Right ventricular TNF resistance during endotoxemia: the differential effects on ventricular function

2007 ◽  
Vol 293 (5) ◽  
pp. R1893-R1897 ◽  
Author(s):  
Troy A. Markel ◽  
Paul R. Crisostomo ◽  
Meijing Wang ◽  
Jeremy L. Herrmann ◽  
Aaron M. Abarbanell ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Ventricular Myocytes ◽  
Left Ventricular ◽  
Sprague Dawley ◽  
Endotoxin Exposure ◽  
Sprague Dawley Rats ◽  
Developed Pressure ◽  
The Right ◽  
Rv Function

Right and left ventricular myocytes originate from different cellular progenitors; however, it is unknown whether these cells differ in their response to endotoxemia. We hypothesized that 1) the percentage of endotoxemic functional depression within the right ventricle (RV) would be smaller than that of the left ventricle; and 2) that better RV function would correlate with lower levels of right ventricular TNF production. Adult Sprague-Dawley rats were divided into right and left control and endotoxin groups. Controls received vehicle, while endotoxin groups received LPS at 20 mg/kg ip. Hearts were excised either 2 or 6 h after injection. Hearts excised at 2 h were assayed for TNF, IL-6, TNF receptor 1 (TNFR1), TNFR2, and via ELISA, while hearts excised at 6 h were assayed via the Langendorff model. The percentage of cardiac functional depression, exhibited as developed pressure, contractility, and rate of relaxation (expressed as a percentage of control) was significantly smaller in right ventricles compared with left ventricles following endotoxin exposure. Tissue levels of TNF were significantly elevated in both right and left ventricles 2 h after endotoxin exposure, and right ventricular endotoxin groups expressed higher levels of TNF compared with their left ventricular counterparts. No significant differences in IL-6, TNFR1, or TNFR2 levels were noted between endotoxin-exposed ventricles. This is the first study to demonstrate that right and left ventricular function differs after endotoxin exposure.

scholarly journals Assessment of right ventricular function during exercise echocardiography in adult patients with tetralogy of Fallot

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
J Peteiro ◽  
M Rivadulla-Varela ◽  
B Bouzas-Zubeldia ◽  
I Martinez-Bendayan ◽  
A Bouzas-Mosquera ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Tetralogy Of Fallot ◽  
Functional Capacity ◽  
Left Ventricular ◽  
Exercise Echocardiography ◽  
Tricuspid Annulus ◽  
Area Change ◽  
Metabolic Equivalents ◽  
Rv Function

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The evaluation of right ventricular (RV) function in patients with  tetralogy of Fallot (TF)  is important as it could impact outcome. Further exhaustive assessments with exercise might offer added information. We aimed to evaluate different parameters of RV function and their changes during exercise echocardiography (ExE) in patients with TF, and to correlate them with functional capacity Methods Treadmill ExE was performed in 31 consecutive patients with corrected TF (mean age 36 ± 11, 22 male), all of them asymptomatic. Left ventricular function was studied at peak exercise, whereas RV function parameters were acquired during the immediate post-exercise period (<1.5 min), along with mitral, tricuspid and pulmonary regurgitation (PR), transtricuspid and transpulmonary systolic gradients, and LV-E/e´ values. RV function was assessed by tricuspid annulus plane systolic excursion (TAPSE), S wave velocity in the RV lateral annulus, and RV area change. A blunted functional capacity (BFC) was considered in case of achieving <100% of the predicted metabolic equivalents (METs) during ExE, according to age and gender. Results Only 1 patient had symptoms during ExE (dyspnea). Achieved METs were 13 ± 3.5 and 10 patients (32%) had BFC. LV ejection fraction (%) changed with exercise from 58 ± 10 to 63 ± 9 (p = 0.05) and E/e´ from 11 ± 4 to 10 ± 3 (p = 0.04). TAPSE did not change (19 ± 5 at rest; 21 ± 7 at exercise; p = NS), neither RV area change (41 ± 11 cm2 at rest; 39 ± 12 cm2 at exercise; p = NS), whereas TDI-S increased from 10.5 ± 2.8 to 13.8 ± 3.1 cm2/s (p < 0.001), and systolic pulmonary pressure from 20 ± 8 to 27 ± 12 mmHg (p = 0.001). Patients with BFC had more frequently significant PR at rest (60% vs 14%; p = 0.015), lower peak systolic blood pressure (152 ± 30 vs 176 ± 24 mmHg, p = 0.02) and higher exercise E/e´ (12.6 ± 2.7 vs 8.9 ± 3.0; p = 0.003), without differ in other parameters. Δ-TDI-S correlated with achieved METs and with the percent achieved of predicted METs (r = 0.46; p = 0.01, y r = 0.47; p = 0.008, respectively). In conclusion, TDI-S assessment at the tricuspid annulus is a useful parameter for assessing RV function during exercise in subjects with TF. Abstract Figure.

