Skip to main content

Postmortem: Anatomic Quantitation

  • Chapter
Myocardial Infarction

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 14))

Abstract

Anatomic estimation of infarct size is considered to be the standard against which other methods of estimating infarct size should be tested. In most animal studies, evaluation of techniques for estimating infarct size as well as evaluation of interventions for limiting infarct size are based upon the direct anatomic determination of infarct size as a benchmark. Clinical studies using direct anatomic estimation of infarct size are less common because, fortunately, relatively few hospitalized patients die after an infarct. Moreover, the small percentage of patients in clinical studies who are autopsied may not be representative of the entire study population, since large or complicated infarcts are probably more common in this group than in the general population of patients with infarcts. Although a larger percentage of patients with small infarcts could be studied by obtaining needle biopsies of the left ventricle during cardiac surgery [1], such studies would not enable accurate estimation of infarct size because of the limited amount of tissue sampled.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bodenheimer MM, Banka VS, Hermann GA, Trout RG, Rasdar H, Helfant RH: Reversible asynergy. Histopathologic and electrographic correlations in patients with coronary artery disease. Circulation 53:792, 1976.

    PubMed  CAS  Google Scholar 

  2. Fishbein MC, Maclean D, Maroko PR: The histopathologic evolution of myocardial infarction. Chest 73:843, 1978.

    Article  PubMed  CAS  Google Scholar 

  3. Page DL, Caulfield JB, Kastor JA, DeSanctis RW, Sanders CA: Myocardial changes associated with cardiogenic shock. N Engl J Med 285.133, 1971.

    Article  PubMed  CAS  Google Scholar 

  4. Fukuyama T, Schechtman KB, Roberts R: The effects of intravenous nitroglycerin on hemodynamics, coronary blood flow and morphologically and enzymatically estimated infarct size in conscious dogs. Circulation 62:1227, 1980.

    PubMed  CAS  Google Scholar 

  5. Reimer KA, Lowe JE, Rasmussen MM, Jennings RB: The wavefront Phenomenon of ischemic cell death: I. Myocardial infarct size vs duration of coronary occlusion in dogs. Circulation 56:786, 1977.

    PubMed  CAS  Google Scholar 

  6. Reimer KA, Jennings RB: The ‘wavefront phenomenon’ of myocardial ischemic cell death: II. Transmural progression of necrosis within the framework of ischemic bed size (myocardium at risk) and collateral flow. Lab Invest 40:633, 1979.

    PubMed  CAS  Google Scholar 

  7. Budd GC, Gohara A, White P, Schott DR, Kooel JA, Ross JN Jr, Leighton RF: Application of a serial frozen sectioning technique to the analysis of myocardial infarct size. Lab Invest 38:533, 1978.

    PubMed  CAS  Google Scholar 

  8. Eckner FAO, Brown BW, Overll E, Glgov S: Alteration of the gross dimensions of the heart and its structures by formalin fixation. A quantitative study. Virchows Arch [Pathol Anat] 346:318, 1969.

    Article  CAS  Google Scholar 

  9. Bahr GF, Bloom G, Friberg U: Volume changes of tissues in physiological fluids during fixation in osmium tetroxide or formaldehyde and during subsequent treatment. Exp Cell Res 12:342, 1957.

    Article  PubMed  CAS  Google Scholar 

  10. Poliner LR, Buja LM, Parkey RW, Stokely EM, Stone MJ, Harris R, Saffer SW, Templeton GH, Bonte FJ, Willerson JT: Comparison of different noninvasive methods of infarct sizing during experimental myocardial infarction. J Nucl Med 18:517, 1977.

    PubMed  CAS  Google Scholar 

  11. Ferrans VJ: Morphological methods for evaluation of myocardial protection. Ann Thorac Surg 20:11, 1975.

    Article  PubMed  CAS  Google Scholar 

  12. Hackel DB, Ratliff NB Jr: A technic to estimate the quantity of infarcted myocardium post mortem. Am J Clin Pathol 61:242, 1974.

