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Morphological, histochemical, and interstitial pressure changes in the tibialis anterior muscle before and after aortofemoral bypass in patients with peripheral arterial occlusive disease.

Albani M, Megalopoulos A, Kiskinis D, Parashos SA, Grigoriadis N, Guiba-Tziampiri O - BMC Musculoskelet Disord (2002)

Bottom Line: Seven days after the reperfusion the areas of both fibre types were even more reduced, being 3,086 microm2 for type I and 4,009 microm2 for type II, the proportion of type I fibres, and the interstitial pressure of tibialis anterior were increased.The findings suggest that chronic ischemia of the leg muscles causes compensatory histochemical changes in muscle fibres resulting from muscle hypoxia, and chronic dennervation-reinnervation changes, resulting possibly from ischemic neuropathy.Reperfusion seems to bring the oxidative capacity of the previously ischemic muscle closer to normal.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Physiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54006, Greece. albani@med.auth.gr

ABSTRACT

Background: Morphological and electrophysiological studies of ischemic muscles in peripheral arterial disease disclosed evidence of denervation and fibre atrophy. The purpose of the present study is to describe morphological changes in ischemic muscles before and after reperfusion surgery in patients with peripheral occlusive arterial disease, and to provide an insight into the effect of reperfusion on the histochemistry of the reperfused muscle.

Methods: Muscle biopsies were obtained from the tibialis anterior of 9 patients with chronic peripheral arterial occlusive disease of the lower extremities, before and after aortofemoral bypass, in order to evaluate the extent and type of muscle fibre changes during ischemia and after revascularization. Fibre type content and muscle fibre areas were quantified using standard histological and histochemical methods and morphometric analysis. Each patient underwent concentric needle electromyography, nerve conduction velocity studies, and interstitial pressure measurements.

Results: Preoperatively all patients showed muscle fibre atrophy of both types, type II fibre area being more affected. The mean fibre cross sectional area of type I was 3,745 microm2 and of type II 4,654 microm2. Fibre-type grouping, great variation in fibre size and angular fibres were indicative of chronic dennervation-reinnervation, in the absence of any clinical evidence of a neuropathic process. Seven days after the reperfusion the areas of both fibre types were even more reduced, being 3,086 microm2 for type I and 4,009 microm2 for type II, the proportion of type I fibres, and the interstitial pressure of tibialis anterior were increased.

Conclusions: The findings suggest that chronic ischemia of the leg muscles causes compensatory histochemical changes in muscle fibres resulting from muscle hypoxia, and chronic dennervation-reinnervation changes, resulting possibly from ischemic neuropathy. Reperfusion seems to bring the oxidative capacity of the previously ischemic muscle closer to normal.

No MeSH data available.


Related in: MedlinePlus

Micrographs from sections of tibialis anterior muscle from patients with peripheral occlusive disease before reperfusion procedure (calibration: 100 μm). (a) Eosin-hematoxylin. (b) SDH; phagocytosis and necrotic muscle fibres (arrows). (c) Myosin-ATPase, acid preincubation; small groups of atrophic angular muscle fibres (arrows), and fibre size diversity. (d) NADH; small areas of fibre-type grouping.
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Figure 1: Micrographs from sections of tibialis anterior muscle from patients with peripheral occlusive disease before reperfusion procedure (calibration: 100 μm). (a) Eosin-hematoxylin. (b) SDH; phagocytosis and necrotic muscle fibres (arrows). (c) Myosin-ATPase, acid preincubation; small groups of atrophic angular muscle fibres (arrows), and fibre size diversity. (d) NADH; small areas of fibre-type grouping.

Mentions: The routine histologic examination revealed pericellular leucocyte infiltration between and within degenerating fibre, and necrotic muscle fibres (Fig. 1a and 1b), regenerated muscle fibres, and fibre size diversity (Fig. 1b and 1c). All patients showed muscle fibre atrophy, which was more pronounced in type II fibres, and great fibre size diversity; the mean area of type II fibres was 4,654 ± 2,626 μm2, a 18–43% reduction when compared to previous reports on healthy subjects of similar age (Table 1). Type I fibre size was 3,745 ± 2,094 μm2, a value which is also 7.5–31% less than the reported value for healthy subjects of similar age (Table 1). The mean proportion of type I fibres was 58.3 % and of type II was 41.7%. NADH-tetrazolium reductase staining demonstrated 55.6 % of oxidative fibres and 44.4 % of nonoxidative (Table 2). Abnormalities typical for denervation and reinnervation, i.e., small angular fibres (Fig. 1b and 1c) and small areas of fibre-type grouping (Fig. 1d) were seen in all samples.