Glibenclamide improves postischemic recovery of myocardial contractile function in trained and sedentary rats

2001 ◽  
Vol 91 (4) ◽  
pp. 1545-1554 ◽  
Author(s):  
Korinne N. Jew ◽  
Russell L. Moore
Keyword(s):  
Contractile Function ◽  
Ischemia Reperfusion ◽  
Left Ventricular ◽  
Treadmill Running ◽  
Sprague Dawley ◽  
Sprague Dawley Rats ◽  
Diastolic Stiffness ◽  
Pressure Development ◽  
Increased Sensitivity ◽  
Developed Pressure

In this study, we sought to determine whether there was any evidence for the idea that cardiac ATP-sensitive K+ (KATP) channels play a role in the training-induced increase in the resistance of the heart to ischemia-reperfusion (I/R) injury. To do so, the effects of training and an KATP channel blocker, glibenclamide (Glib), on the recovery of left ventricular (LV) contractile function after 45 min of ischemia and 45 min of reperfusion were examined. Female Sprague-Dawley rats were sedentary (Sed; n = 18) or were trained (Tr; n = 17) for >20 wk by treadmill running, and the hearts from these animals used in a Langendorff-perfused isovolumic LV preparation to assess contractile function. A significant increase in the amount of 72-kDa class of heat shock protein was observed in hearts isolated from Tr rats. The I/R protocol elicited significant and substantial decrements in LV developed pressure (LVDP), minimum pressure (MP), rate of pressure development, and rate of pressure decline and elevations in myocardial Ca2+ content in both Sed and Tr hearts. In addition, I/R elicited a significant increase in LV diastolic stiffness in Sed, but not Tr, hearts. When administered in the perfusate, Glib (1 μM) elicited a normalization of all indexes of LV contractile function and reductions in myocardial Ca2+content in both Sed and Tr hearts. Training increased the functional sensitivity of the heart to Glib because LVDP and MP values normalized more quickly with Glib treatment in the Tr than the Sed group. The increased sensitivity of Tr hearts to Glib is a novel finding that may implicate a role for cardiac KATP channels in the training-induced protection of the heart from I/R injury.

scholarly journals Partitioning the Right Ventricle Into 15 Segments and Decomposing Its Motion Using 3D Echocardiography-Based Models: The Updated ReVISION Method

2021 ◽  
Vol 8 ◽  
Author(s):  
Márton Tokodi ◽  
Levente Staub ◽  
Ádám Budai ◽  
Bálint Károly Lakatos ◽  
Máté Csákvári ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Left Ventricular ◽  
3D Echocardiography ◽  
Mechanical Adaptation ◽  
Relative Contribution ◽  
Clinical Scenarios ◽  
The Face ◽  
The Right ◽  
Rv Function

Three main mechanisms contribute to global right ventricular (RV) function: longitudinal shortening, radial displacement of the RV free wall (bellows effect), and anteroposterior shortening (as a consequence of left ventricular contraction). Since the importance of these mechanisms may vary in different cardiac conditions, a technology being able to assess their relative influence on the global RV pump function could help to clarify the pathophysiology and the mechanical adaptation of the chamber. Previously, we have introduced our 3D echocardiography (3DE)-based solution—the Right VentrIcular Separate wall motIon quantificatiON (ReVISION) method—for the quantification of the relative contribution of the three aforementioned mechanisms to global RV ejection fraction (EF). Since then, our approach has been applied in several clinical scenarios, and its strengths have been demonstrated in the in-depth characterization of RV mechanical pattern and the prognostication of patients even in the face of maintained RV EF. Recently, various new features have been implemented in our software solution to enable the convenient, standardized, and more comprehensive analysis of RV function. Accordingly, in our current technical paper, we aim to provide a detailed description of the latest version of the ReVISION method with special regards to the volumetric partitioning of the RV and the calculation of longitudinal, circumferential, and area strains using 3DE datasets. We also report the results of the comparison between 3DE- and cardiac magnetic resonance imaging-derived RV parameters, where we found a robust agreement in our advanced 3D metrics between the two modalities. In conclusion, the ReVISION method may provide novel insights into global and also segmental RV function by defining parameters that are potentially more sensitive and predictive compared to conventional echocardiographic measurements in the context of different cardiac diseases.

