title: Widespread myocardial inflammation and infarct-related artery patency.
abstract: BACKGROUND
  Diffuse coronary vascular inflammation is associated with acute coronary syndromes. However, it is unknown whether inflammation also occurs within the myocardium. Therefore, this study was aimed at assessing the presence of activated cells in unaffected remote myocardium of patients with acute myocardial infarction (AMI), in comparison to the peri-infarct region from the same cases, and in comparison to myocardial specimens from control hearts.
  
  
  RESULTS
  Sixteen patients dying 1 to 12 weeks after AMI and 16 control subjects were selected at autopsy. Myocardial specimens were taken at remote unaffected viable regions and at peri-infarct regions in cases with AMI. Confocal microscopy was performed to measure the number of activated cells (DR+), T-lymphocytes (CD3+), and activated T-lymphocytes (CD3+/DR+). Activated cells and activated T-lymphocytes were found in remote unaffected regions in 11 of 16 cases (69%), in peri-infarct zone in all cases (100%), and in none of the control hearts (0%, P<0.001 versus others). A greater myocardial inflammatory burden in remote regions but not in peri-infarct regions was associated with persistent infarct-related artery occlusion (P<0.05).
  
  
  CONCLUSIONS
  This study for the first time shows the presence of activated T-lymphocytes in remote unaffected myocardial regions in approximately two thirds of patients with recent AMI. Because these cells are associated with persistent infarct-related artery occlusion, our data may suggest that an antigenic stimulus present also in the myocardium triggers an immune response that may be critical to precipitate artery occlusion.
authors.affiliation: Institute of Cardiology, Catholic University, Rome, Italy. abbatea@yahoo.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Abbate
authors.forename: Elena
authors.initials: E
authors.lastname: Bonanno
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mauriello
authors.forename: Rossana
authors.initials: R
authors.lastname: Bussani
authors.forename: Giuseppe G L
authors.initials: GG
authors.lastname: Biondi-Zoccai
authors.forename: Giovanna
authors.initials: G
authors.lastname: Liuzzo
authors.forename: Antonio Maria
authors.initials: AM
authors.lastname: Leone
authors.forename: Furio
authors.initials: F
authors.lastname: Silvestri
authors.forename: Aldo
authors.initials: A
authors.lastname: Dobrina
authors.forename: Feliciano
authors.initials: F
authors.lastname: Baldi
authors.forename: Franco
authors.initials: F
authors.lastname: Pandolfi
authors.forename: Luigi M
authors.initials: LM
authors.lastname: Biasucci
authors.forename: Alfonso
authors.initials: A
authors.lastname: Baldi
authors.forename: Luigi G
authors.initials: LG
authors.lastname: Spagnoli
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000368:Aged; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000276:immunology* / Q000473:pathology; D009205:Myocarditis / Q000276:immunology* / Q000473:pathology; D012008:Recurrence; D013577:Syndrome; D013601:T-Lymphocytes / Q000276:immunology; D014654:Vascular Patency