Morphological, histochemical, and interstitial pressure changes in the tibialis anterior muscle before and after aortofemoral bypass in patients with peripheral arterial occlusive disease.

Albani M, Megalopoulos A, Kiskinis D, Parashos SA, Grigoriadis N, Guiba-Tziampiri O - BMC Musculoskelet Disord (2002)

Micrographs from sections of tibialis anterior muscle from patients with peripheral occlusive disease before reperfusion procedure (calibration: 100 μm). (a) Eosin-hematoxylin. (b) SDH; phagocytosis and necrotic muscle fibres (arrows). (c) Myosin-ATPase, acid preincubation; small groups of atrophic angular muscle fibres (arrows), and fibre size diversity. (d) NADH; small areas of fibre-type grouping.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC89010&req=5

Figure 1: Micrographs from sections of tibialis anterior muscle from patients with peripheral occlusive disease before reperfusion procedure (calibration: 100 μm). (a) Eosin-hematoxylin. (b) SDH; phagocytosis and necrotic muscle fibres (arrows). (c) Myosin-ATPase, acid preincubation; small groups of atrophic angular muscle fibres (arrows), and fibre size diversity. (d) NADH; small areas of fibre-type grouping.
Mentions: The routine histologic examination revealed pericellular leucocyte infiltration between and within degenerating fibre, and necrotic muscle fibres (Fig. 1a and 1b), regenerated muscle fibres, and fibre size diversity (Fig. 1b and 1c). All patients showed muscle fibre atrophy, which was more pronounced in type II fibres, and great fibre size diversity; the mean area of type II fibres was 4,654 ± 2,626 μm2, a 18–43% reduction when compared to previous reports on healthy subjects of similar age (Table 1). Type I fibre size was 3,745 ± 2,094 μm2, a value which is also 7.5–31% less than the reported value for healthy subjects of similar age (Table 1). The mean proportion of type I fibres was 58.3 % and of type II was 41.7%. NADH-tetrazolium reductase staining demonstrated 55.6 % of oxidative fibres and 44.4 % of nonoxidative (Table 2). Abnormalities typical for denervation and reinnervation, i.e., small angular fibres (Fig. 1b and 1c) and small areas of fibre-type grouping (Fig. 1d) were seen in all samples.

Bottom Line: Seven days after the reperfusion the areas of both fibre types were even more reduced, being 3,086 microm2 for type I and 4,009 microm2 for type II, the proportion of type I fibres, and the interstitial pressure of tibialis anterior were increased.The findings suggest that chronic ischemia of the leg muscles causes compensatory histochemical changes in muscle fibres resulting from muscle hypoxia, and chronic dennervation-reinnervation changes, resulting possibly from ischemic neuropathy.Reperfusion seems to bring the oxidative capacity of the previously ischemic muscle closer to normal.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Physiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54006, Greece. albani@med.auth.gr

ABSTRACT

Background: Morphological and electrophysiological studies of ischemic muscles in peripheral arterial disease disclosed evidence of denervation and fibre atrophy. The purpose of the present study is to describe morphological changes in ischemic muscles before and after reperfusion surgery in patients with peripheral occlusive arterial disease, and to provide an insight into the effect of reperfusion on the histochemistry of the reperfused muscle.

Methods: Muscle biopsies were obtained from the tibialis anterior of 9 patients with chronic peripheral arterial occlusive disease of the lower extremities, before and after aortofemoral bypass, in order to evaluate the extent and type of muscle fibre changes during ischemia and after revascularization. Fibre type content and muscle fibre areas were quantified using standard histological and histochemical methods and morphometric analysis. Each patient underwent concentric needle electromyography, nerve conduction velocity studies, and interstitial pressure measurements.

Results: Preoperatively all patients showed muscle fibre atrophy of both types, type II fibre area being more affected. The mean fibre cross sectional area of type I was 3,745 microm2 and of type II 4,654 microm2. Fibre-type grouping, great variation in fibre size and angular fibres were indicative of chronic dennervation-reinnervation, in the absence of any clinical evidence of a neuropathic process. Seven days after the reperfusion the areas of both fibre types were even more reduced, being 3,086 microm2 for type I and 4,009 microm2 for type II, the proportion of type I fibres, and the interstitial pressure of tibialis anterior were increased.

Conclusions: The findings suggest that chronic ischemia of the leg muscles causes compensatory histochemical changes in muscle fibres resulting from muscle hypoxia, and chronic dennervation-reinnervation changes, resulting possibly from ischemic neuropathy. Reperfusion seems to bring the oxidative capacity of the previously ischemic muscle closer to normal.

No MeSH data available.


Related in: MedlinePlus