scholarly journals Short-term melatonin supplementation decreases oxidative stress but does not affect left ventricular structure and function in myxomatous mitral valve degenerative dogs

2022 ◽  
Vol 18 (1) ◽  
Author(s):  
Wanpitak Pongkan ◽  
Chanon Piamsiri ◽  
Sirada Dechvongya ◽  
Verasak Punyapornwitthaya ◽  
Chavalit Boonyapakorn
Keyword(s):  
Oxidative Stress ◽  
Clinical Trial ◽  
Mitral Valve ◽  
Left Ventricular ◽  
Structure And Function ◽  
Post Treatment ◽  
Metabolic Parameters ◽  
Lv Function ◽  
And Function ◽  
Blood Profiles

Abstract Background Cardiac wall stress and high oxidative stress are often found in cases of myxomatous mitral valve degenerative (MMVD) disease and can lead to myocardial injuries and cardiac dysfunction. Melatonin, an antioxidant, has been shown to exert cardioprotection in laboratory animal models. However, its effect on metabolic parameters and left ventricular (LV) adaptation in MMVD dogs has rarely been investigated. This clinical trial hypothesized that a melatonin supplement for 4 weeks would improve metabolic parameters, LV structure (diameters and wall thickness), and LV function in MMVD dogs. Blood profiles, echocardiograms, and oxidative stress levels were obtained from 18 dogs with MMVD stage B2 and C at baseline and after prescribed Melatonin (2 mg/kg) for 4 weeks. Eleven dogs with MMVD stage B2 and C, which received a placebo, were evaluated as a control group. Results In this clinical trial, the baseline plasma malondialdehyde (MDA) was no different between the treatment and placebo groups. The post-treatment plasma MDA levels (4.50 ± 0.63 mg/mL) in the treatment group was significantly decreased after 4 weeks of melatonin supplementation compared to pre-treatment levels (7.51 ± 1.11 mg/mL) (P = 0.038). However, blood profiles and LV structure and function investigated using echocardiography were found not to different between pre-and post-treatment in each group. No adverse effects were observed following melatonin supplementation. Conclusions This clinical trial demonstrated that a melatonin supplement for 4 weeks can attenuate oxidative stress levels in MMVD dogs, especially in MMVD stage C, but does not result in LV structural changes or LV function in MMVD dogs of either stage B2 or stage C.

scholarly journals Effects of Pirfenidone on Echocardiographic Parameters of Left Ventricular Structure and Function in Patients with Idiopathic Pulmonary Fibrosis

2020 ◽  
Vol 5 (2) ◽  
pp. 35-42
Author(s):  
Shehab Al-Ansari ◽  
Allen Borowski ◽  
Ali Fuad ◽  
Omar Alawadhi ◽  
Haris Riaz ◽  
...  
Keyword(s):  
Treatment Group ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Diastolic Dysfunction ◽  
Left Ventricular ◽  
Structure And Function ◽  
Control Group ◽  
Lv Function ◽  
Echocardiographic Parameters ◽  
And Function

AbstractAim: Pirfenidone is a novel anti-fibrotic agent utilized in the treatment of idiopathic pulmonary fibrosis (IPF). It has been implicated in mitigating myocardial fibrosis and left ventricular (LV) systolic and diastolic dysfunction in animal models. However, its impact on LV mechanics in humans remains unknown. The aim of this study was to retrospectively evaluate the effects of pirfenidone on echocardiographic parameters of LV function and structure in patients with IPF.Methods: A total of 124 patients with IPF were included in this study: 64 patients treated with pirfenidone (treatment group) and 60 patients not taking pirfenidone (control group), who had serial pretreatment/baseline and posttreatment/follow-up echocardiograms done within a time frame of four years. Changes in the means of parameters of LV function (systolic, diastolic, and global longitudinal strain) and LV structure (mass and volume indices) were compared between the treatment and control groups. This was followed by a subgroup analysis that included only 88 patients (47 treated, 41 controls) with echocardiographic evidence of myocardial dysfunction at baseline (defined as an ejection fraction of ≤45, or diastolic dysfunction stage 1 or more) in addition to a known clinical diagnosis of congestive heart failure. To account for potential confounders, a secondary adjusted analysis by way of 1:1 propensity score matching (PSM) was carried out. This yielded a sample consisting of 62 patients with 56 patients in the subgroup cohort.Results: Patients in the treatment group were significantly younger (69.4 vs. 77 years, p<0.001) and had relatively lower forced vital capacity (69.9% vs. 80.6%, p = 0.005) in comparison to the control group. However, after PSM, the age demographics were comparable between both groups (72.18 vs. 72.15, p = 0.9). In the primary unadjusted analysis, there was no statistically significant change in any of the mean parameters of LV function and structure after pirfenidone administration when compared to the control group. Furthermore, no significant differences were noted in the subgroup cohort. Such findings were re-demonstrated after a secondary analysis with PSM.Conclusion: From an echocardiographic perspective, pirfenidone had no significant effects on LV structure and function in patients with IPF, even in patients with more overt cardiac dysfunction.

