scholarly journals Quantitative Evaluation On Cardiac Remodeling Mechanism After Intensive Exercise: A Preliminary Study of Non-enhanced Cardiac Cine MRI

2021 ◽  
Author(s):  
hongqin Liang ◽  
Liqiang Zhu ◽  
Bing Ji ◽  
Yongning Shang ◽  
xiaoyue Zhou ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Myocardial Strain ◽  
Strain Analysis ◽  
Exercise Group ◽  
Left Ventricular ◽  
Cine Mri ◽  
Control Group ◽  
Peak Strain ◽  
Functional Parameters ◽  
Time To Peak

Abstract Purpose: High intensity and longtime aerobic exercise may lead to the remodeling of both left and right ventricles with increased myocardial mass and cavity dilatation,which is mainly reflected in the changes of traditional cardiac function parameters.Feature tracking myocardial strain allows quantitative strain analysis of myocardial functionThe purpose was to quantitatively evaluate traditional cardiac function and feature tracking myocardial strain of exercise-induced ,andMaterials and methods: The study included 67 healthy volunteers (21 ± 2 years of age). The exercise group (n=43) who fulfilled our defined exercise criteria. The control group (n=23) who maintained a basic daily life .Noncontrast enhancement CMR scanning were performed on all the subjects using a 3T MRI scanner .Cvi42 software was used for post-processing . Left ventricular cardiac function and overall globle stress were measured.Results: Cardiac function parameters in the exercise group were significantly higher than those of the control group except for the ejection fractions (EFs) and heart rates (HRs). The GRS peak strain and GLS peak diastolic strain rates of both groups were significantly different (P＜0.05).The GRS peak strains and EFs were partly correlated (R=0.61). The GRS peak diastolic strains and cardiac Indices (CIs) were significantly correlated (R=0.68). The GCS and GRS Peak Strains showed highly negative correlations (R=–0.96). The GCS and GRS time to peak values were also highly correlated (R= 0.87). Conclusion:The initial results showed that Changes in the functional parameters were more obvious than in the myocardial strain parameters, and some strain indices were correlated with the cardiac functional parameters,when the remodeling of the heart occurs.This is a new attempt to quantitatively assessment of Cardiac function and strain by Non-contrast-enhanced magnetic resonance.

Hemodynamic forces and myocardial deformation using cine MRI in Marfan syndrome

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Cinque ◽  
A Guala ◽  
M Pisaniello ◽  
S Strada ◽  
R Fernandez ◽  
...  
Keyword(s):  
Early Detection ◽  
Marfan Syndrome ◽  
Systolic Dysfunction ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Cine Mri ◽  
Control Group ◽  
Left Ventricular Volumes ◽  
Hemodynamic Forces ◽  
Cardiovascular Assessment

Abstract Funding Acknowledgements Type of funding sources: None. Introduction. Cardiovascular assessment of Marfan syndrome (MS) patients has normally focused on the aortic root and vascular manifestations due to the high risk of aortic dissection. Although primary myocardial impairment has long been suspected, the evidence has been controversial. Advanced in CMR may support the early detection of cardiac dysfunction. Beyond left ventricle ejection fraction (EF) and myocardial strain (S), a new parameter is emerging, the hemodynamic forces (HF) exchanged between the blood flowing in the heart and the myocardium.  The application of these techniques to MS could be useful in demonstrating the presence of primary myocardial impairment. Aim. The aim of this study is to explore myocardial function in MS through the evaluation in cine CMR of EF, S and cardiac HF exchanged between the blood and the myocardium and compare these data with those of a control group (C). Methods. We retrospectively analysed CMR cine images of MS (diagnosed according revised Ghent criteria) without valvular disease or previous cardio surgery, and C, in standard long-axis projections, to define endocardial borders for subsequent quantification of left ventricular volumes, EF, longitudinal, circumferential and radial S, apex-to-base and lateral-to-septum HF (expressed in mN and as a percentage of gravity acceleration). The analysis were performed on Medical Imaging Systems (QStrain version 1.3.0.79; MEDIS) (Figure 1). Results. 108 MS and 44 C had a good quality study, suitable for MEDIS analysis. The mean age was 33 ± 13 ys in MS, 35 ± 12 ys in C; 39% were male in MS, 50% in C. The results of left ventricular function were: EF 63 ± 7% in MS vs 66 ± 5% in C group, p .008, global longitudinal S -24.5 ± 4.1% in MS vs -26.2 ± 4.1 in C, p .014; global circumferential S -30.6 ± 6.3% in MS vs -33.8 ± 4.4 in C, p .002; radial S 64.5 ± 16.2% in MS vs 72.7 ± 15.9 in C, p .005; apex-to-base HF 13.2 ± 4.7% in MS vs 17.8 ± 7.6% in C, p .000; lateral-to-septum 2.6 ± 1.3% in MS vs 3.1 ± 1.4% in C, p .048. Moreover, 4.6% MS patients had mid reduced EF (40-50%); 9.2% had global longitudinal S reduction (cut off -19.3%); 7.4% had global circumferential S reduction (cut-off -21.7%). Conclusion. These data provide support for the existence of a cardiomyopathy in MS. In our opinion, the term "primary cardiomyopathy" is not appropriate to describe this condition: patients with MS have changes in aortic stiffness and probably in cardiac afterload. The HF data are the most interesting of this study, both in the validation of this new parameter and in early detection a cardiomyopathy in MS Moreover, the reduction of global circumferential S, as wall as global longitudinal S, in MS patients may help provide new elements to characterize the MS cardiomyopathy: sure enough, in literature, circumferential strain abnormalities are related to afterload increase. HF analysis is really a new challenge of cardiac imaging, as sensitive markers of subtle systolic dysfunction. Abstract Figure. Figue 1. Analisis exemple.

scholarly journals Effect of a 12-Week Concurrent Training Intervention on Cardiometabolic Health in Obese Men: A Pilot Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Francisco J. Amaro-Gahete ◽  
Jesús G. Ponce-González ◽  
Juan Corral-Pérez ◽  
Daniel Velázquez-Díaz ◽  
Carl J. Lavie ◽  
...  
Keyword(s):  
Energy Metabolism ◽  
Cardiac Function ◽  
Cardiometabolic Risk ◽  
Exercise Group ◽  
Left Ventricular ◽  
Concurrent Training ◽  
Cardiometabolic Health ◽  
Training Intervention ◽  
Control Group ◽  
Z Score

The present study aimed to investigate the effects of a 12-week concurrent training intervention on cardiometabolic health in obese men. Twelve obese men (42.5 ± 5.3 years old) participated in the current 12−week randomized controlled trial with a parallel group design. The participants were randomly assigned to a concurrent training group or to a no-exercise control group. Anthropometry and body composition assessment were determined by electrical bio-impedance. Blood samples were obtained and a cardiometabolic risk Z-Score was calculated. Energy metabolism-related parameters [i.e., resting metabolic rate (RMR), respiratory quotient (RQ), and substrate oxidation in both resting conditions and during exercise] were determined by indirect calorimetry. Echocardiographic studies were performed using an ultrasound system equipped with a transducer to measure cardiac function. A significant decrease of weight (Δ = −4.21 kg; i.e., primary outcome), body mass index (Δ = −1.32 kg/m2), fat mass (FM; Δ = −3.27 kg), blood pressure (BP; Δ = −10.81 mmHg), and cardiometabolic risk Z-Score (Δ = −0.39) was observed in the exercise group compared with the control group (all P < 0.05), while no significant changes were noted in waist circumference (WC), lean mass (LM), bone mineral content, glycemic and lipid profiles, liver function, nor in energy metabolism-related parameters (all P > 0.1). Moreover, a significant increment of left ventricular (LV) end diastolic diameter (Δ = −4.35 mm) was observed in the exercise group compared with the control group (P = 0.02). A 12-week concurrent training intervention is an effective strategy to induce weight and fat loss with simultaneous reductions of BP and cardiometabolic risk, and improving cardiac function in obese men.