Abstract 301: Decreased Right Ventricular Function in a Novel Model of Pulmonary Insufficiency in Rat

2012 ◽  
Vol 111 (suppl_1) ◽  
Author(s):  
Rong Jiang ◽  
Ming Shen ◽  
Guoliang Ding ◽  
Mary B Wagner ◽  
Paul Kirshbom
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Sham Group ◽  
Pulmonary Valve ◽  
Left Ventricular ◽  
Pulmonary Insufficiency ◽  
Isolated Hearts ◽  
Regurgitant Flow ◽  
Novel Model ◽  
Rv Function

The population of adult patients with right ventricular (RV) dysfunction is increasing due in part to the increasing number of children with corrected congenital heart defects that now survive to adulthood. We have developed a novel model of pulmonary insufficiency (PI) to investigate the time course of right ventricular failure due to volume loading. Methods: PI was created in Sprague-Dawley rats by disrupting the pulmonary valve. After a limited thoracotomy, a custom made hook was inserted through the RV apex into the RV-pulmonary artery annulus and moved back and forth several times to disrupt the valve. After 16-18 weeks, function was assessed by echocardiography (Visualsonics 2100) and RV function was measured using a Langendorff isolated heart system. Results: Evidence of PI was noted by regurgitant flow using color Doppler. There was no difference in RV weight or left ventricular function by echo between the sham and PI groups. Tricuspid annular plane systolic excursion (TAPSE) was significantly lower in PI compared to sham (2.46±0.19, n=8 vs. 3.16±0.13, n=5, p<0.05) indicating diminished RV function. Furthermore, in isolated hearts, developed pressure (DP) was significantly smaller in PI compared to sham (25.5±2.7, n=9 vs. 36.5±3.6 mmHg, n=5, p<0.05) as was the minimum derivative of pressure (dPmin, -500±46, n=9 vs. -731±81 mmHg/s, n=5, p<0.02). We separated the PI group into mild-PI and moderate-PI based on the amount of regurgitant flow. Isolated hearts were perfused with dobutamine to determine RV functional reserve. For the sham group, there was a dose-dependent increase of DP in response to dobutamine (36.5±3.6 vs. 38.0±1.7 vs. 51.2±4.1 mmHg for baseline, 100 nM, and 1 μ M (n=5), p<0.05 for 1 μ M vs. baseline and 100 nM). Similar results were found for dPmin and dPmax. In contrast, dobutamine did not significantly increase any functional parameters in the mild or moderate-PI groups. Conclusions: Disruption of the pulmonary valve in a rat model caused mild to moderate PI. Measures of RV function (TAPSE and DP) were decreased in the PI group. Response to dobutamine was robust in the sham group and diminished in both mild and moderate PI groups. This is a novel model of PI that can be used to investigate the mechanisms of RV failure in response to volume overload.

Echocardiography in Left Ventricular Assist Device Recipients

2019 ◽  
pp. 195-207
Author(s):  
Yan Topilsky ◽  
Ofer Havakuk
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
Pump Output ◽  
The Right

Echocardiography is enormously useful in managing patients treated with left ventricular assist devices (LVADs), but its use in these patients is rarely addressed specifically. The combined functions of the LVAD and the native left and right ventricles create unique hemodynamic conditions, which must be considered in a comprehensive echocardiographic assessment of patients receiving LVADs. This chapter reviews the hemodynamic effects of LVADS, including the trade-off between pump output and flow pulsatility, left ventricular and left arterial unloading, and the effects of LVADs on the right heart. It then describes the preoperative use of echocardiography in patient selection, including how to assess right ventricular function, aortic and tricuspid regurgitation, and patent foramen ovale. It then considers the intraoperative assessment of the left heart, right ventricular function; tricuspid, aortic, and mitral regurgitation; the inflow and outflow cannulas, and pump flow and total cardiac output. Finally, the authors address the postoperative uses of echocardiography in surveillance, including assessing hypovolemia, postoperative tamponade, impeller thrombosis, and cannula kinking or obstruction, as well as how to optimize LVAD function and to troubleshoot LVAD malfunctions.

scholarly journals Impact of tricuspid annular size reduction on right ventricular function, geometry and strain†

