A canine model of chronic ischemic cardiomyopathy: characterization of regional flow-function relations

1999 ◽  
Vol 276 (2) ◽  
pp. H446-H455 ◽  
Author(s):  
Soroosh Firoozan ◽  
Kevin Wei ◽  
Andre Linka ◽  
Danny Skyba ◽  
N. Craig Goodman ◽  
...  
Keyword(s):  
Canine Model ◽  
Left Ventricular ◽  
Wall Thickening ◽  
Flow Function ◽  
Chronic Coronary Artery Disease ◽  
Close Coupling ◽  
Lv Dysfunction ◽  
Regional Flow ◽  
Artery Disease ◽  
Observation Period

The controversy regarding the mechanism(s) of left ventricular (LV) dysfunction in chronic coronary artery disease is, in part, related to the lack of an appropriate animal model for this condition. We have developed such a model by placing Ameroid constrictors on proximal portions of coronary arteries in dogs who were euthanized (mean of 6 wk) after the development of severe global LV dysfunction noted on two-dimensional echocardiography. The LV end-systolic size nearly doubled ( P < 0.001) over the observation period, and the percent change in LV size from end diastole to end systole decreased by >50% ( P< 0.001). Regional dysfunction was noted in 23 of 24 myocardial beds analyzed within regions showing no gross evidence of infarction. In 10 of these beds, severe dysfunction was noted without a decrease in radiolabeled microsphere-derived myocardial blood flow (MBF). In 13 myocardial beds, decrease in function was associated with a decrease in MBF ( P < 0.001), with close coupling noted between percent wall thickening and MBF. In the beds that exhibited an ultimate decrease in MBF, the decrease in function preceded the decrease in MBF. In conclusion, we describe chronic LV dysfunction in a canine model of multivessel stenosis that closely mimics chronic ischemic LV dysfunction in humans. Whereas regional function is severely reduced in this model, MBF is varied in different segments and at different times during the observation period. These results provide new insights regarding flow-function relations in chronic ischemic LV dysfunction.

scholarly journals Changes in mechanics of septal and lateral walls in patients with left bundle-branch block are related to extent of systolic dysfunction

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
K Kupczynska ◽  
KA Nguyen ◽  
E Surkova ◽  
CH Palermo ◽  
F Sambugaro ◽  
...  
Keyword(s):  
Left Bundle Branch Block ◽  
Systolic Dysfunction ◽  
Lateral Wall ◽  
Left Ventricular ◽  
Public Institution ◽  
Healthy Controls ◽  
Bundle Branch Block ◽  
Funding Sources ◽  
Lv Dysfunction ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Karolina Kupczynska was supported by research grant awarded by the Club 30 of the Polish Cardiac Society Background Left bundle branch block (LBBB) affects left ventricular (LV) mechanics and promotes systolic dysfunction. Purpose To analyse myocardial work (MW) and myocardial work efficiency (MWE) of the septal and LV lateral wall in healthy controls and LBBB patients with various degrees of LV dysfunction using non-invasive method. Methods Our study involved 102 healthy controls (mean age 41.5 ± 15.7 years, 45% male) and 58 LBBB patients without coronary artery disease (mean age 65 ± 13 years, 60% male) divided into 3 groups based on their LVEF: preserved (n= 27), mid-range (n= 16) and reduced (n= 15). Myocardial work parameters were estimated in septal and lateral wall by LV pressure-strain loop obtained by echocardiography. Results There were no differences between septal and lateral MW and MWE in healthy controls (p = NS). We found lower septal MW in comparison to lateral MW (p &lt; 0.0001), but there were no differences in MWE (p = NS) in LBBB patients with preserved LVEF. Patients with LBBB and mid-range or reduced LVEF had lower MW (p &lt; 0.0001 in both subgroups) and lower MWE (p = 0.002 and p = 0.0001, respectively) in septum compared with lateral wall. There was a progressive decrease in septal MW and MWE with the occurring of LBBB and the worsening of LVEF (figure A). Interestingly in healthy controls there was significantly lower lateral MW but higher MWE in comparison to group with LBBB and preserved LVEF. We did not detect differences between LBBB groups with preserved and mid-range LVEF, but patients with reduced LVEF had significant reduction in terms of lateral MW and MWE (figure B). Conclusions Impairment in septal myocardial work escalated according to the appearance of LBBB and LVEF loss. Septal dysfunction was compensated by the effective myocardial work of the lateral wall in LBBB patients with preserved and mid-range LVEF. Mechanical dysfunction of the lateral wall was associated with severely reduced LVEF. Abstract Figure.

