NDLI: Regenerative healing following foetal myocardial infarction.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Herdrich, Benjamin J. Danzer, Enrico Davey, Marcus G. Allukian, Myron Englefield, Virginia Gorman, Joseph H. Gorman, Robert C. Liechty, Kenneth W.
Description	Country affiliation: United States Author Affiliation: Herdrich BJ ( The University of Pennsylvania School of Medicine, Philadelphia, PA, USA. benjamin.herdrich@uphs.upenn.edu)
Abstract	OBJECTIVES: The adult response to myocardial infarction results in inflammation, scar formation, left ventricular dilatation, and loss of regional and global function. Regenerative scarless healing has been demonstrated in foetal dermis and tendon and is associated with diminished inflammation. We hypothesised that following foetal myocardial infarction, there would be minimal inflammation, regenerative healing, and preservation of function. METHODS: Anteroapical myocardial infarction encompassing 20% of the left ventricle was created in adult or early gestation foetal sheep. Myocardial function was serially assessed using quantitative echocardiography. Infarct architecture was examined histologically for evidence of scar formation. Cellular inflammation, cellular proliferation, and apoptosis were assessed using immunohistochemistry. RESULTS: In the adult sheep 4 weeks following myocardial infarction, there was a significant decline in ejection fraction (EF) (41±7.4% to 26±7.4%, p<0.05), and the akinetic myocardial segment increased in size (6.9±0.8 cm to 7.9±1.1 cm, p<0.05). By contrast, there was no decline in the foetal EF (53±8.1% to 55±8.8%) and no akinetic foetal myocardial segment 4 weeks post-infarction. The foetal infarcts lacked an inflammatory cell infiltrate and healed with minimal fibrosis, compared with the adults. Foetal infarcts also demonstrated 5-bromo-2'-deoxyuridine (BrdU)+ proliferating cells, including cardiomyocytes, within the infarct. CONCLUSIONS: These data demonstrate that the foetal response to myocardial infarction is dramatically different from the adult and is characterised by minimal inflammation, lack of fibrosis, myocardial proliferation and restoration of cardiac function. Diminished inflammation is associated with foetal regenerative cardiac healing following injury. Understanding the mechanisms involved in foetal myocardial regeneration may lead to applications to alter the adult response following myocardial infarction.
File Format	HTM / HTML
ISSN	10107940
e-ISSN	1873734X
DOI	10.1016/j.ejcts.2010.03.049
Journal	European Journal of Cardio-Thoracic Surgery
Issue Number	6
Volume Number	38
Language	English
Publisher	Oxford University Press
Publisher Date	2010-12-01
Publisher Place	Germany
Access Restriction	Open
Subject Keyword	Discipline Cardiology__semicolon__surgery Fetal Diseases Physiopathology Fetal Heart Physiology Myocardial Infarction Regeneration Animals Apoptosis Cicatrix Pathology Disease Models, Animal Ultrasonography Ventricular Remodeling Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine

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