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  • 1
    ISSN: 1432-2307
    Keywords: Myocardial infarction ; Tetrazolium salts ; NAD ; Oxidoreductases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Tetrazolium salts (NBT) stain normal myocardium whereas infarcts are not stained. We tried to elucidate the staining mechanism which discriminates normal from infarcted canine myocardium. The left anterior descending coronary artery (LAD) was occluded in dogs for between 4 and 32 h. The activities of four different tissue dehydrogenases were measured after 4, 8, 16, and 32 h of ischaemia. Nicotinamide adenine dinucleotides (NAD, NADH, NADPH) were determined in needle biopsies taken from the ischaemic region 1/2, 1, 11/2, 2 and 4 h after occlusion of the LAD. In another set of experiments the NBT stain was altered by the addition of NADH, NAD, NADPH, NADP, succinate, lactate and phenazine methosulfate respectively and the effect of the added substances on the previously nonstained infarcts was examined. We further compared histochemically determined infarct size to the ultrastructural extent of infarcts. Activities of the tissue dehydrogenases did not change after 4 h of ischaemia, although the NBT stain revealed a large infarction. At that time total NAD, the sum of NAD+NADH, had decreased from about 600 pmoles/mg tissue to about 200 pmoles/mg tissue and addition of the coenzymes or succinate could “repair” the biochemical lesion. After 24 h of ischaemia the activities of dehydrogenases and diaphorases were markedly decreased. Our data indicate that loss of the reduced coenzymes plays a key role in identifying myocardial infarction with tetrazolium salts. In older infarctions loss of coenzymes is joined by decreased activities of dehydrogenases and diaphorases. The principal mechanisms of staining is an enzymatic cycling.
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  • 2
    ISSN: 1432-1238
    Keywords: Infarct size ; Intraaortic balloon pumping ; Collateral flow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To determine the influence of IABP on infarct size and collateral blood flow in each of 12 openchest anaesthetised mongrel dogs two small branches of the left coronary artery were occluded consecutively. The perfusion areas of both branches were comparable in size. IABP was started immediately before ligation of the first branch for a 90-min period followed by a reperfusion period of 90 min. Subsequently the second vessel was also occluded for 90 min as a control without IABP while myocardial oxygen consumption remained constant and was then reperfused. Infarct size was expressed as a percentage of the perfusion area. A difference in infarct size with and without IABP (18±17, 18±10% respectively) could not be observed. However a significant increase of collateral blood flow due to IABP in the subendocardial layer from 8.9±4.8 to 14.9±4.6 ml/100 g/min (p〈0.05) was prevalent. In the subepicardial layer the augmentation from 23.7±19.9 to 26.9±15.2 was not significant. Thus, in spite of a small increase of collateral blood flow in the subendocardial layer of the ischemic myocardium the infarct size was not reduced by IABP in our dog model.
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  • 3
    ISSN: 1435-1803
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Beeinflussung der myokardialen Infarktgröße durch Hyaluronidase (HY) nach experimentellem Koronargefäßverschluß wurde an zwei Gruppen von Hunden untersucht. Gruppe I erhielt HY als Bolus von 500 IU/kg KG vor 90minütiger Okklusion eines mittelgroßen Marginal- oder Diagonalastes. Die gleiche Dosis HY wurde mit konstanter Geschwindigkeit während des Koronarverschlusses infundiert. Ein zweites Gefäß desselben Herzens wurde bei vergleichbaren Bedingungen ohne Therapie verschlossen. Diese Arterie wurde vor der ersten Gabe von HY reperfundiert. Gruppe II erhielt intrakoronar 500 IU/kg. Danach wurde die LAD bei geschlossenem Thorac okkludiert. In der folgenden 24stündigen Okklusionsperiode wurde die Dosis von 200 IU/kg HY siebenmal in regelmäßigen Abständen injiziert. In beiden Gruppen wurden durch HY weder der Kollateral- noch der normale Fluß verändert, ebenso blieben hämodynamische Parameter konstant. Trotzdem führte die Therapie in Gruppe I zu einer Verringerung der Infarktgröße von einer Nekrose von 29% des Perfusionsgebietes (Kontrolle) zu 14% nach HY. Nach 24stündiger kontinuierlicher Therapie hingegen unterschied sich die Infarktgröße nicht von einer Kontrolle. HY konnte daher signifikant den Übergang von Ischämie zu Nekrose verzögern, aber nicht verhindern. Die Infarktgröße nach 24stündigem Verschluß war indifferent gegenüber einer Kontrollgruppe.