Impact of Valve Surgery on Serum Osteopontin Levels in Patients with Mitral Regurgitation

Cardiology ◽  
2015 ◽  
Vol 130 (2) ◽  
pp. 82-86
Author(s):  
H.M. Gunes ◽  
G.B. Guler ◽  
E. Guler ◽  
G.G. Demir ◽  
S. Hatipoglu ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Lv Function ◽  
Vena Contracta ◽  
Atherosclerotic Lesions ◽  
Lv Dysfunction ◽  
Echocardiographic Parameters ◽  
Artery Disease ◽  
The Impact

Objective: Osteopontin (OPN), a sialoprotein present within atherosclerotic lesions, especially in calcified plaques, is linked to the progression of coronary artery disease and heart failure. We assessed the impact of valve surgery on serum OPN and left ventricular (LV) function in patients with mitral regurgitation (MR). Methods: Thirty-two patients with severe MR scheduled for surgery were included in the study. Echocardiography markers were assessed preoperatively and at 3 months following the surgery and matched with the serum OPN levels. Results: Valve surgery was associated with a reduction of the ejection fraction (EF) from 55.2 ± 6.3 to 48.8 ± 7.1% after surgery, p < 0.001. Following surgery, the OPN level was significantly higher than preoperatively (mean 245, range 36-2,284 ng/ml vs. 76, 6-486 ng/ml, p = 0.007). Preoperative OPN exhibited a slight negative correlation with the EF (r = -0.35, p = 0.04), and a moderate correlation with vena contracta (r = -0.38, p = 0.02). There were no other meaningful correlations between conventional echocardiographic parameters and OPN. Conclusion: Following valve surgery due to severe MR, patients exhibited a decrease in EF and an increase in OPN levels. The assessment of preoperative OPN failed to strongly predict probable LV dysfunction.

scholarly journals Takotsubo Cardiomyopathy and Non-ST-Segment Elevation Myocardial Infarction: Predictors of Left Ventricular Dysfunction

2017 ◽  
Vol 11 ◽  
pp. 117954681771610
Author(s):  
Andrew Hinojos ◽  
Thomas E Vanhecke ◽  
Susan Enright ◽  
Nathan Elg ◽  
Kristina Gifft ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular ◽  
Retrospective Case ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
Lv Dysfunction ◽  
St Segment ◽  
Artery Disease ◽  
Control Study

Background: Acute coronary syndrome (ACS) from non-ST-segment elevation myocardial infarction (NSTEMI) and Takotsubo (TK) cardiomyopathy present with similar initial clinical features and can result in left ventricular (LV) dysfunction and acute heart failure. Methods: This study was a retrospective case-control study that identified patients aged 18 years and older who presented with ACS and underwent cardiac catheterization. Results: There were a total of 321 patients in the TK group and 1031 patients in the NSTEMI group. There was significantly worse LV dysfunction in the TK group with average ejection fraction (EF) of 44.35% (±15.11%) versus NSTEMI with an average EF of 47.36% (±13.5%) ( P < .001). The presence of TK yielded of an odds ratio (OR) of 2.373 (95% confidence interval [CI]: 1.165-3.618) and presence of peripheral artery disease (PAD) yielded an OR of 2.053 (95% CI: 1.165-3.618). Conclusions: The presence of TK cardiomyopathy and PAD were independent predictors of patients who had LVEF of <35% and elevated B-type natriuretic peptide levels.

P606High intermodality variability in ejection fraction measured by echocardiography, cardiac magnetic resonance and single photon emission computed tomography in chronic coronary artery disease patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T M Stokke ◽  
S I Sarvari ◽  
A W Bjerring ◽  
K H Haugaa ◽  
M T Elahi ◽  
...  
Keyword(s):  
Single Photon ◽  
Photon Emission ◽  
Left Ventricular ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Chronic Coronary Artery Disease ◽  
Single Photon Emission Computed ◽  
Artery Disease ◽  
Dimensional Echocardiography ◽  
Photon Emission Computed Tomography

Abstract Background Clinical treatment strategies are often based on measurement of left ventricular ejection fraction (LVEF). There is limited evidence about variations in LVEF when measured by different imaging modalities. Purpose To investigate the intermodality variability of LVEF measured by two-dimensional echocardiography (2DE), three-dimensional echocardiography (3DE), cardiac magnetic resonance (CMR), and single photon emission computed tomography (SPECT) in patients with chronic coronary artery disease (CAD). Methods Patients from a multicenter study (DOPPLER-CIP – Determining optimal noninvasive parameters for the prediction of left ventricular remodeling in chronic ischemic patients) with chronic CAD were included. LVEF was measured by CMR and at least one additional modality. In each modality, LVEF was measured by a core laboratory independently of the other modalities. Measurements of LVEF by CMR were compared to 2DE, 3DE and SPECT using correlation and Bland-Altman plots. Results A total of 343 patients were included. Mean age was 63.9±8.3 years and 253 (74%) were males. Mean LVEF by CMR was 61.8±11.6%. Correlations between CMR LVEF and other modalities were moderate for 2DE and 3DE, and good for SPECT (Figure A-C). CMR had significantly greater correlation to SPECT, compared to 2DE and 3DE. Bland-Altman plots indicated relatively wide limits of agreement between all modalities, ranging from 31% to 42% (Figure, D-F). Mean absolute difference of LVEF between CMR and other modalities were 8.5% for 2DE, 9.0% for 3DE, and 8.3% for SPECT. The percentage of measurements that fell within a range of 5% difference compared to CMR LVEF was 41% for 2DE, 34% for 3DE and 37% for SPECT (all p>0.05). Conclusions In a multicenter study with chronic CAD patients, LVEF assessed by CMR had better correlation to SPECT, compared to 2DE and 3DE. However, there was considerable variability among all three modalities that were compared to CMR. Awareness of these variations are important in clinical management.

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