The aim – to define features of adaptation and pathological changes of myocardium in ischemia and out of ischemia zones in patients with chronic coronary heart disease.
Material and methods. The clinical material of intraoperative myocardial biopsies in patients with chronic ischemic heart disease received in and out of ischemia zones was studied. The semi thin samples of tissue were placed in epoxide resins and painted with toluidine blue. Transmissive electron microscopy, histochemical tests with succinate dehydrogenase, АTPаse, Ca2+ and glycosaminoglycans, morphometric studies were performed.
Results. Common general and special regional features of adaptation and pathological changes in the ischemia zone were established. These changes are initiated by different factors which are dominant in the actively working and hibernation areas. The typical variants of cardiomyocyte death in areas with differing blood supply were determined.
Conclusions. The morphological and functional changes of myocardium in chronic coronary heart disease are associated with transport, trophic, neurohumoral, immunology and inflammation factors. Alterations of the contractile myocardium in the ischemic and non-ischemic areas have fundamentally different mechanisms.