scholarly journals Multiparametric CMR Imaging of Myocardial Structure and Function Changes in Diabetic Mini-pigs With Preserved LV Function : A Preliminary Study

2021 ◽  
Author(s):  
Guozhu Shao ◽  
Yukun Cao ◽  
Yue Cui ◽  
Xiaoyu Han ◽  
Jia Liu ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
T1 Mapping ◽  
Extracellular Volume ◽  
Left Ventricular ◽  
Structure And Function ◽  
Lv Function ◽  
Myocardial Structure ◽  
And Function ◽  
Mini Pigs

Abstract Background: The purpose of this study is to dynamically monitor the myocardial structure and function changes in diabetic mini-pigs by 1.5T cardiac magnetic resonance. Methods: Cardiac magnetic resonance (CMR) T1 mapping was performed in three male streptozotocin-induced diabetic mini-pigs. T1-mapping and ECV-mapping were acquired at basal, mid and apical segments. CMR feature-tracking (CMR-FT) is used to quantify left ventricle global longitudinal (LVGLS), circumferential (LVGCS) and radial strain(LVGRS). Epicardial adipose tissue (EAT) was evaluated using a commercially available software.Results: Left ventricular mass (LVM), myocardial T1 value and extracellular volume (ECV) value increased gradually after 3, 4.5 and 6 months of modeling, while LVGLS decreased gradually after 3 months of modeling（Modeling 3M VS 1.5M：LVM，34.0 ± 1.9 VS 26.4 ± 1.3，P=0.027；T1，1012.3 ± 9.6 VS 1002.2 ± 11.4, P=0.014; ECV，24.3 ± 1.6 VS 22.4 ± 1.6，P=0.014；GLS：-20.8 ± 1.3 VS -23.0 ± 1.6，P=0.014；Modeling 4.5M VS 3M：LVM，37.5 ± 1.3 VS 34.0 ± 1.9，P=0.005；T1, 1017.8 ± 9.5 VS 1012.3 ± 9.6, P＜0.001；ECV，26.2 ± 1.5 VS 24.3 ± 1.6，P=0.037；GLS：-19.4 ± 1.4 VS -20.8 ± 1.3，P=0.016；Modeling 6M VS 4.5M：LVM，42.9 ± 1.6 ± 1.9 VS 37.5 ± 1.3，P=0.008；T1，1026.6 ± 10.2 VS 1017.8 ± 9.5, P=0.003；ECV，28.6 ± 1.8 VS 26.2 ± 1.5，P=0.016；GLS：-17.9 ± 1.1 VS -19.4 ± 1.4，P=0.019). EAT did not increase significantly until the sixth month (Modeling 6M VS 4.5M, EAT: 24.1 ± 3.1 VS 20.2 ± 2.4, P= 0.043).Conclusion: The progressive impairments in LV structure and myocardial deformation occurs in diabetic mini-pigs. T1 mapping and CMR-FT technology are promising to monitor abnormal changes of diabetic myocardium in early stage of diabetic cardiomyopathy.

Abstract 19900: Impact of Baseline Fitness in Young Adulthood and Age Related Fitness Changes on Cardiac Structure and Function in Middle Age: The CARDIA Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Ambarish Pandey ◽  
Norrina Allen ◽  
Colby Ayers ◽  
Jared Reis ◽  
Henrique Moreira ◽  
...  
Keyword(s):  
Young Adults ◽  
Risk Factor ◽  
Young Adulthood ◽  
Middle Age ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Structure And Function ◽  
Lv Function ◽  
Increased Risk ◽  
And Function

