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High magnification micrograph showing contraction band necrosis and karyolysis. H&E stain.

Contraction band necrosis is a type of uncontrolled cell death (necrosis) unique to cardiac myocytes and thought to arise in reperfusion from hypercontraction, which results in sarcolemmal rupture.[1]

It is a characteristic histologic finding of a recent myocardial infarction (heart attack) that was partially reperfused.

The name of the histopathologic finding comes from the appearance under the microscope; contraction bands are thick intensely eosinophilic staining bands (typically 4-5 micrometres wide) that span the short axis of the myocyte. They can be thought of extra thick striae, typical of cardiac muscle and striated muscle.

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PathophysiologyEdit

Contraction band necrosis is thought to arise by two mechanisms:[1]

  1. a calcium-dependent mechanism - activation of the contractile machinery of the cell via its usual mechanism, calcium, which is in excess due to ischemia.
  2. a calcium-independent mechanism, as seen in rigor mortis - activation of the contractile machinery in the setting of low ATP.

Reperfusion associated cell death has been modulated (reduced) in animal studies[2] and is an area of active research, which holds the potential to significantly reduce the morbidity (disease burden) and mortality (death) of cardiovascular disease.[1]

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ReferencesEdit

  1. ^ a b c Rodríguez-Sinovas A, Abdallah Y, Piper HM, Garcia-Dorado D (December 2007). "Reperfusion injury as a therapeutic challenge in patients with acute myocardial infarction". Heart Fail Rev. 12 (3-4): 207–16. PMID 17530396. doi:10.1007/s10741-007-9039-9. 
  2. ^ Garcia-Dorado D, Inserte J, Ruiz-Meana M, et al. (November 1997). "Gap junction uncoupler heptanol prevents cell-to-cell progression of hypercontracture and limits necrosis during myocardial reperfusion". Circulation. 96 (10): 3579–86. PMID 9396458. doi:10.1161/01.cir.96.10.3579. 

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