Title:The Meaning of Different Forms of Structural Myocardial Injury, Immune Response and Timing of Infarct Necrosis and Cardiac Repair
Volume: 13
Issue: 1
Author(s): Emanuela Turillazzi*, Cristoforo Pomara, Stefania Bello, Margherita Neri, Irene Riezzo and Vittorio Fineschi
Affiliation:
- Institute of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia,Italy
Keywords:
Biomolecular mechanisms, cardiac repair, cellular mechanisms, histomorphological dating, myocardial infarction,
therapeutic strategies.
Abstract: Although a decline in the all-cause and cardiac mortality rates following myocardial infarction (MI)
during the past 3 decades has been reported, MI is a major cause of death and disability worldwide. From a
pathological point of view MI consists in a particular myocardial cell death due to prolonged ischemia. After
the onset of myocardial ischemia, cell death is not immediate, but takes a finite period of time to develop. Once
complete myocytes’ necrosis has occurred, a process leading to a healed infarction takes place. In fact, MI is a dynamic process
that begins with the transition from reversible to irreversible ischemic injury and culminates in the replacement of dead
myocardium by a fibrous scar. The pathobiological mechanisms underlying this process are very complex, involving an inflammatory
response by several pathways, and pose a major challenge to ability to improve our knowledge. An improved understanding
of the pathobiology of cardiac repair after MI and further studies of its underlying mechanisms provide avenues
for the development of future strategies directed toward the identification of novel therapies. The chronologic dating of MI is
of great importance both to clinical and forensic investigation, that is, the ability to create a theoretical timeline upon which
either clinicians or forensic pathologists may increase their ability to estimate the time of MI. Aging of MI has very important
practical implications in clinical practice since, based on the chronological dating of MI, attractive alternatives to solve therapeutic
strategies in the various phases of MI are developing.