Introduction: Low cardiorespiratory fitness (CRF) in mid-life is a significant risk factor for heart failure (HF) at a later age. However, the contribution of CRF in early adulthood to HF risk is not well understood. Because of the established association of subclinical abnormalities in left ventricular (LV) structure and function with HF risk, we studied the association between early life CRF levels and measures of LV structure and function in middle-age. Methods: We included the Coronary Artery Risk Development in Young Adults (CARDIA) study participants who had a maximal exercise treadmill test (modified Balke protocol) at year 0 and an echocardiogram at year 25. Percent change in CRF [ΔCRF (%)] was calculated in the subgroup of participants who had a repeat CRF test at year 20. Associations of baseline CRF and ΔCRF (%) with measures of LV structure [end-diastolic volume (LVEDV), relative wall thickness (RWT)] and function [global longitudinal strain (GLS), Septal & Lateral E/e`] were assessed using multivariable linear regression. Results: We included 3,433 participants (baseline age: 25 years, 55% women) in the study. After adjustment for baseline characterstics, cumulative cardiovascular risk factor burden, and baseline and follow up body mass index (BMI), lower baseline CRF was associated with higher septal E/e`(β = -0.05, p = 0.01), higher lateral E/e` (β = -0.06, p = 0.008), and lower LVEDV (β = 0.07, p = 0.004). In contrast, CRF was not associated with GLS (p = 0.22) and RWT (p=0.27). Among participants with repeat CRF test (n =2,544), ΔCRF (%) was associated with LVEDV but not with measures of LV function. The association of baseline CRF with E/e` did not attenuate after additional adjustment for ΔCRF (%) (Table). Conclusions: Lower CRF in young adulthood is associated with subclinical abnormalities in diastolic function in middle age. These findings suggest that low CRF may identify young adults at increased risk of HF with preserved ejection fraction in later life.

Effect of macitentan on left ventricular (LV) function in pulmonary arterial hypertension (PAH): results from REPAIR

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Rosenkranz ◽  
R Channick ◽  
E Cottreel ◽  
N Galie ◽  
D.G Kiely ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Left Ventricular ◽  
Structure And Function ◽  
Functional Class ◽  
Lv Function ◽  
Funding Source ◽  
Open Label ◽  
Right Heart Catheterisation ◽  
Phosphodiesterase Type 5 Inhibitor ◽  
And Function

Abstract Introduction PAH impacts right ventricular (RV) structure and function but also leads to changes in the LV due to RV/LV interaction and underfilling. REPAIR, the first PAH study to use a primary endpoint assessed by cardiac MRI (cMRI), reported that RV stroke volume (RVSV) increased by 12 mL and pulmonary vascular resistance (PVR) decreased by 38% from baseline (BL) to Week 26 with macitentan. Purpose To assess the effect of macitentan on LV function in patients with PAH. Methods REPAIR (NCT02310672) was a 52-week, multicentre, open-label, single-arm, phase 4 study assessing the effect of macitentan primarily on RV structure and function, determined by cMRI and right heart catheterisation. Macitentan 10 mg was initiated in treatment-naïve patients, in patients receiving stable background phosphodiesterase type-5 inhibitor (PDE5i) at BL, or in initial combination with PDE5i. Exploratory LV endpoints were assessed by cMRI at Weeks 26 and 52. Safety was assessed up to end of study treatment +30 days in all patients who received ≥1 dose of macitentan (N=87). Patients with BL and Week 26 assessments for both PVR and RVSV were included in the modified Full Analysis Set (mFAS; N=71). Results In the mFAS, 57 (80%) patients were female. At BL, median age was 45 years; median (Q1, Q3) six-minute walk distance was 395 (323, 483) m; 48%/51% of patients were WHO functional class II/III; 59% had idiopathic PAH. Compared to BL, at Weeks 26 and 52 there were significant changes in LV cMRI parameters (table). The most common AEs were peripheral oedema (22%), headache (21%) and dizziness (14%). Conclusions Macitentan led to improvements in LV mass, volume and function, including clinically-relevant increases in LV stroke volume, at both 26 and 52 weeks in patients with PAH. Safety was consistent with other macitentan clinical trial data. Funding Acknowledgement Type of funding source: Other. Main funding source(s): Actelion Pharmaceuticals Ltd

scholarly journals Left Ventricle Architecture and Valvular Integrity Following Microaxial Mechanical Support: A Two-Year Follow-Up Study

2021 ◽  
Vol 10 (6) ◽  
pp. 1273
Author(s):  
Georgios Chatzis ◽  
Styliani Syntila ◽  
Harald Schuett ◽  
Christian Waechter ◽  
Holger Ahrens ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Structural Integrity ◽  
Mitral Valve Regurgitation ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Lv Function ◽  
Long Term Effects ◽  
And Function

