Mouse model of post-infarct ventricular rupture: time course, strain- and gender-dependency, tensile strength, and histopathology.

OBJECTIVE Recent studies on mice with surgically induced acute myocardial infarction (AMI) have documented the frequent occurrence of ventricular rupture, an event not previously reported in other laboratory species. We have examined the natural history, histopathology and myocardial mechanical strength in mice with AMI. METHODS AMI was induced by coronary artery occlusion and animals were monitored for fatal events. Gross and histological examinations were undertaken. RESULTS Rupture occurred in the left ventricular free wall at 2-6 days after AMI. Incidence of rupture in male mice varied among three strains studied (3% for FVB/N, 27% for C57B/6J, and 59% for 129sv, P<0.05) and was lower in female than male mice (23% vs. 59%, P<0.05). Histologically, ruptured hearts had rapid-occurring and severe infarct expansion, multifocal intramural hemorrhage and leucoyte infiltration at the border zone and infarcted zone. In vitro, infarcted left ventricles demonstrated a 50-60% reduction in muscle tensile strength. This reduction preceded the onset of rupture and was related to the time-window of rupture and to infarct size. CONCLUSION LV wall rupture in the mouse occurs within a narrow time-window after AMI and is strain- and gender-dependent. Infarct expansion, regional hemorrhage with formation of hematoma and leuocyte accumulation are important pathological changes leading to reduced myocardial tensile strength.

[1]  R. M. Rubison,et al.  A composite view of cardiac rupture in the United States National Registry of Myocardial Infarction. , 1996, Journal of the American College of Cardiology.

[2]  M. Fishbein,et al.  Effects of late coronary artery reperfusion after myocardial necrosis is complete. , 1984, American heart journal.

[3]  T. Ichiki,et al.  Targeted Deletion of Angiotensin II Type 2 Receptor Caused Cardiac Rupture After Acute Myocardial Infarction , 2002, Circulation.

[4]  S. Sankey,et al.  Estrogen and testosterone have opposing effects on chronic cardiac remodeling and function in mice with myocardial infarction. , 2003, American journal of physiology. Heart and circulatory physiology.

[5]  B. Jugdutt Left ventricular rupture threshold during the healing phase after myocardial infarction in the dog. , 1987, Canadian journal of physiology and pharmacology.

[6]  K. Kuck,et al.  Transmural, haemorrhagic myocardial infarction after intracoronary streptokinase. Clinical, angiographic, and necropsy findings. , 1982, British heart journal.

[7]  W. Steffee,et al.  Myocardial Healing and Repair after Experimental Infarction in the Rabbit , 1983, Circulation research.

[8]  J. Skurnick,et al.  Cardiac Rupture in Acute Myocardial Infarction: A Reassessment , 2002, The American journal of forensic medicine and pathology.

[9]  H. Sather,et al.  INTENSIVE THERAPY FOR CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKAEMIA AND UNFAVOURABLE PRESENTING FEATURES Early Conclusions of Study CCG-106 by the Childrens Cancer Study Group , 1988, The Lancet.

[10]  M. Cavasin,et al.  Temporal changes in matrix metalloproteinase expression and inflammatory response associated with cardiac rupture after myocardial infarction in mice. , 2004, Life sciences.

[11]  R. Virmani,et al.  Association of eosinophils with cardiac rupture. , 1985, Human pathology.

[12]  F. Harrell,et al.  Cardiac rupture, mortality and the timing of thrombolytic therapy: a meta-analysis. , 1990, Journal of the American College of Cardiology.

[13]  A. Skene,et al.  Cardiac rupture associated with thrombolytic therapy: impact of time to treatment in the Late Assessment of Thrombolytic Efficacy (LATE) study. , 1995, Journal of the American College of Cardiology.

[14]  M. Matsuda,et al.  Cineangiographic and pathological features of the infarct related vessel in successful and unsuccessful thrombolysis. , 1989, British heart journal.