    PubMed  CAS  Google Scholar 

  13. Alonso DR, Scheidt S, Post M, Killip T: Pathophysiology of cardiogenic shock: quantification of myocardial necrosis, clinical, pathologic, and electrocardiographic correlations. Circulation 48:588, 1973.

    PubMed  CAS  Google Scholar 

  14. Maclean D, Fishbein MC, Maroko PR, Braunwald E: Hyaluronidase-induced reductions in myocardial infarct size. Science 194:199, 1976.

    Article  PubMed  CAS  Google Scholar 

  15. Virmani R, Roberts WC: Quantification of coronary arterial narrowing and of left ventricular myocardial scarring in healed myocardial infarction with chronic, eventually fatal, congestive cardiac failure. Am J Med 68:831, 1980.

    Article  PubMed  CAS  Google Scholar 

  16. Spadaro J, Fishbein MC, Hare C, Pfeffer MA, Maroko PR: Characterization of myocardial infarcts in the rat. Arch Pathol Lab Med 104:179, 1980.

    PubMed  CAS  Google Scholar 

  17. Weibel ER: Stereological methods, vol 1: Practical methods for biological morphometry. London, New York: Academic Press, 1979.

    Google Scholar 

  18. Hanarayan C, Bennett MA, Brewer DN, Pentecost BL: Study of infarcted myocardium in cardiac shock. Br Heart J 32:555, 1970.

    PubMed  CAS  Google Scholar 

  19. Cheitlin MD, Robinowitz M, McAllister H, Hoffmann JIE, Bharati S, Lev M: The distribution of fibrosis in the left ventricle in congenital aortic stenosis and coarctation of the aorta. Circulation 62:823, 1980.

    PubMed  CAS  Google Scholar 

  20. DiBona DR, Powell WJ Jr: Quantitative correlation between cell swelling and necrosis in myocardial ischemia in dogs. Circ Res 47:653, 1980.

    PubMed  CAS  Google Scholar 

  21. White FC, Sanders M, Peterson T, Bloor CM: Ischemic myocardial injury after exercise stress in the pressure-overloaded heart. Am J Pathol 97:473, 1979.

    PubMed  CAS  Google Scholar 

  22. Gil J, Sailage DA: Morphometry of pinocytotic vesicles in the capillary endothelium of rabbit lungs using automated equipment. Circ Res 47:384, 1980.

    PubMed  CAS  Google Scholar 

  23. Smith LR, Zissermann D, Cunningham W, Wixson SE, Bishop SP, Hood WPJr, Mantle JA, Rogers WJ, Russell RO Jr, Logic JR, Rackley CE: Measurement of cardiac parameters from cardiovascular images. In: Computers in cardiology. Long Beach, CA: IEEE Computer Society, 1976, p 49.

    Google Scholar 

  24. Savage RM, Wagner GS, Ideker RE, Podolsky SA, Hackel DB: Correlation of postmortem anatomic findings with electrocardiographic changes in patients with myocardial infarction: retrospective study of patients with typical anterior and posterior infarcts. Circulation 55:279, 1977.

    PubMed  CAS  Google Scholar 

  25. Boor PJ, Reynolds ES: A simple planimetric method for determination of left ventricular mass and necrotic myocardial mass in postmortem hearts. Am J Clin Pathol 68:387, 1977.

    PubMed  CAS  Google Scholar 

  26. Schuster EH, Bulkley BH: Expansion of transmural myocardial infarction: a pathophysiologic factor in cardiac rupture. Circulation 60:1532, 1979.

    PubMed  CAS  Google Scholar 

  27. Schuster EH, Bulkley BH: Ischemic cardiomyopathy: a clinicopathologic study of fourteen patients. Am Heart J 100:506, 1980.

    Article  PubMed  CAS  Google Scholar 

  28. Ideker RE, Wagner GS, Ruth WK, Alonso DR, Bishop SP, Bloor CM, Fallon JT, Gottlieb GJ, Hackel DB, Phillips HR, Reimer KA, Roark SF, Rogers WJ, Savage RM, Selvester RH: Evaluation of a QRS scoring system for estimating myocardial infarct size. II. Correlation with quantitative anatomic findings for anterior infarcts. (Submitted for publication.)