Although the use of microaxilar mechanical circulatory support systems may improve the outcome of patients with cardiogenic shock (CS), little is known about its effect on the long-term structural integrity of left ventricular (LV) valves as well as on the development of LV-architecture. Therefore, we aimed to study the integrity of the LV valves and architecture and function after Impella support. Thus, 84 consecutive patients were monitored over two years having received ImpellaTM CP (n = 24) or 2.5 (n = 60) for refractory CS (n = 62) or for high-risk percutaneous coronary interventions (n = 22) followed by optimal medical treatment. Beside a significant increase in LV ejection fraction after two years (p ≤ 0.03 vs. pre-implantation), we observed a statistically significant decrease in LV dilation (p < 0.001) and severity of mitral valve regurgitation (p = 0.007) in the two-year follow-up period, suggesting an improved LV architecture. Neither the duration of support, nor the size of the Impella device or the indication for its use revealed any devastating impact on aortic or mitral valve integrity. These findings indicate that Impella device is a safe means of support of LV-function without detrimental long-term effects on the structural integrity of LV valves regardless of the size of the device or the indication of support.

P4445Effects of interleukin 17A inhibition on myocardial deformation and vascular function in psoriasis:one year follow-up

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
I Ikonomidis ◽  
G Makavos ◽  
J Thymis ◽  
P Rafouli-Stergiou ◽  
H Triantafyllidi ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Strain Rate ◽  
Vascular Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Post Treatment ◽  
Myocardial Deformation ◽  
Lv Function ◽  
Flow Reserve ◽  
Markers Of Oxidative Stress

Abstract Background Interleukin (IL)-17A activity is implicated in the clinical course of psoriasis. We investigated the effects of IL-17A inhibition on vascular and left ventricular (LV) function in psoriasis patients. Methods One hundred psoriasis patients received either an anti-IL-17A agent (secukinumab n=50), or cyclosporine treatment (n=50). At baseline and after 4 and 12 months of treatment, we measured (1) LV global longitudinal strain (GLS), strain rate (GLSR), strain rate at early diastole (GLSRE), twisting (LVtwist), (2) coronary flow reserve (CFR), (3) pulse wave velocity (PWV), (4) malondialdehyde (MDA) and protein carbonyl (PC) as markers of oxidative stress, (5) psoriasis severity and extent assessed by Psoriasis Area and Severity Index (PASI). Results Compared to treatment with cyclosporine, anti IL-17A treatment resulted in greater improvement in GLS (GLS: −16.7±3 at baseline vs −18.3±2.8 at 4 months vs −19±3 at 12 months post treatment with anti-IL-17 respectively, p=0.02, GLS: −16.8±2.9 at baseline vs −17.2±2.7 at 4 months vs −17.1±2.9 at 12 months post treatment with cyclosporine respectively, p=0.2), GLSR (−0.9±0.3 at baseline vs −1.08±0.3 at 4 months vs −1.11±0.2 at 12 months post treatment with anti-IL-17 respectively, p=0.02, −0.9±0.2 at baseline vs −0.95±0.2 at 4 months vs −0.96±0.2 at 12 months post treatment with cyclosporine respectively, p=0.5) GLSRE and LV twist (13.7±5.1 at baseline vs 18.1±6 at 4 months vs 17.8±5.6 at 12 months post treatment with anti-IL-17 respectively, p=0.001, 13±5.3 at baseline vs 13.8±5.6 at 4 months vs 15.5±5.3 at 12 months post treatment with cyclosporine respectively, p=0.6).Treatment with anti-IL-17A also resulted in greater improvement of CFR compared to cyclosporine treatment (2.6±0.3 at baseline vs 3±0.3 at 4 months vs 3.1±0.3 at 12 months post treatment with anti-IL-17 respectively, p=0.01, 2.7±0.4 at baseline vs 2.8±0.3 at 4 months vs 2.7±0.3 at 12 months post treatment with cyclosporine respectively, p=0.5) and PWV decreased after treatment with anti-IL-17 (10.2±1.8 at baseline vs 9.3±1.5 at 4 months vs 9.7±1.8 at 12 months post treatment with anti-IL-17 respectively, p=0.04, whereas higher values of PWV were observed after cyclosporine treatment (9.7±1.9 at baseline vs 10.8±1.7 at 4 months vs 11.2±2 at 12 months post treatment with cyclosporine respectively, p=0.02). PASI score was similarly improved after treatment with either anti-IL-17A or cyclosporine. Markers of oxidative stress were reduced after treatment with anti-IL-17A, in contrast to elevation of oxidative stress markers after treatment with cyclosporine. Changes of myocardial deformation markers and CFR after treatment with anti-IL-17A correlated with concomitant reduction of oxidative stress. Conclusions In psoriasis patients, inhibition of IL-17A results in a greater improvement of vascular and myocardial function compared with cyclosporine treatment.

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