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Am J Physiol Heart Circ Physiol (May 20, 2005). doi:10.1152/ajpheart.00423.2005
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Submitted on April 28, 2005
Accepted on May 17, 2005

Electromechanical analysis of infarct border zone in chronic myocardial infarction

Hiroshi Ashikaga1*, Steven R Mickelsen1, Daniel B Ennis1, Ignacio Rodriguez1, Peter Kellman1, Han Wen1, and Elliot R McVeigh1

1 Laboratory of Cardiac Energetics, National Heart, Lung and Blood Institute, Bethesda, MD, USA

* To whom correspondence should be addressed. E-mail: ashikagah{at}nhlbi.nih.gov.

To test the hypothesis that alterations in electrical activation sequence contribute to depressed systolic function in the infarct border zone, we examined the anatomical correlation of abnormal electromechanics and the infarct geometry in the canine post-myocardial infarction (MI) heart, using a high-resolution MR-based cardiac electromechanical mapping technique. Three to eight weeks after creating an MI in six dogs, a 247-electrode epicardial sock was placed over the ventricular epicardium under thoracotomy. MI location and geometry were evaluated with delayed hyperenhancement MRI. Three dimensional systolic strains in epicardial and endocardial layers were measured in five short axis slices using motion tracking MRI (DENSE). Epicardial electrical activation was determined from sock recordings immediately prior to and following the MR scans. The electrodes and MR images were spatially registered to create a total of 160 nodes per heart that contain mechanical, transmural infarct extent, and electrical data. The average depth of the infarct was 55±11% and the infarct covered 28±6% of the LV mass. Significantly delayed activation (>mean+2SD) was observed within the infarct zone. The strain map showed abnormal mechanics, including abnormal stretch and loss of the transmural gradient of radial, circumferential and longitudinal strains, in the region extending far beyond the infarct zone. We conclude that the border zone is characterized by abnormal mechanics directly coupled with normal electrical depolarization. This indicates that impaired function in the border zone is not contributed by electrical factors, but results from mechanical interaction between the ischemic and normal myocardium.




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