    Notes: Summary The effect of hyaluronidase (HY) on myocardial infarct size after experimental coronary artery occlusion was studied in two groups of dogs. Group I received HY as a bolus of 500 IU/kg BW prior to occlusion of a medium-sized marginal or diagonal vessel during 90 minutes. Another 500 IU/kg of HY was infused at constant rate during coronary occlusion. Another artery of the same heart was occluded under comparable conditions without therapy. This artery was reperfused before the first dose of HY. In group II the LAD was occluded in a closed chest preparation after intracoronary injection of 500 IU/kg BW of HY. During the ensuing 24 hours occlusion period the dose of 200 IU/kg HY was repeated seven times in regularly spaced intervals. Neither collateral nor normal flow was altered in both groups by HY and hemodynamic conditions remained constant. Nevertheless in group I therapy led to a reduction of infarct size from 29% (control) to 14% necrosis of the perfusion area after HY, whereas after 24 hours of continuing therapy the size of the infarcted area did not differ from control. Thus HY was able to significantly postpone the transition of ischemia to necrosis but was unable to prevent it. Infarct size following 24 hours of occlusion was not different from a control group.
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Basic research in cardiology 75 (1980), S. 572-582 
    ISSN: 1435-1803
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Über die Wirkung einer Reperfusion nach unterschiedlich langem Koronargefäßverschluß liegen einander widersprechende Ergebnisse vor: Rettung ischämischen Myokards einerseits und Vergrößerung des Infarkts andererseits, besonders im Zusammenhang mit hämorrhagischer Infarzierung. Zur Abklärung dieser Frage und zur Bewertung unserer eigenen Methode der Infarktgrößenbestimmung, die z. T. auf einer Reperfusion beruht, wurden an 12 Hunden 2 Koronargefäße des jeweils selben Herzens okkludiert. Ein Gefäßgebiet wurde reperfundiert, das andere nicht. Durch die Auswahl zweier klein- bis mittelgroßer Arterien mit vergleichbarem Perfusionsgebiet und durch Aufrechterhaltung eines konstanten MVO2 waren die Bedingungen beider Okklusionsperioden vergleichbar. Die Infarktgröße von reperfundiertem und nichtreperfundiertem Myokard war identisch-sowohl nach drei wie nach sechs Stunden Okklusionsdauer. Reperfusion nach sechsstündiger Okklusion war immer mit hämorrhagischer Infarzierung verknüpft, während nichtreperfundierte Infarkte hämorrhagiefrei blieben. Jedoch unterschieden sich hämorrhagische und nichthämorrhagische Infarkte aus einem Herzen nicht in ihrer Ausdehnung.
    Notes: Summary Reperfusion following various intervals of coronary occlusion has produced conflicting results: increase in infarct size, especially with hemorrhage into the tissue, was reported as well as salvage of ischemic myocardium. To examine the problem and for the validation of our own method for infarct size measurement, which depends to a certain degree on reperfusion, we occluded two coronary arteries of the same heart in each of 12 open-chest dogs. One artery was reperfused, the other not. Comparable conditions for both occlusions were warranted by selection of small-to-medium sized arteries of equal size and by maintaining of constant MVO2. Reperfused and non-reperfused myocardium did not differ with regard to infarct size, neither after a three-hour nor after a six-hour occlusion. Reperfusion always led to hemorrhagic infarction when performed after six-hour occlusion, while nonreperfused infarctions showed no hemorrhage. Hemorrhagic infarcts were not larger as compared to the non-hemorrhagic infarct in the same heart.
