CARDIOMYOCITE HIBERNATION AND HEPATIZATION IN ISHEMIC HEART DISEASE
Journal Title: Праці Наукового товариства ім. Шевченка - Year 2015, Vol 43, Issue 2
Abstract
Introduction. Myocardial hibernation is a clinically imported syndrome leading to cardiac dysfunction and heart failure, which could be partly reversible after appropriate pharmacotherapy or revascularization. It is revealed in ischemic heart disease various forms and needs well-timed diagnostics and appropriate pharmacotherapy or revascularization. The aim of the investigation was to reveal the ultra structural features o f hibernating cardiomyocytes (CMC) located near chronic post infarction aneurism wall, their ultra structural organization, viability and mechanisms o f death, as to provide rationale for therapeutic treatment. Material and Methods. Intraoperative myocardial biopsies were obtained during post infarction chronic aneurism ventriculoplastic o f five patients suffering from arterial hypertension and diabetes mellitus. Results. On the periphery of post infarction chronic aneurism wall we have revealed a certain number ofhibernating CMC without cardio specificity because they contain increased amount o f aggregated glycogen granules in rosett-formes (a-glycogen) characteristic for hepatocytes but not for cardiomyocytes. The last classically contain dispers glycogen particles b-glycogen. Such hepatized CMC were predominantly revealed near diskinetic aneurism wall. Ultrastructural changes in hibernating CMC consisted in progressive glycogen accumulation in sarcoplasma, with mitochondria becoming altered and disorganized, myofibrils relaxed, fragmented and decreasing in volume. Finally hibernating CMC dye via apoptosis and secondary necrosis. Apoptotic bodies could persist for a considerable period of time because they are surrounded by a thickend basement membrane or plasmatic membrane and do not induce hemotaxis. That’s why we didn’t reveal their phagocytosis by macrophages. Conclusions. Postinfarction cardiosclerosis is typically accompanied with cardiomyocyte hibernation and their hepatisation near postinfarction aneurism wall especially in patients suffering from diabetes mellitus. Accumulation a-glycogen in CMC indicates their irreversible hibernation and could be the reason for invasive treatment.
Authors and Affiliations
Yulian KYYAK, Olga BARNETT, Vasyl KOVALYSHYN, Hryhoriy KYYAK, Dmytro BESH, Volodymer MOROZ
Keywords
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