    Google Scholar 

  29. Roark SF, Ideker RE, Wagner GS, Alonso DR, Bishop SP, Bloor CM, Fallon JT, Gottlieb GJ, Hackel DB, Phillips HR, Reimer KA, Rogers WJ, Ruth WK, Savage RM, Selvester RH: Evaluation of a QRS scoring system for estimating myocardial infarct size. III. Correlation with quantitative anatomic findings for inferior infarcts. (Submitted for publication.)

    Google Scholar 

  30. Ward RM, Ideker RE, Wagner GS, Alonso DR, Bishop SP, Bloor CM, Fallon JT, Gottlieb GJ, Hackel DB, Phillips HR, Reimer KA, Roark SF, Rogers WJ, Ruth WK, Savage RM, Selvester RH: Evaluation of a QRS scoring system for estimating myocardial infarct size. IV. Correlation with quantitative anatomic findings for postero-lateral infarcts. (Submitted for publication)

    Google Scholar 

  31. James G, James RC (eds) Mathematics dictionary. New York: Van Nostrand Reinhold, 1976.

    Google Scholar 

  32. Laxer C, Ideker RE, Smith WM, German LD, Harrison L, Pilkington TC: Computer acquisition of a database for relating myocardial infarct geometry to cardiac electrical potentials. In: Computers in cardiology. Los Angeles, CA: IEEE Computer Society, 1980, p 339.

    Google Scholar 

  33. Roberts AJ, Cipriano PR, Alonso DR, Jacobstein JG, Combes JR, Gay WA Jr: Evaluation of methods for quantification of experimental myocardial infarction. Circulation 57:35, 1978.

    PubMed  CAS  Google Scholar 

  34. Ideker RE, Behar VS, Wagner GS, Starr JW, Starmer CF, Lee KL, Hackel DB: Evaluation of asynergy as an indicator of myocardial fibrosis. Circulation 57:715, 1978.

    PubMed  CAS  Google Scholar 

  35. Stokely EM, Buja LM, Lewis SE, Parkey RW, Bonte FJ, Harris RJ Jr, Willerson JT: Measurement of acute myocardial infarcts in dogs with 99mTc-stannous pyrophosphate scintigrams. J Nucl Med 17:1, 1976.

    PubMed  CAS  Google Scholar 

  36. Hutchins GM, Bulkley BH: Infarct expansion versus extension: two different complications of acute myocardial infarction. Am J Cardiol 41:1127, 1978.

    Article  PubMed  CAS  Google Scholar 

  37. Rivas F, Cobb FR, Bache RJ, Greenfield JC Jr: Relationship between blood flow to ischemic regions and extent of myocardial infarction. Serial measurement of blood to ischemic regions in dogs. Circ Res 38:439, 1976.

    PubMed  CAS  Google Scholar 

  38. Bardeen CR: Determination of the size of the heart by means of the X-rays. Am JAnat 23:423, 1918.

    Article  Google Scholar 

  39. Rackley CE, Dodge HT, Coble YD Jr, Hag RE: A method for determining left ventricular mass in man. Circulation 29:666, 1964.

    PubMed  CAS  Google Scholar 

  40. Barnes AR: Correlation of initial deflections of ventricular complex with situation of acute myocardial infarction. Am Heart J 9:728, 1934.

    Article  Google Scholar 

  41. Saÿen JJ, Sheldon WF: The heart muscle and the electrocardiogram in coronary disease. II. Difficulties of description and illustration of ventricular muscle lesions, with a method for their graphic representation in a myocardial map. Am Heart J 38:688, 1949.

    Article  PubMed  Google Scholar 

  42. Burch GE, Horan LG, Ziskind J, Cronvich JA: A correlative study of postmortem, electrocardiographic, and spatial vectorcardiographic data in myocardial infarction. Circulation 18:325, 1958.

    PubMed  CAS  Google Scholar 

  43. Horan LG, Flowers NC, Johnson JC: Significance of the diagnostic Q wave of myocardial infarction. Circulation 43:428, 1971.