2019 ◽  
Vol 56 (2) ◽  
pp. 400-408 ◽  
Author(s):  
Marcin Malinowski ◽  
Tomasz Jaźwiec ◽  
Matthew Goehler ◽  
Jared Bush ◽  
Nathan Quay ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Cross Sectional Area ◽  
Free Wall ◽  
Sectional Area ◽  
Tricuspid Annulus ◽  
Cross Sectional ◽  
Area Reduction ◽  
The Right ◽  
Rv Function

Abstract OBJECTIVES Restrictive tricuspid annuloplasty is a clinically accepted approach to treat functional tricuspid regurgitation. We set out to investigate the effect of varying degrees of tricuspid annular reduction on the right ventricular (RV) function, geometry and strain. METHODS Eight, healthy sheep (45 ± 4 kg) had 6 sonomicrometry crystals implanted around the tricuspid annulus and 20 onto the epicardium of the right ventricle defining 3 free wall regions: basal, mid and lower. A polypropylene annuloplasty suture was placed around the tricuspid annulus and externalized to an epicardial tourniquet. Simultaneous echocardiographic, haemodynamic and sonomicrometry data were acquired at baseline and during 5 consecutive annular reduction steps (TAR 1–5) with successive (5–7 mm) suture cinching. RV free wall circumferential, longitudinal and areal cardiac and interventional strains, RV radius of curvature (ROC), cross-sectional area and tricuspid annular dimensions were calculated from 3-dimensional crystal coordinates. RESULTS TAR 1–5 resulted in 19 ± 15%, 35 ± 15%, 51 ± 15%, 60 ± 15% and 68 ± 13% tricuspid annular area reduction, respectively. TAR 1 and 2 had minimal influence on the RV function, RV-ROC and strains. TAR 4 and 5 decreased RV-ROC in basal and mid-regions, but reduced the RV cross-sectional area change (from 19 ± 4% at baseline to 14 ± 3% and 13 ± 2%, respectively, P < 0.001) and circumferential and areal strains. TAR 3 significantly decreased free wall RV-ROC from 44.0 ± 1.5 to 42.6 ± 2.4 mm P < 0.001 at the RV base but maintained the regional ventricular function and strains. CONCLUSIONS In healthy ovine hearts, a tricuspid annular area reduction of ∼50% provides optimal conditions for reducing RV-ROC while maintaining regional RV function and strain patterns.

P1493Prognostic significance of right ventricular function during exercise in patients with non-obstructive hypertrophic cardiomyopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Hirasawa ◽  
M Izumo ◽  
K Mizukoshi ◽  
T Suzuki ◽  
Y Sato ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Risk Stratification ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Life Threatening ◽  
Rv Function

Abstract Background Hypertrophic cardiomyopathy (HCM) is a heterogeneous condition that may present crucial complication including life-threatening arrhythmia and sudden cardiac death. However, the risk stratification of HCM without left ventricular outflow tract (LVOT) obstruction had not been fully elucidated. Moreover, although recent studies have revealed the right ventricle (RV) involvement of HCM, the prognostic importance of RV function during exercise is unclear. Purpose To investigate the prognostic significance of RV function in patients with non-obstructive HCM using exercise stress echocardiography (ESE). Methods and results This study conducted on 100 HCM patients (age 62.9±13.6 years, 63% men) with preserved left ventricular ejection fraction who underwent ESE using semi-supine bicycle ergometer. Ten patients with significant LVOT obstruction (≥30mmHg) were excluded and 9 were also excluded because of the inadequate imaging quality or insufficiency of data. Among remaining 81 non-obstructive HCM patients, 9 patients suffered from HCM related cardiac events including cardiac death, unexpected hospitalization, life-threatening arrhythmias, and new-onset of syncope during the mean follow up period of 2.6±1.6 years. A multivariate Cox Hazard analysis revealed that low tricuspid annular plane systolic excursion during exercise (Ex-TAPSE, cut-off: 24mm) was an independent predictor of cardiac events. (hazard ratio: 18.66, 95% confidence interval: 3.66–338.46, P<0.001) The estimated cumulative cardiac event free survival using the Kaplan-Meier method was significantly lower in patients with reduced Ex-TAPSE (<24mm) than those with preserved Ex-TAPSE (Log-rank, P<0.01). K-M curve according to Ex-TAPSE Conclusion Ex-TAPSE had a strong predictive value of clinical outcomes in non-obstructive HCM patients. Right ventricular function during exercise may have crucial role in the risk stratification of non-obstructive HCM.

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