The exact time of onset of functional expansion after acute myocardial infarction/ischemia remains unclear in spite of its potential link to chronic pathologic infarct expansion and its potential implications for therapy. To examine this early change in ventricular morphology, 14 open-chest dogs were studied with two-dimensional echocardiography before and after occlusion (10 minutes) of the left anterior descending coronary artery (LAD, n=7) or circumflex artery (CIRC, n=7). The endocardial surface area (ESA) and the area of abnormal wall motion (AWM) were reconstructed from the echocardiographic data using a previously reported technique for quantitatively mapping the ESA and extent of AWM. For the total group (N = 14), the mean ESA before occlusion was 48.9 ± 9.8 cm2, increasing to 65.7 ± 18.9 cm2 at 10 minutes occlusion (p < 0.001). For the LAD subgroup, the mean ESA before occlusion was 50.7 ± 9.3 cm2, increasing to 79.1 ± 14.1 cm2 at 10 minutes following occlusion (p < 0.001). For the CIRC subgroup, the mean ESA before occlusion was 47.1 ± 10.8 cm2, increasing to 52.3 ± 12.6 cm2 at 10 minutes after occlusion (p < 0.001). The ESA increase for the LAD subgroup was significantly larger than that of the CIRC subgroup (LAD range 14.5 to 49.9 cm2 versus CIRC range 1.5 to 9 cm2, p < 0.0001). Coronary occlusion resulted in similarly sized regions of AWM for both subgroups (LAD, 31.3 ± 12.2 cm2 versus CIRC, 25.9 ± 10.3 cm2, p = n.s.). For the LAD group, the largest increase in endocardial circumference occurred within the zone of AWM at the apex (39.9 ± 12%). The endocardial surface area therefore expands immediately after coronary occlusion and the magnitude of this process is primarily related to the site (anteroapical) rather than to the extent of AWM.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine