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Understanding the viability of the ischemic myocardial tissue is a criticalissue in determining the appropriate surgical procedure for patients withchronic heart failure after myocardial infarction (MI). Conventional MIevaluation methods are; however, preoperatively performed and/or give anindirect information of myocardial viability such as shape, color, and bloodflow. In this study, we realize the evaluation of MI in patients undergoingcardiac surgery by Raman spectroscopy under label-free conditions, which isbased on intrinsic molecular constituents related to myocardial viability. Weidentify key signatures of Raman spectra for the evaluation of myocardialviability by evaluating the infarct border zone myocardium that were excisedfrom five patients under surgical ventricular restoration. We also obtain aprediction model to differentiate the infarcted myocardium from thenon-infarcted myocardium by applying partial least squaresregression-discriminant analysis (PLS-DA) to the Raman spectra. Our predictionmodel enables identification of the infarcted tissues and the non-infarctedtissues with sensitivities of 99.98% and 99.92%, respectively. Furthermore, theprediction model of the Raman images of the infarct border zone enabled us tovisualize boundaries between these distinct regions. Our novel application ofRaman spectroscopy to the human heart would be a useful means for the detectionof myocardial viability during surgery.

Label-free evaluation of myocardial infarct in surgically excised ventricular myocardium by Raman spectroscopy