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  • 5
    ISSN: 1435-1803
    Keywords: NAD ; ultrastructure ; ischemic cell injury
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Der biochemische Mechanismus, der dafür verantwortlich ist, daß reversibel geschädigte Zellen schließlich sterben, ist unbekannt. Wir untersuchten, ob der Verlust an Nicotinamidcoenzymen der entscheidende Grund für den Zelluntergang sein kann. Bei 6 Hunden wurde der Ramus interventricularis anterior für 4 h unterbunden. Transmurale Nadelbiopsien wurden nach 1/2 h, 1 h, 1 1/2 h, 2 h und 4 h Ischämie aus dem ischämischen Gebiet entnommen und in subepikardiale und subendokardiale Hälften unterteilt. Zu den angegebenen Zeiten wurden die Konzentrationen der Coenzyme NAD, NADH und NADPH in den Biopsien gemessen und der Schädigungsgrad des Gewebes durch elektronenmikroskopische Untersuchung bestimmt. Die Glycohydrolaseaktivität (E.C. 3.2.2.5) wurde in Gehirn, Herz, Niere und Skelettmuskel von 4 Ratten ermittelt. Gesamt-NAD, die Summe von NAD und NADH, nahm signifikant nach einer Stunde im ischämischen Subendokard ab. Der Verlust and NADPH trat erst nach zwei Stunden ein. Wenn durch ultrastrukturelle Untersuchung irreversible Zellschädigung festgestellt wurde, hatte der Gesamtgehalt von NAD etwa 60–70% abgenommen. Die Glycohydrolaseaktivität war am höchsten im Gehirn, gefolgt von Herz, Niere und Skelettmuskel und entspricht der unterschiedlichen Ischämietoleranz dieser Organe. Wir nehmen an, daß der entscheidende Grund für die irreversible Zellschädigung die Gewebsazidose ist, die zu einer Aktivierung der Glycohydrolase führt, die ihrerseits die lebenswichtigen Coenzyme spaltet.
    Notes: Summary We investigated if the loss of nicotinamide coenzymes in ischemic-infarcted myocardium may be responsible for the transition from reversibly ischemic to irreversibly infarcted cell damage. The LAD was occluded in 6 dogs for 4 h. Transmural needle biopsies were taken from the ischemic-infarcted region after 1/2, 1, 1 1/2, 2, and 4 h of ischemia and further divided into subepicardial and subendocardial halves. At each time interval the concentration of the nicotinamide coenzymes NAD, NADH, and NADPH were measured, and the degree of cellular injury was evaluated by electron microscopy. The glycohydrolase activity (EC 3.2.2.5), the enzyme which splits NAD, was determined in brain, myocardium, kidney, and skeletal muscle of 4 rats. Total NAD, the sum of NAD and NADH, started to decrease significantly in the ischemic subendocarium 1 h after onset of ischemia. Degradation of NADPH occurred later. Loss ot total NAD was about 60–70% when electron microscopy diagnosed irreversible cell injury. The glycohydrolase activity was the highest in brain followed by myocardium, kidney, and skeletal muscle, reflecting the different tolerances of these tissues towards ischemia. The key mechanism for ischemic injury seems to be the tissue acidosis which activates the glycohydrolase leading to a loss of the vital coenzymes.
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  • 6
    ISSN: 1435-1803
    Keywords: closed chest ; infarct size ; critical flow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Myocardial infarction was induced in 7 mongrel dogs by transfemoral intraluminal occlusion of the left anterior descending coronary artery. Perfusion area at risk was determined by post-mortem coronarography and infarct size by macrohistological staining with para-nitrophenoltetrazolium. Regional flow was determined by injection of radioactive microspheres 0.2 hours, 12 hours, and 24 hours post occlusion. Infarct size as determined by planimetry of post-mortem angiograms and macrohistological stains at identical magnification revealed 74.5±12.1% infarcted tissue of the perfusion area at risk. The flow of the necrotic tissue was below 13 ml/100 g min without exception, indicating a threshold perfusion for maintenance of myocardial viability. Accordingly, a flow of ≦10 ml/100 g min identified 93% of the entire infarcted myocardium, resulting in 71±20% as compared to the perfusion area at risk. Based on the good agreement of macrohistological and flow data, the evolution of myocardial injury was determined by flow measurements. The results indicated a different progression of the borders of critical flow in the subendocardial and subepicardial layers, whereas in the subendocardium 85% of the tissue at risk was identified by the critical flow at 0.2 hours and 97% at 12 hours, the subepicardial flow changed at a different pace: only 53% showed subcritical perfusion at 0.2 hours, 61% at 12 hours with a final increase of 39% from 12 to 24 hours.
