Post-MI survival and necropsy
Over 4 weeks of follow-up, 17% (4/23) of the C57 mice versus 40% (8/20) of the Gal-3 KO mice were found dead. The necropsy was performed; the dead Gal-3 KO mice showed larger hearts than the C57 mice (Figure 1), and 38% of the C57 mice compared with 32% of the Gal-3 KO mice had macroscopic chest clots that were directly associated with cardiac rupture. The latter demonstrated that the cause of death was not related to cardiac rupture. By the end of the protocol and after the necropsy, cardiac remodeling could be identified by simple macroscopic visualization of the heart's necrotic areas. Figure 1 shows a representative image of the hearts of both experimental groups, in which an increase in the size of the hearts, the extension, and the presence of aneurism of the scar was primary identified and found to be markedly increased in the hearts of Gal-3 KO mice with MI.
Cardiac remodeling and function in vivo
The first approach for evaluating cardiac remodeling and function in vivo is echocardiography, which is a non-invasive method to assess cardiac geometry and function. Thus, echocardiography can be used to quantify LV dilation, LV wall thickness, and contractility at different time points of MI. Figure 2B,C show representative echocardiograms of Gal-3 KO mice (Figure 2B) and C57 mice (Figure 2C) at 1 week post MI. Interestingly, the Gal-3 KO mice showed larger LV cavity size than the C57 group (Figure 2B,C), showing that the deficiency of Gal-3 had a deleterious effect on cardiac remodeling and myocardial function after MI. To estimate systolic function, the quantification of morphological parameters is needed. In these experimental conditions, chronic LV function was significantly reduced in both genotypes with MI.
Histology and morphometry
Cardiac remodeling can be analyzed by quantifying the infarct size and morphometric parameters in slices stained with Masson's trichrome by quantitative planimetry. With this stain, the infarct zone is stained blue, and the healthy cardiac tissue is stained slightly red. Once these colors are identified, the respective areas are carefully determined by drawing a perimeter line and measuring them using image analysis software (Figure 3).
Expansion is one of the first phenomena to occur after post-MI remodeling. The remodeling can lead to the overestimation of the infarct zone in the case of overexpansion. Therefore, it is important to measure the expansion index by quantifying the length and thickness of the scar. Figure 3 shows Masson's trichrome-stained slices from representative images in which the colors for quantification are indicators of the parameters and the measurements obtained with this technique.
Thus, the scar thickness and scar thickness ratio can be calculated at 1 and 4 weeks (Figure 3A-D). At 1 week post MI, the scar thickness was greatly reduced in Gal-3 KO mice compared with C57 mice, while at 4 weeks post MI, there was no difference between both experimental groups. The temporal evolution of scar thickness progressively decreased from early to chronic MI, while in mice lacking Gal-3, the thinnest region of the infarct zone was clearly identified from 1 week after MI (Figure 3A-D and Table 1).
In addition, the hypertrophy of myocytes can be quantified in rhodamine-conjugated lectin-stained slices using the MCSA (Figure 4). The MCSA at 4 weeks showed a significant increase in both genotype groups with MI. However, the increase in hypertrophy observed in C57 mice with MI was absent in the mice lacking Gal-3 (Figure 4). Finally, slices stained with picrosirius red are currently used for quantifying myocardial fibrosis because this stain is specific for collagen fibers and not only for fibrous tissue (unlike Masson's trichome stain). By identifying the collagen fibers (stained in red) and myocytes (stained in yellow), both areas can be quantified, and the collagen percentage can be calculated (Figure 5) either in the infarct zone or the remote zone. The lack of Gal-3 markedly prevented the increase in the collagen volume fraction at the infarct zone in mice with MI (Figure 5).

Figure 1: Macroscopic images of hearts with MI. The left image corresponds to a heart with MI from a C57 mouse, and on the right is a heart from a Gal-3 KO mouse at 7 days post MI. The lack of Gal-3 has disrupted cardiac remodeling. Scale bar = 5 mm. This figure was adapted from Cassaglia et al.4. Abbreviations: MI = myocardial infarction; Gal-3 = galectin-3; KO = knockout. Please click here to view a larger version of this figure.