Utility of 2D-speckle tracking echocardiography in early identification of left ventricular dysfunction in antineoplastic therapy-induced cardiotoxicity.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 631-631
Author(s):  
Carmela Coppola ◽  
Carlo G. Tocchetti ◽  
Giovanna Piscopo ◽  
Clemente Cipresso ◽  
Carlo Maurea ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Antineoplastic Therapy ◽  
Speckle Tracking ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Dysfunction ◽  
Increased Risk ◽  
2D Speckle Tracking ◽  
Group D

631 Background: ErbB2 is overexpressed in about 25% of breast cancers; in the heart, it modulates myocardial development and function. Trastuzumab (T), an anti-ErbB2 inhibitor, has improved the prognosis of patients with breast cancer, but is related to an increased risk of asymptomatic left ventricular (LV) dysfunction (3-34%) and heart failure (2-4%). Conventional measures of ventricular function, such as fractional shortening (FS) and ejection fraction (FE) are insensitive in detecting early cardiomyopathy induced by antineoplastic therapy. Aim of this study is to evaluate whether myocardial strain by 2D-speckle tracking (ST) is able to identify early LV dysfunction in mice treated with doxorubicin (D) and T, alone or in combination (D+T) and to relate data of cardiac function with tissue alterations. Methods: Cardiac function was measured with FS, by M-mode echocardiography, and with radial myocardial strain with ST in sedated C57BL/6 mice (8-10 wk old) at time 0, 2 and 6 days of daily administration of D, T, D+T and in a control group. In excised hearts, we evaluated TNFα and CD68 by immunohistochemistry; interstizial fibrosis was analyzed with picrosirius red staining. Results: FS was reduced in group D and D+T at 2 days (52+0.2% and 49+2% respectively), both p<0.001 vs 60+0.4% (sham), while in group T it decreased only at 6 days (49+1.5% vs 60+0.5%, p=.002). In contrast, after 2 days, myocardial strain was already reduced not only in D and D+T, but also in T alone: 43+3%, 49+1%, and 44+7%, respectively, all p<0.05 vs sham (66+0.6%). Cardiotoxicity was associated with significant alterations in extracellular matrix remodeling as confirmed by an increase of interstizial collagen with D (4.56%), T (2.17%) and D+T (3.77%)at 6 days p<0.05 vs sham (1.17%) and by increased cardiac inflammation in fact the myocytes were positive for TNFα and CD68 cells/mm2at 6 days in group D (16.46% and 155 respectively), in group T+D (12.35% and 74.16) and in group T (5.65% and 72.32) p<0.01 vs sham (0.56% and 2.3). Conclusions: Myocardial strain identifies LV systolic dysfunction earlier than conventional echocardiography and can be a useful tool to predict cardiotoxicity in this setting.

Utility of 2D-speckle tracking echocardiography in diagnosis of left ventricular dysfunction in anti-ErbB2 therapy.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 169-169
Author(s):  
Nicola Maurea ◽  
Giovanna Piscopo ◽  
Clemente Cipresso ◽  
Domenica Rea ◽  
Emanuela Esposito ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Speckle Tracking ◽  
Systolic Dysfunction ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Dysfunction ◽  
Increased Risk ◽  
2D Speckle Tracking ◽  
Group D

