Comparative analysis of Lie and Mallory methods for detecting myocardial ischemic injury

Introduction. In pathological practice, one of the primary histochemical methods for detecting early ischemic damage to cardiomyocytes is staining with hematoxylin-basic fuchsin-picric acid (HBFP), commonly known as the Lie method. HBFP staining results in red-brown staining of the sarcoplasm of ischemic cardiomyocytes due to basic fuchsin, while intact myocytes appear yellow due to picric acid. However, critical evaluations have raised concerns about using the Lie method in postmortem diagnosis. Therefore, to improve the diagnosis of early ischemic damage, it appears reasonable to supplement the Lie method with an equally accessible and informative histochemical approach, which is why our study included the Mallory staining method, as this technique employs acid fuchsin, but differs in its staining profile from the Lie method. Materials and methods. The study was performed using autopsy and experimental materials. The autopsy material included 23 samples of various nosologies accompanied by acute heart failure. The experimental material included 50 rats, in which two types of experiments modeled acute myocardial injury. The first one was conducted on 22 rats, in which ischemia was induced by perfusion arrest in isolated hearts using the Langendorff method. In the other 28 animals, ischemic injury was stimulated through forced swimming with a load until exhaustion. Results. Both Mallory and Lie staining methods allow for identifying a fuchsinophilic substrate indicative of ischemic damage to cardiomyocytes of various origins in both autopsy and experimental materials. Damaged cardiomyocytes positively stained with basic fuchsin appeared red-brown against an intact yellow background, while Mallory staining produced orange-red against a red-purple background. In the experimental models, the results of both staining methods were in full agreement, with Mallory staining demonstrating high sensitivity (96.88%) and specificity (92.31%). In sectional observations, staining results were consistent between the two methods in 82% of cases. Additionally, Mallory staining revealed areas of fibrosis when aniline blue was employed. Conclusion. Mallory trichrome staining can serve as a supplementary method for verifying ischemic myocardial damage in both autopsy and experimental materials. Beyond detecting early signs of ischemia, it also enables the assessment of chronic myocardial ischemia via visualization of fibrotic changes. The method is reproducible and accessible in everyday practice. Keywords: HBFP staining, Mallory staining, myocardial ischemia