Figure 2: Echocardiography. (A) Schematic image of the mouse echocardiographic position and the direction of the transductor for the long axis and short axis. Echocardiographic traces were obtained in both strains of mice at 1 week post MI. M-mode echocardiograms of (B) a Gal-3 KO mouse and (C) a control mouse The use of M-mode echocardiography allows for the assessment of the LV wall thickness and the LV internal dimensions in systole and diastole (IVSd, LVIDd, and PWd and IVSs, LVIDs, and PWs are the LV interventricular septum thicknesses and LV posterior wall thicknesses at diastole and systole, respectively.) This figure was adapted from Cassaglia et al.4. Abbreviations: MI = myocardial infarction; Gal-3 = galectin-3; KO = knockout.; LV = left ventricle; IVSd = interventricular septum thickness at diastole; LVIDd = LV internal dimensions at end diastole; PWd = posterior wall thickness at diastole; IVS = interventricular septum; PW = posterior wall; L = long axis; S = short axis. Please click here to view a larger version of this figure.

Figure 3: Representative images of Masson's trichrome-stained slices. The slices are from the middle section of the heart, showing all the measurements obtained for quantifying the infarct size, septum thickness, and scar thickness. These parameters were used to calculate the expansion index (original magnification: 20x). Myocardial morphometry at (A) 1 week after MI in C57 mice; (B) 1 week after MI in Gal-3 KO mice; (C) 4 weeks after MI in C57 mice; (D) and 4 weeks after MI in Gal-3 KO mice. (E,F) TTC staining of infarcted hearts after 24 h in (E) C57 and (F) Gal-3 KO mice. This figure was adapted from Cassaglia et al.4. Scale bars = 1 mm. Abbreviations: MI = myocardial infarction; Gal-3 = galectin-3; KO = knockout. Please click here to view a larger version of this figure.

Figure 4: Representative images of rhodamine-conjugated lectin-stained sections. Rhodamine-stained sections allow for the quantification of the myocyte cross-sectional area at the remote zone at 4 weeks post MI. Original magnification = 400x, scale bar = 40 µm. This figure was adapted from Cassaglia et al.4. Abbreviations: MI = myocardial infarction; Gal-3 = galectin-3; KO = knockout. Please click here to view a larger version of this figure.

Figure 5: Myocardial collagen volume fraction quantification at the remote zone. Data after (A) 1 week and (B) 4 weeks post MI or sham; (C) representative images of a picrosirius red-stained section of the MI zone at 1 week and 4 weeks post MI. The inset shows the representative images obtained with the image analysis software (red shows collagen, and yellow shows non-collagen). Scale bars = 40 µm. This figure was adapted from Cassaglia et al.4. Abbreviations: MI = myocardial infarction; Gal-3 = galectin-3; KO = knockout. Please click here to view a larger version of this figure.
| Experimental groups | C57 | Gal-3 KO | C57 | Gal-3 KO |
| 1 week | 1 week | 4 weeks | 4 weeks |
| Endocardial Length at MI (mm) | 6.9 | 8.5 | 7.6 | 6.1 |
| Epicardial Length at MI (µm) | 7.1 | 10.7 | 6.7 | 6.5 |
| Endocardial Length non-MI zone (mm) | 5.5 | 3.2 | 6.2 | 4.7 |
| Epicardial Length non-MI zone (mm) | 7.4 | 3.8 | 10.4 | 9.5 |
| Septum Thickness (mm) | 1.1 | 1.1 | 1.4 | 1.1 |
| Scar Thickness (mm) | 0.8 | 0.5 | 0.2 | 0.2 |
Table 1: Representative measurements of the morphometric analysis at 1 week and 4 weeks post MI. Abbreviations: MI = myocardial infarction; Gal-3 = galectin-3; KO = knockout.