Circulation, Vol 81, 949-958, Copyright © 1990 by American Heart Association
JG Pickering and DR Boughner
Long-distance procurement of cardiac allografts is commonly used to
increase the supply of donor organs but has recently been associated with
the development of impaired diastolic function. Therefore, the effect of
the total ischemic duration on myocardial fibrosis was quantitatively
evaluated in 36 cardiac transplant recipients in whom the ischemic time
ranged from 70 to 363 (mean, 189 +/- 83) minutes. Interstitial collagen was
quantified with polarization microscopy and digital image analysis in 115
endomyocardial biopsy specimens taken 5- 10 days after surgery. The
technique, developed for this study, showed excellent correlation with
hydroxyproline analysis (r = 0.98, p less than 0.001). Collagen volume
fraction in biopsy specimens from the transplanted hearts was significantly
greater than that in biopsy samples from seven normal, age-matched autopsy
hearts (4.7 +/- 1.9% vs. 2.9 +/- 0.6%, p less than 0.02). The degree of
fibrosis correlated with the total ischemic time (r = 0.60, p less than
0.001). Donor age ranged from 10 to 51 years and did not correlate with the
degree of fibrosis. No relation was found between the corresponding
collagen content and right atrial pressure, pulmonary artery wedge
pressure, or cardiac output measured at the time of biopsy. Myocyte damage
was observed in eight of the 36 patients and was characterized by a
striking loss of muscle birefringence. We conclude that cardiac allograft
fibrosis may be identified shortly after transplantation and is dependent
on the total ischemic duration.
ARTICLES
Fibrosis in the transplanted heart and its relation to donor ischemic time. Assessment with polarized light microscopy and digital image analysis
Department of Medicine, University of Western Ontario, London, Canada.
This article has been cited by other articles:
 |
|
 |
|
  A. Zhang, J. J. David, S. V. Subramanian, X. Liu, M. D. Fuerst, X. Zhao, C. V. Leier, C. G. Orosz, R. J. Kelm Jr., and A. R. Strauch Serum response factor neutralizes Pur{alpha}- and Pur{beta}-mediated repression of the fetal vascular smooth muscle {alpha}-actin gene in stressed adult cardiomyocytes Am J Physiol Cell Physiol, March 1, 2008; 294(3): C702 - C714. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Koch, C. Geil-Bierschenk, R. Rieker, T. J. Dengler, F.-U. Sack, P. Schirmacher, S. Hagl, and P. A. Schnabel Morphometric changes of the right ventricle in the first two weeks after clinical heart transplantation: analysis of myocardial biopsies from patients with complicated versus uncomplicated course. Eur. J. Cardiothorac. Surg., August 1, 2006; 30(2): 370 - 378. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Zhang, X. Liu, J. G. Cogan, M. D. Fuerst, J. A. Polikandriotis, R. J. Kelm Jr., and A. R. Strauch YB-1 Coordinates Vascular Smooth Muscle {alpha}-Actin Gene Activation by Transforming Growth Factor {beta}1 and Thrombin during Differentiation of Human Pulmonary Myofibroblasts Mol. Biol. Cell, October 1, 2005; 16(10): 4931 - 4940. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Salih, K. P. McCarthy, and S. Y. Ho The fibrous matrix of ventricular myocardium in hypoplastic left heart syndrome: a quantitative and qualitative analysis Ann. Thorac. Surg., January 1, 2004; 77(1): 36 - 40. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. C. Grimm, P. Nickerson, J. Gough, R. McKenna, E. Stern, J. Jeffery, and D. N. Rush Computerized Image Analysis of Sirius Red-Stained Renal Allograft Biopsies as a Surrogate Marker to Predict Long-Term Allograft Function J. Am. Soc. Nephrol., June 1, 2003; 14(6): 1662 - 1668. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. M. Seccia, A. S. Belloni, R. Kreutz, M. Paul, G. G. Nussdorfer, A. C. Pessina, and G. P. Rossi Cardiac fibrosis occurs early and involves endothelin and AT-1 receptors in hypertension due to endogenous angiotensin II J. Am. Coll. Cardiol., February 19, 2003; 41(4): 666 - 673. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. H. Yamani, S. A. Haji, R. C. Starling, E. M. Tuzcu, N. B. Ratliff, D. J. Cook, A. Abdo, T. Crowe, M. Secic, P. McCarthy, et al. Myocardial ischemic-fibrotic injury after human heart transplantation is associated with increased progression of vasculopathy, decreased cellular rejection and poor long-term outcome J. Am. Coll. Cardiol., March 20, 2002; 39(6): 970 - 977. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Meyer, L. E. Bennett, R. J. Novick, and J. D. Hosenpud Effect of Donor Age and Ischemic Time on Intermediate Survival and Morbidity After Lung Transplantation Chest, November 1, 2000; 118(5): 1255 - 1262. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Pauschinger, D. Knopf, S. Petschauer, A. Doerner, W. Poller, P. L. Schwimmbeck, U. Kuhl, and H.-P. Schultheiss Dilated Cardiomyopathy Is Associated With Significant Changes in Collagen Type I/III ratio Circulation, June 1, 1999; 99(21): 2750 - 2756. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. M. Thai, H. T. Van, M. A. Gaballa, S. Goldman, and T. E. Raya Effects of AT1 receptor blockade after myocardial infarct on myocardial fibrosis, stiffness, and contractility Am J Physiol Heart Circ Physiol, March 1, 1999; 276(3): H873 - H880. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Coirault, J.-L. Samuel, D. Chemla, J.-C. Pourny, F. Lambert, F. Marotte, and Y. Lecarpentier Increased compliance in diaphragm muscle of the cardiomyopathic Syrian hamster J Appl Physiol, November 1, 1998; 85(5): 1762 - 1769. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. T. Armstrong, P. F. Binkley, P. B. Baker, P. D. Myerowitz, and C. V. Leier Quantitative investigation of cardiomyocyte hypertrophy and myocardial fibrosis over 6 years after cardiac transplantation J. Am. Coll. Cardiol., September 1, 1998; 32(3): 704 - 710. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Wharton, K. Morgan, R. A. D. Rutherford, J. D. Catravas, A. Chester, B. F. Whitehead, M. R. D. Leval, M. H. Yacoub, and J. M. Polak Differential Distribution of Angiotensin AT2 Receptors in the Normal and Failing Human Heart J. Pharmacol. Exp. Ther., January 1, 1998; 284(1): 323 - 336. [Abstract] [Full Text]
|
|
|
|
 |
|
 C. G. Brilla, L. Matsubara, and K. T. Weber Advanced Hypertensive Heart Disease in Spontaneously Hypertensive Rats: Lisinopril-Mediated Regression of Myocardial Fibrosis Hypertension, August 1, 1996; 28(2): 269 - 275. [Abstract] [Full Text]
|
|
|
|
|
|
B. Fyfe, E. Loh, G. L. Winters, G. S. Couper, A. I. Kartashov, and F. J. Schoen Heart Transplantation–Associated Perioperative Ischemic Myocardial Injury : Morphological Features and Clinical Significance Circulation, March 15, 1996; 93(6): 1133 - 1140. [Abstract] [Full Text]
|
|
|
|
 |
|
 P. A. Dowdy, A. Miniaci, S. P. Arnoczky, P. J. Fowler, and D. R. Boughner The Effect of Cast Immobilization on Meniscal Healing: An Experimental Study in the Dog Am. J. Sports Med., December 1, 1995; 23(6): 721 - 728. [Abstract] [PDF]
|
|
|
|
|
|
A. Nicoletti, D. Heudes, N. Hinglais, M.-D. Appay, M. Philippe, C. Sassy-Prigent, J. Bariety, and J.-B. Michel Left Ventricular Fibrosis in Renovascular Hypertensive Rats : Effect of Losartan and Spironolactone Hypertension, July 1, 1995; 26(1): 101 - 111. [Abstract] [Full Text]
|
|
|
|
|
|
M. H. Yamani, E. M. Tuzcu, R. C. Starling, N. B. Ratliff, Y. Yu, D. G. Vince, K. Powell, D. Cook, P. McCarthy, and J. B. Young Myocardial Ischemic Injury After Heart Transplantation Is Associated With Upregulation of Vitronectin Receptor ({alpha}v{beta}3), Activation of the Matrix Metalloproteinase Induction System, and Subsequent Development of Coronary Vasculopathy Circulation, April 23, 2002; 105(16): 1955 - 1961. [Abstract] [Full Text] [PDF]
|
|