Thermotropic structural changes in plasma lipoproteins in ischemic heart disease

Objective. The aim of this study was to determine atrial structural remodeling during the development of ischemic heart disease. Material and methods. Quantitative histomorphometric parameters of interstitial collagen network (the percentage volume, perimeter, number of fibers per field and collagen–cardiomyocyte volume ratio) of the atria of 132 autopsied men (mean age 49.7±8.9 years) who had died suddenly (within 6 hours since the onset of terminal heart attack symptoms) due to the first (no postinfarction scars) and repeated (postinfarction scars present) acute “pure” ischemic heart disease were investigated. Results. The main remodeling feature of the wall of the both atria among ischemic heart disease subjects is hypertrophy of cardiomyocytes and hyperplasia of interstitial fibrillar collagen network with the maintenance of the same proportion of contractile myocardium and fibrillar collagen network volume. This proportion in the case of the left atrium persists in both pre- and postinfarction ischemic heart disease groups, while myocardium of the right atrium in preinfarction group subjects is characterized by an excess increase of collagen network as compared to cardiomyocyte hypertrophy, which levels again with that of the control in postinfarction group. Conclusions. At preinfarction stage of ischemic heart disease, remodeling of both atria develops and progresses in the left atrium at postinfarction stage in the relationship with increase of left ventricular dysfunction.

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Emerging methods for the characterization of ischemic heart disease: ultrafast Doppler angiography, micro-CT, photon-counting CT, novel MRI and PET techniques, and artificial intelligence

European Radiology Experimental ◽

10.1186/s41747-021-00207-3 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Martin J. Willemink ◽

Akos Varga-Szemes ◽

U. Joseph Schoepf ◽

Marina Codari ◽

Koen Nieman ◽

...

Keyword(s):

Artificial Intelligence ◽

Heart Disease ◽

Ischemic Heart Disease ◽

Structural Changes ◽

Photon Counting ◽

Ischemic Heart ◽

Micro Ct ◽

Positron Emission ◽

Fibrotic Scar

AbstractAfter an ischemic event, disruptive changes in the healthy myocardium may gradually develop and may ultimately turn into fibrotic scar. While these structural changes have been described by conventional imaging modalities mostly on a macroscopic scale—i.e., late gadolinium enhancement at magnetic resonance imaging (MRI)—in recent years, novel imaging methods have shown the potential to unveil an even more detailed picture of the postischemic myocardial phenomena. These new methods may bring advances in the understanding of ischemic heart disease with potential major changes in the current clinical practice. In this review article, we provide an overview of the emerging methods for the non-invasive characterization of ischemic heart disease, including coronary ultrafast Doppler angiography, photon-counting computed tomography (CT), micro-CT (for preclinical studies), low-field and ultrahigh-field MRI, and 11C-methionine positron emission tomography. In addition, we discuss new opportunities brought by artificial intelligence, while addressing promising future scenarios and the challenges for the application of artificial intelligence in the field of cardiac imaging.

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