[15]  E. Portiansky,et al.  Myocardial hypertrophy of normotensive Wistar-Kyoto rats. , 2004, American journal of physiology. Heart and circulatory physiology.

[16]  J. Soler‐Soler,et al.  Relevance of electrocardiographic findings, heart failure, and infarct site in assessing risk and timing of left ventricular free wall rupture during acute myocardial infarction. , 1995, The American journal of cardiology.

[17]  F. Schoen,et al.  Biomechanical properties of reperfused transmural myocardial infarcts in rabbits during the first week after infarction. Implications for left ventricular rupture. , 1992, Circulation research.

[18]  B. Bulkley,et al.  Expansion of Transmural Myocardial Infarction A Pathophysiologic Factor in Cardiac Rupture , 1979, Circulation.

[19]  R. Kloner,et al.  Effect of myocyte necrosis on strength, strain, and stiffness of isolated myocardial strips. , 1987, American heart journal.

[20]  A. Maseri,et al.  Age-Related Increase in Mortality among Patients with First Myocardial Infarctions Treated with Thrombolysis , 1993 .

[21]  A. Luttun,et al.  Inhibition of plasminogen activators or matrix metalloproteinases prevents cardiac rupture but impairs therapeutic angiogenesis and causes cardiac failure , 1999, Nature Medicine.

[22]  S. Carlson,et al.  Long-term telemetric recording of arterial pressure and heart rate in mice fed basal and high NaCl diets. , 2000, Hypertension.

[23]  D R Boughner,et al.  Role of Collagen in Acute Myocardial Infarct Expansion , 1991, Circulation.

[24]  A. Takeshita,et al.  Targeted deletion of MMP-2 attenuates early LV rupture and late remodeling after experimental myocardial infarction. , 2003, American journal of physiology. Heart and circulatory physiology.

[25]  W. Roberts,et al.  Frequency of rupture of the left ventricular free wall or ventricular septum among necropsy cases of fatal acute myocardial infarction since introduction of coronary care units. , 1989, The American journal of cardiology.

[26]  M. Reardon,et al.  Ischemic left ventricular free wall rupture: prediction, diagnosis, and treatment. , 1997, The Annals of thoracic surgery.

[27]  T. Onodera,et al.  Macroscopic hemorrhagic infarction following selective coronary thrombolysis in acute myocardial infarction. , 1985, Japanese circulation journal.

[28]  A. Dart,et al.  Serial echocardiographic assessment of left ventricular dimensions and function after myocardial infarction in mice. , 2000, Cardiovascular research.

[29]  S. Hindman,et al.  Surgical experience with left ventricular free wall rupture. , 2001, The Annals of thoracic surgery.

[30]  K. Batts,et al.  Postinfarction rupture of the left ventricular free wall: clinicopathologic correlates in 100 consecutive autopsy cases. , 1990, Human pathology.

[31]  W. Edwards,et al.  Cardiac rupture, a clinically predictable complication of acute myocardial infarction: report of 70 cases with clinicopathologic correlations. , 1993, Journal of the American College of Cardiology.

[32]  E. Antman,et al.  Fatal cardiac rupture among patients treated with thrombolytic agents and adjunctive thrombin antagonists: observations from the Thrombolysis and Thrombin Inhibition in Myocardial Infarction 9 Study. , 1999, Journal of the American College of Cardiology.

[33]  J. López-Sendón,et al.  Diagnosis of subacute ventricular wall rupture after acute myocardial infarction: sensitivity and specificity of clinical, hemodynamic and echocardiographic criteria. , 1992, Journal of the American College of Cardiology.

[34]  E. Sonnenblick,et al.  Collagen Loss in the Stunned Myocardium , 1992, Circulation.

[35]  V. Richard,et al.  Healing of myocardial infarcts in dogs. Effects of late reperfusion. , 1995, Circulation.

[36]  A. Dart,et al.  Lower Risk of Postinfarct Rupture in Mouse Heart Overexpressing &bgr;2-Adrenergic Receptors: Importance of Collagen Content , 2002, Journal of cardiovascular pharmacology.