое состояние левого желудочка в зависимости от степени нарушения локальной сократимости у больных ишемической болезнью сердца с тяжелой левожелудочковой дисфункцией. Сибирский медицинский журнал 2011; 26 (3) Выпуск 1: 115-8).

6. Bogunezkii AA, Usov VY, Babokin VE. Magnetic resonance imaging with contrast enhancement: prognostic role in determining the arrhythmogenic focus. Bulletin of Siberian Medicine 2014; 13 (1): 98-102. Russian (Богунецкий А. А., Усов В. Ю., Бабокин В. Е. Магнитно-резонансная томография сердца с контрастным усилением: прогностическая роль в определении аритмогенного очага. Бюллетень сибирской медицины. 2014; 13 (1): 98-102).

7. Babokin VE, Minin SM, Gutor SS, et al. Concordance of electrophysiological and perfusion abnormalities in the left ventricular myocardium in post infarction aneurisms with ventricular tachycardia. Almanach of Clinical Medicine 2015; 38: 11-8. Russian (Бабокин В. Е., Минин С. М., Гутор С. С. и др. Сопряженность электрофизиологических и перфузионных изменений миокарда левого желудочка при постинфарктных аневризмах с желудочковой тахикардией. Альманах клинической медицины 2015; 38: 11-8).

8. Babokin VE, Shipulin VM, Antonchenko IV, et al. Radiofrequency labels in surgical treatment of left ventricle postinfarction aneurysms and ventricular tachycardias. Thoracic and cardiovascular surgery 2011; 5: 23-8. Russian (Бабокин В. Е., Шипулин В. М., Антонченко И. В. и др. Радиочастотные метки в хирургическом лечении больных с постинфарктной аневризмой левого желудочка и желудочковыми тахикардиями. Грудная и сердечно-сосудистая хирургия 2011; 5: 23-8).

9. Dor V, Civaia F, Alexandrescu C, et al. The post–myocardial infarction scarred ventricle and congestive heart failure: The preeminence of magnetic resonance imaging for preoperative, intraoperative, and postoperative assessment. J Thorac Cardiovasc Surg 2008; 136 (6): 1405-12.

10. Kautzner J, Kirstein Pedersen A, Peichl P. Electroanatomical mapping of the heart. Remedica Publishing, 2006. 160 p.

11. Nartsissova GP. Segmental structure of the heart. Segments of the left and right ventricles in assessing regional function. Circulatory and cardiac pathology 2010; 4: 93-5. Russian (Нарциссова Г. П. Сегментарное строение сердца. Сегменты левого и правого желудочков в оценке региональной функции. Патология кровообращения и кардиохирургия 2010; 4: 93-5).

12. Cerqueira MD, Weissman NJ, Dilsizian V. Standatdized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 2002; 105: 539-42.


Review

For citations:


Babokin V.E., Rogovskaya Yu.V., Shipulin V.M., Batalov R.E., Popov S.V. THE MORPHOLOGY OF ELECTROPHYSIOLOGICAL DISORDERS OF MYOCARDIUM IN POSTINFARCTION ANEURYSM AND VENTRICULAR TACHICARDIA. Russian Journal of Cardiology. 2015;(11):18-22. (In Russ.) https://doi.org/10.15829/1560-4071-2015-11-18-22

Views: 788


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1560-4071 (Print)
ISSN 2618-7620 (Online)