The variable morphological coexistence of apoptosis and necrosis in human myocardial infarction: significance for understanding its pathogenesis, clinical course, diagnosis and prognosis.

摘要: BACKGROUND Myocardial infarction includes both apoptosis and necrosis, but little is known of the morphological relationship these two different forms cell death in human heart, despite possibility that this may have clinical importance. METHODS Hearts from 77 cases fatal myocardial were examined. Twelve morphologically representative hearts selected for immunohistochemical staining to define detail histology cytology apoptotic areas. RESULTS Both necrosis present every heart. Necrotic myocytes quickly disintegrate evoke acute inflammation. Apoptotic retain their membrane integrity do not Phagocytosis cells bodies occurred with engulfment by either neighboring or macrophages, predominantly latter. In many areas, phagocytic capacity was overwhelmed, resulting large pools lying free extracellular space. CONCLUSIONS Because integrity, enzymatic diagnosis due necrosis. Measurement any intracellular enzyme consequently always underestimates extent infarction, often a margin. Morphological progression depend upon exceeding local phagocytosis cells. However, dying are equally dead. There need better definition role hibernation (or stunning), ischemic preconditioning pathogenesis silent angina, post-myocardial remodeling.