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  • 7
    ISSN: 1435-1803
    Keywords: regional ischemia ; perfusion deficit, supply/demand ratio ; collateral flow ; instantaneous oxygen consumption ; development of necrosis ; infarct size
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary It is well known that coronary occlusions of short duration do not produce infarcts in the dog heart, but permanent occlusions always do. The aim of this paper was to investigate with quantitative direct measurements the determinants of infarct size within these two extremes. We measured left ventricular $$M\dot V_2$$ , coronary and collateral blood flow and infarct size after occlusion times varying between 45 minutes and 24 hours. $$M\dot VO_2$$ was kept low in one group by establishing low heart rates with a synthetic opiate. In another group, $$M\dot V_2$$ was kept elevated by giving synthetic catecholamines (dobutamine) that stimulated contractility and heart rate. Under the described experimental conditions LV-coronary blood flow reflected the true demand for blood and oxygen. The ratio of collateral blood flow over coronary blood flow (both measured with tracer microspheres) was therefore a good approximation of the supply-demand ratio (SD). Since collateral flow was inhomogeneously distributed across the left ventricular wall, the SD-ratio showed similar variations. As the collateral blood flow increased with elapsed time after coronary occlusion, the SD-ratio improved. Since high LV-O2-demand increased coronary flow but exerted practically no influence on collateral flow, this situation influenced the SD-ratio in a negative way. Decreased O2-demand had the opposite effect. The SD-ratio is thus a valid expression of the relative and absolute blood flow deficit as influenced by the local and general O2-demand. We found significant and characteristic correlations between the SD-ratio and infarct which was only influenced by time. A blood flow deficit of 90% (i.e., collateral flow =10% of required flow) produced a 50%-infarct (relative to the risk-region) with a 45-min occlusion but a 90%-infarct with occlusion times of 3 hrs and longer. If the perfusion deficit is only 0.5 (collateral flow =50% of required flow), no infarct is detectable at occlusion times shorter than 3 hrs. Small perfusion deficits of only 20% below required flow caused infarctions at 24 hrs and longer. In the group where the SD-ratio was closer to unity because of a low overall LV-O2-consumption (bradycardia), infarcts at t=24 hrs were significantly smaller than in the group with a high $$LV - M\dot VO_2$$ .
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  • 8
    ISSN: 1435-1803
    Keywords: collaterals ; myocardial protection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Previous work of this laboratory has shown that collateral flow can be increased over six weeks by a subcritical external constriction of the circumflex artery causing a 50±10% reduction of postocclusive reactive hyperemia. To investigate collateral function in acuté myocardial infarction, the model was used to ligate two distant coronary branches on the ventricle simultaneously in order to compare in 8 dogs infarct size and perfusion area of the ligated vessels in control and collateralized sections. The acute collateral flow measured 7.2±2.5 ml/100 g/min−1 and increased to 17.3±6.7 (p〈0.001) over 6 weeks. Separate analysis revealed a predominant increase of collateral flow in the epicardial layers 23.1±7.5 (p〈0.01) versus 6.9±2.8 (p〈0.01) in the subendocardium. Infarct size in the control area was 52.0±14.7% of the perfusion area, in the collateralized zone 19.0±14.2% (p〈0.001). Infarct size expressed as per cent of perfusion area and collateral flow in the area at risk expressed as per cent of flow of normal sections correlated: (r=0.76; p〈0.05). Therefore, infarct size after a 6 hour coronary occlusion can be considered a function of the collateral flow over normal perfusion ratio. Localized induction of collaterals in this model caused a significant reduction of infarct size in relation to the perfusion area at risk.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Basic research in cardiology 76 (1981), S. 144-151 
    ISSN: 1435-1803
    Keywords: myocardial infarction ; β-adrenergic blockade ; infarct size ; collateral flow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An 10 Hunden wurde die Wirkung von Pindolol auf die Hämodynamik, die regionale Myokardperfusion und die Infarktgröße nach experimentellem Koronarverschluß untersucht. An jedem Herzen wurden hintereinander 2 mittelgroße Äste der linken Koronararterie okkludiert. Nach Ligatur (90 Minuten) und Reperfusion der ersten Arterie (Kontrollarterie) wurde die Inititaldosis Pindolol (0,25 mg/kg Körpergewicht) infundiert. Während der Ligatur (90 Minuten) der zweiten Arterie (Testarterie) wurde eine Erhaltungsdosis Pindolol (0,3 mg/kg Körpergewicht/90 Minuten) infundiert. Der linke Ventrikeldruck, LV-dp/dt max., Aortendruck und Herzfrequenz wurden kontinuierlich gemessen. Der myokardiale Sauerstoffverbrauch wurde vom Computer (Bretschneider-Formel) während des Experimentes berechnet. Die Myokarddurchblutung wurde mit Hilfe der “tracer microsphere”-Technik bestimmt. Das Nekrosegebiet wurde makrohistochemisch (NBT-Färbung) und das Perfusionsgebiet der verschlossenen Arterie wurde angiographisch definiert. Die resultierende Infarktgröße wurde als Quotient aus Nekrose-und Perfusionsgebiet in Prozent ausgedrückt. Pindolol verursachte einen signifikanten Abfall des linken Ventrikeldrucks, und LV-dp/dt, die Herzfrequenz, änderte sich nicht. Der myokardiale Sauerstoffverbrauch nahm signifikant von 7,9±1,4 auf 6,9±1,9 ml/min×100g ab. Der Kollateralfluß betrug im Perfusionsgebiet der Kontrollarterie 11,2±5,9% und in dem der Testarterie 10,0±4,4% der Normaldurchblutung. Die Infarktgröße konnte durch Pindolol nicht beeinflußt werden, sie betrug nach Verschluß der Kontrollarterie 48,2±22,2% und nach Verschluß der Testarterie 43,0±23,9%.
    Notes: Summary The effect of Pindolol on myocardial infarct size was studied in 10 open chest dogs. In each animal a sequential occlusion and reperfusion of 2 medium-sized branches of the left coronary artery was performed in the same heart. After occlusion and reperfusion of the control artery the initial dose of Pindolol (0.25 mg/kg body weight) was administered. Thereafter the test artery was occluded, followed by a maintenance dose of Pindolol (0.3 mg/kg body weight). The drug caused a significant decrease in LVP and LV-dp/dt but no change in heart rate. MVO2 also decreased significantly. Regional myocardial blood flow was measured with the tracer microsphere method. Collateral flow in the perfusion area of the control artery was 11.2±5.9% and in the area of the test artery 10.0±4.4% of normal. No change in the endo/epi ratio as a result of treatment was observed. The area of infarction (p-nitroblue tetrazolium-reaction) was divided by the area of perfusion (angiography). Infarct size, expressed as the percentage of the perfusion area. was 48.2±22.2% in the region of the control artery and 43.0±23.9% in the region of the test artery. The difference was statistically not significant.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Basic research in cardiology 76 (1981), S. 480-484 
    ISSN: 1435-1803
    Keywords: coronary artery ; vascular smooth muscle ; spontaneous activity ; experimental occlusion ; collateral arteries ; coronary spasm ; tetraethylammonium ; indomethacin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Collateral vessels from dogs showed good mechanical responses, with well-developed inhibitory responses, for example to noradrenaline. Endogenous inhibitory processes, which resulted in a low spontaneous basal tone, were also well-developed in most tissues. However, signs of hyperactivity were observed in some cases — and this might be the most interesting result. This hyperactivity was characterized by a strong phasic spontaneous activity. This might be an abnormality associated with the rapid proliferation of smooth muscle cells in collateral vessels. It is quite possible that such states of hyperactivity may play a role in human pathology, producing coronary spasm and leading to angina or infarction, perhaps even in hearts with well developed collaterals.
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