    PubMed  CAS  Google Scholar 

  44. Richman HG, Yokoi M, Gleason D, Nishijima K, Simonson E: Reliability of the vectorcardiographic diagnosis of myocardial infarction. In: Vectorcardiography II. Amsterdam: North-Holland, 1971, p 343.

    Google Scholar 

  45. Baltaxe HA, Alonso DR, Lee JG, Prat J, Husted JW, Stakes JW III: Impaired left ventricular contractility in ischemic heart disease: angiographic and histopathologic correlations. Radiology 113:581, 1974.

    PubMed  CAS  Google Scholar 

  46. James TN: Anatomy of the coronary arteries. New York: Harper and Row, 1961.

    Google Scholar 

  47. Bevington PR: Data reduction and error analysis for the physical sciences. New York: McGraw-Hill, 1969.

    Google Scholar 

  48. Mathieu O, Cruz-Orive LM, Hoppeler H, Weibel ER: Measuring error and sampling variation in stereology: comparison of the efficiency of various methods for planar image analysis. J Microsc 121: 75, 1981.

    Article  PubMed  CAS  Google Scholar 

  49. Gundersen HJG, Østerby R: Optimizing sampling efficiency of stereological studies in biology: or ‘Do more less well!’ J Microsc 121:65, 1981.

    Article  PubMed  CAS  Google Scholar 

  50. Shay J: Economy of effort in electron microscope morphometry. Am J Pathol 81:503, 1975.

    PubMed  CAS  Google Scholar 

  51. Geer JC, Crago CA, Little WC, Gardner LL, Bishop SP: Subendocardial ischemic myocardial lesions associated with severe coronary atherosclerosis. Am J Pathol 98:663, 1980.

    PubMed  CAS  Google Scholar 

  52. Baroldi G: Different types of myocardial necrosis in coronary heart disease: a pathophysiologic review of their functional significance. Am Heart J 89:742, 1975.

    Article  PubMed  CAS  Google Scholar 

  53. Sulkin NM, Sulkin DF: An electron microscopic study of the effects of chronic hypoxia on cardiac muscle, hepatic, and autonomic ganglion cells. Lab Invest 14:1523, 1965.

    PubMed  CAS  Google Scholar 

  54. Buja LM, Poliner LR, Parkey RW, Pulido JI, Hutcheson D, Platt MR, Mills LJ, Bonte FJ, Willerson JT: Clinicopathologic study of persistently positive technetium-99 m stannous pyrophosphate myocardial scintigrams and myocytolytic degeneration after myocardial infarction. Circulation 56:1016, 1977.

    PubMed  CAS  Google Scholar 

  55. Silver MD, Baroldi G, Mariani F: The relationship between acute occlusive coronary thrombi and myocardial infarction studied in 100 consecutive patients. Circulation 61:219, 1980.

    PubMed  CAS  Google Scholar 

  56. Schlesinger MJ, Reiner L: Focal myocytolysis of the heart. Am J Pathol 31:443, 1955.

    PubMed  CAS  Google Scholar 

  57. Ratshin RA, Massing GK, James TN: The clinical significance of the location of acute myocardial infarction. In. Corday E, Swan HJC (eds) myocardial infarction: new perspectives in diagnosis and management. Baltimore: Williams and Wilkins, 1973, p 77.

    Google Scholar 

  58. Lowe JE, Reimer KA, Jennings RB: Experimental infarct size as a function of the amount of myocardium at risk. Am J Pathol 90:363, 1978.

    PubMed  CAS  Google Scholar 

  59. Lee JT, Ideker RE, Reimer KA: Myocardial infarct size and location with respect to the coronary vascular bed at risk in man. Circulation 64:526, 1981.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1982 Martinus Nijhoff Publishers, The Hague / Boston / London

About this chapter

Cite this chapter

Ideker, R.E., Hackel, D.B., McClees, E.C. (1982). Postmortem: Anatomic Quantitation. In: Wagner, G.S. (eds) Myocardial Infarction. Developments in Cardiovascular Medicine, vol 14. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-7452-4_14

Download citation

  • DOI: https://doi.org/10.1007/978-94-009-7452-4_14

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-009-7454-8

  • Online ISBN: 978-94-009-7452-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics