scholarly journals Early detection of left ventricular diastolic dysfunction using conventional and speckle tracking echocardiography in a large animal model of metabolic dysfunction

2017 ◽  
Author(s):  
Mark M. P. van den Dorpel ◽  
Ilkka Heinonen ◽  
Sanne M. Snelder ◽  
Hendrik J. Vos ◽  
Oana Sorop ◽  
...  
Keyword(s):  
Animal Model ◽  
Early Detection ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Large Animal Model ◽  
Large Animal ◽  
Metabolic Dysfunction ◽  
Ventricular Diastolic Dysfunction

Abstract 15194: Multiple Co-morbidities Produce Left Ventricular Diastolic Dysfunction in a Large Animal Model

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Oana Sorop ◽  
Ilkka Heinonen ◽  
Matthijs van Kranenburg ◽  
Vincent J de Beer ◽  
Yanti Octavia ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Systemic Inflammation ◽  
Microvascular Dysfunction ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Large Animal Model ◽  
Coronary Microvascular Dysfunction ◽  
Large Animal ◽  
Ventricular Diastolic Dysfunction

More than 50% of patients with heart failure have preserved ejection fraction (HFpEF) characterized by diastolic dysfunction. HFpEF usually occurs in female patients with multiple comorbidities such as obesity, hypercholesterolemia, diabetes mellitus (DM) and hypertension. Here we studied the effects of DM, high fat diet (HFD), and chronic kidney disease (CKD) on diastolic dysfunction in swine. In 11 female swine, DM type 2 (3x50mg/kg iv streptozotocin), hypercholesterolemia (HFD 1% cholesterol) and CKD by renal artery embolization (38-42μm polyethylene beads), were induced (DM+HFD+CKD). Swine were followed for 6 months. Eight female healthy swine on normal pig-chow, matched for age were used as controls (CON). The DM+HFD+CKD showed hyperglycemia (22.7±0.9mmol/l in DM+HFD+CKD vs 6.1±0.67mmol/l in CON), hypercholesterolemia (16.9±3.4 vs 2.2±0.1mmol/l), hypertriglyceridemia (1.20±0.36 vs 0.28±0.05mmol/l) and hypertension (awake mean arterial pressure: 108±6 vs 84±3mmHg; all P≤0.05). These co-morbidities resulted in chronic systemic inflammation (TNF-α: 231±64 vs 74±24pg/ml), impaired coronary small artery endothelium-dependent vasodilation to bradykinin, capillary rarefaction (cap./fiber ratio 0.58 vs 0.99) and increased myocardial superoxide production (14.8±0.9 vs 6.4±0.3 RLU/sec/g), due to increased NOX activity (all P≤0.05). The coronary microvascular abnormalities were associated with increased myocardial collagen content (4.7±0.3 vs 2.4±0.2%) and elevated passive cardiomyocyte force, (both P≤0.05), resulting in reduced E/A ratio (0.99±0.14 vs 1.53±0.23), measured with cardiac MRI, and increased LV end-diastolic stiffness (0.79±0.19 vs 0.29±0.03 mmHg/ml/mg) derived from LV pressure-volume relations obtained with a conductance catheter (both P≤0.05). In contrast, ejection fraction was maintained, (45±4 vs 54±3%, P=NS). In summary, multiple comorbidities, including DM, hypercholesterolemia, CKD and hypertension in female swine trigger a series of events, starting with systemic inflammation, increased oxidative stress and coronary microvascular dysfunction, resulting in myocardial stiffening, and leading to diastolic dysfunction.

scholarly journals P932 What is new in the assessment of patients with hereditary hemochromatosis - can 2D speckle tracking echocardiography be helpful in the early detection of heart abnormalities?

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
L Danilowicz-Szymanowicz ◽  
K Rozwadowska ◽  
M Swiatczak ◽  
K Sikorska ◽  
M Fijalkowski ◽  
...  
Keyword(s):  
Early Detection ◽  
Iron Overload ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Hereditary Hemochromatosis ◽  
Rotation Velocity ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Dysfunction ◽  
Heart Abnormalities

Abstract Background Hereditary hemochromatosis (HH) is a very common genetic disease. Abnormally increased intestinal iron absorption and accelerated recycling of iron lead to progressive body iron accumulation and the generation of oxidative stress in tissues. In the late stages iron overload of the heart can lead to the left ventricular (LV) dysfunction. It is believed, that two dimensional speckle tracking echocardiography (2D STE) can evaluate LV dysfunction more accurately and earlier than conventional echocardiography. Evaluation of such assessment was the purpose of this paper. Methods We prospectively enrolled 58 patients with genetically confirmed HH; 29 healthy age- and sex-matched volunteers constituted the control group. Classic echocardiographic and 2D STE parameters (GE VIVID E9, EchoPAC v201) were compared between the groups, additionally correlations between echo and iron turnover parameters were performed. Results The HH patients had all standard echo parameters within the normal range. All 2D STE parameters were significantly worse in HH than in control group (Table 1). We did not find any correlation between echo and iron turnover parameters, whilst significant correlation with the time from diagnosis and the numbers of venesections was noticed. Conclusions Novel 2D STE analyzes seem to be helpful in early detection of heart abnormalities in HH patients. The correlations between the echo and iron indices are weak, allowing to suggest the lack of a "direct" relationship between the iron turnover and myocardial function and that myocardial iron overload is not the only mechanism involved in development of HH cardiomyopathy. HH All n = 58 Controls n = 29 p LAVI (ml/BSA) 31 (23-37) 22 (19-27) <0.001 RWT 0.42 (0.38-0.47) 0.38 (0.34-0.43) <0.003 LVMI (g/BSA) 78 (58-96) 66 (53-72) <0.006 E/Em 7.0 (5.6-8.3) 6.7 (5.0-7.5) 0.071 LVEF (%) 60 (54-62) 63 (61-65) <0.006 LV twist (º) 17.2 (13.1-22.2) 24.1 (19.9-32.1) <0.001 LV torsion (º/cm) 2.2 (1.6-2.9) 3.3 (2.7-4.3) <0.001 LV peak rotation velocity (º/s) 118.0 (88.3-146.3) 140.0 (112.7-168.9) <0.015 LV peak untwisting velocity (º/s) -132.0 (-163.5–93.0) -156.0 (-197.0–122.6) <0.039 Peak systolic longitudinal strain (%) -18.3 (-20.0–16.9) -21.0 (-22.0–19.3) <0.001

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