Esophagus histological analysis after hyperthermia-induced injury: implications for cardiac ablation.
OBJECTIVE
To evaluate and numerically score histological alterations observed in the acute phase in the esophagus after being exposed to a hyperthermic dosage and subsequently to correlate the scores obtained with the hyperthermic treatment parameters (i.e. temperature (T) and time (t)).


METHODS
Esophagus samples obtained from New Zealand white rabbits were immersed in a temperature-controlled saline bath at 40, 50, 60 and 70 degrees C for 30, 60 and 90 s. Samples were then processed for histological analysis (Masson Trichrome technique), and evaluated by searching for objective heat-damage signs. A numerical value was assigned to each sample for each finding.


RESULTS
In general, all the layers were affected by the treatment, however, the greatest alterations were found in the epithelium and deeper muscular layers (circular and longitudinal). We found no damage (i.e. no differences to control) in all of the samples treated at 40 degrees C, and severe damage in treatments at 60 and 70 degrees C, regardless of exposure time. On the other hand, samples treated at 50 degrees C did show different results related to time: no damage for 30 s, light damage for 60 s, and moderate damage for 90 s. We assigned a score value to each hyperthermic dosage, and obtained the fitted equation based on a logarithmic transformation of the Arrhenius equation: Score = 130.7 - 40,851/(T + 273) + log t, (R(2) = 0.9326, P < 0.0001).


CONCLUSIONS
Hyperthermic treatment mainly affects the epithelium and deeper muscular layers. The results suggest a damage threshold of 50 degrees C for treatments of 30-90 s. The proposed scoring system provides a good fit with the hyperthermic parameters.
Lequerica
Juan L
JL
Cardiac Research Laboratory, Instituto de Biomedicina de Valencia (CSIC), Valencia, Spain.
Sanz
Ernesto
E
Hornero
Fernando
F
Herrero
Maria
M
Ruiz
Nuria
N
Burdio
Fernando
F
Berjano
Enrique J
EJ