169 Background: ErbB2 is overexpressed in about 25% of breast cancers; in the heart, it modulates myocardial development and function. Trastuzumab (T), an anti-ErbB2 inhibitor, has improved the prognosis of patients with breast cancer, but is related to an increased risk of asymptomatic left ventricular (LV) dysfunction (3-34%) and heart failure (2-4%). Conventional measures of ventricular function, such as fractional shortening (FS) and ejection fraction (FE) are insensitive in detecting early cardiomyopathy induced by antineoplastic therapy. Here, we aim at assessing whether myocardial strain by 2D-speckle tracking (ST) is able to identify early LV dysfunction in mice treated with doxorubicin (D) and T, alone or in combination (D+T) and to relate data of cardiac function with tissue alterations. Methods: Cardiac function was measured with FS, by M-mode echocardiography, and with radial myocardial strain with ST in sedated C57BL/6 mice (8-10 wk old) at time 0, 2 and 6 days of daily administration of D (2.17 mg/kg/day), T (2.25 mg/kg/day), D+T (2.17 mg/kg/day + 2.25 mg/kg/day) and in a control group. In excised hearts, we evaluated TNFα and CD68 by immunohistochemistry; interstizial fibrosis was analyzed with picrosirius red staining. Results: FS was reduced in group D and D+T at 2 days (52+0.2% and 49+2%), both p<0.001 vs 60+0.4% (sham), while in group T it decreased only at 6 days (49+1.5% vs 60+0.5%, p=.002). In contrast, after 2 days, myocardial strain was already reduced not only in D and D+T, but also in T alone: 43+3%, 49+1%, and 44+7%, respectively, all p<0.05 vs sham (66+0.6%). Cardiotoxicity was associated with significant alterations in extracellular matrix remodeling as confirmed by an increase of interstizial collagen with D (4.56%), T (2.17%) and D+T (3.77%)at 6 days p<0.05 vs sham (1.17%) and by increased cardiac inflammation in fact the myocytes were positive for TNFα and CD68 cells/mm2at 6 days in group D (16.46% and 155), in group T+D (12.35% and 74.16) and in group T (5.65% and 72.32) p<0.01 vs sham (0.56% and 2.3). Conclusions: Myocardial strain identifies LV systolic dysfunction earlier than conventional echocardiography and can be a useful tool to predict cardiotoxicity in this setting.

Abstract 95: Longitudinal In Vivo Quantification of Infarct Size and Cardiac Function in a Murine Model of Myocardial Infarction using Novel Compact High-Performance MRI

2014 ◽  
Vol 115 (suppl_1) ◽  
Author(s):  
Tonya Coulthard ◽  
Jun Wu
Keyword(s):  
Cardiac Function ◽  
Infarct Size ◽  
Contrast Agents ◽  
Coronary Revascularization ◽  
Myocardial Strain ◽  
Cine Mri ◽  
Peak Strain ◽  
Contrast Imaging ◽  
Increased Sensitivity

Intro: Delayed Enhancement Imaging (DEI) characterizes MI and predicts therapeutic efficacy following coronary revascularization, stem cell transplantation, or other procedures. Typically gadolinium-based (Gd) contrast agents are injected intravenously and accumulate in the lesion, differentiating between normal and diseased myocardium. Traditionally, DEI has been explored using superconducting high-field MRI. Using a novel compact MRI at 1 Tesla, there is increased sensitivity to Gd-based contrast agents compared with higher-field MRI systems. Hypothesis: In this study, DEI on a compact MRI system was employed with spatial intensity analysis to measure infarct size. Tagged cine MRI assessed myocardial strain using the HARP method. Post-mortem histology of Masson Trichrome staining estimated infarct size. Correlation analysis determined relationships between infarct size measured via DEI and histology. Methods: C57BL/6 MI mice had ligation of the left anterior descending artery. Four sham control and five MI mice we imaged using compact MRI (ICON compact MRI, Billerica, MA) and monitored longitudinally over 21 days for infarct progression and cardiac function in vivo. DE imaging was performed 10-20 minutes post injection of 2 μL Gd contrast agent (ProHance, 0.5 mmol/ml). Images were acquired in short axis, 1 mm superior to the apex. Post-processing analysis (pcVirtue, Diagnosoft, Morrisville, NC) measured cardiac function and infarct size. Results and Conclusions: Analyses of DEI data indicate an average infarct size of 24.85 +/- 15.09 % in the left ventricle. One week after MI induction, a much lower EF was observed in MI mice with respect to control (35.3 +/- 7.567% vs. 67.3 +/- 1.6 %), with a slight recovery of cardiac function in MI mice by week 3 (EF = 45.5 +/- 3.1%). Strain analysis also indicated significantly lower average peak strain in MI vs control mice (6.9 +/- 4.3 vs. 21.5 +/- 0.4 %). Preliminary results demonstrate successful monitoring of cardiac function while performing DEI to visualize and quantify MI at 1 Tesla and leverage the benefits of the increased sensitivity of Gd-based contrast imaging with novel compact MRI. Such imaging and analysis techniques could be used to test efficacy of multiple therapeutic interventions.

scholarly journals Changes in left ventricular electromechanical relations during targeted hypothermia

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Kristin Wisløff-Aase ◽  
Viesturs Kerans ◽  
Kristina Haugaa ◽  
Per Steinar Halvorsen ◽  
Helge Skulstad ◽  
...  
Keyword(s):  
Heart Rate ◽  
Qt Interval ◽  
Clinical Importance ◽  
Left Ventricular ◽  
Peak Strain ◽  
Time To Peak ◽  
Mechanical Dispersion ◽  
Dispersion Of Repolarization ◽  
Aortic Valve Closure ◽  
Prolonged Qt Interval

Abstract Background Targeted hypothermia, as used after cardiac arrest, increases electrical and mechanical systolic duration. Differences in duration of electrical and mechanical systole are correlated to ventricular arrhythmias. The electromechanical window (EMW) becomes negative when the electrical systole outlasts the mechanical systole. Prolonged electrical systole corresponds to prolonged QT interval, and is associated with increased dispersion of repolarization and mechanical dispersion. These three factors predispose for arrhythmias. The electromechanical relations during targeted hypothermia are unknown. We wanted to explore the electromechanical relations during hypothermia at 33 °C. We hypothesized that targeted hypothermia would increase electrical and mechanical systolic duration without more profound EMW negativity, nor an increase in dispersion of repolarization and mechanical dispersion. Methods In a porcine model (n = 14), we registered electrocardiogram (ECG) and echocardiographic recordings during 38 °C and 33 °C, at spontaneous and atrial paced heart rate 100 beats/min. EMW was calculated by subtracting electrical systole; QT interval, from the corresponding mechanical systole; QRS onset to aortic valve closure. Dispersion of repolarization was measured as time from peak to end of the ECG T wave. Mechanical dispersion was calculated by strain echocardiography as standard deviation of time to peak strain. Results Electrical systole increased during hypothermia at spontaneous heart rate (p < 0.001) and heart rate 100 beats/min (p = 0.005). Mechanical systolic duration was prolonged and outlasted electrical systole independently of heart rate (p < 0.001). EMW changed from negative to positive value (− 20 ± 19 to 27 ± 34 ms, p = 0.001). The positivity was even more pronounced at heart rate 100 beats/min (− 25 ± 26 to 41 ± 18 ms, p < 0.001). Dispersion of repolarization decreased (p = 0.027 and p = 0.003), while mechanical dispersion did not differ (p = 0.078 and p = 0.297). Conclusion Targeted hypothermia increased electrical and mechanical systolic duration, the electromechanical window became positive, dispersion of repolarization was slightly reduced and mechanical dispersion was unchanged. These alterations may have clinical importance. Further clinical studies are required to clarify whether corresponding electromechanical alterations are accommodating in humans.

scholarly journals Impact of type 2 diabetes mellitus on left ventricular diastolic function in patients with essential hypertension: evaluation by volume-time curve of cardiac magnetic resonance

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Wei-feng Yan ◽  
Yue Gao ◽  
Yi Zhang ◽  
Ying-kun Guo ◽  
Jin Wang ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Diastolic Function ◽  
Control Group ◽  
Peak Strain ◽  
Filling Rate ◽  
Time Curve ◽  
Time To Peak ◽  
Peak Ejection Rate ◽  
Lv Diastolic Dysfunction

Abstract Background Essential hypertension and type 2 diabetes mellitus (T2DM) are two common chronic diseases that often coexist, and both of these diseases can cause heart damage. However, the additive effects of essential hypertension complicated with T2DM on left ventricle (LV) diastolic function have not been fully illustrated. This study aims to investigate whether T2DM affects the diastolic function of the LV in patients with essential hypertension using the volume-time curve from cardiac magnetic resonance (CMR). Methods A total of 124 essential hypertension patients, including 48 with T2DM [HTN(T2DM +) group] and 76 without T2DM [HTN(T2DM-) group], and 52 normal controls who underwent CMR scans were included in this study. LV volume-time curve parameters, including the peak ejection rate (PER), time to peak ejection rate (PET), peak filling rate (PFR), time to peak filling rate from end-systole (PFT), PER normalized to end-diastolic volume (PER/EDV), and PFR normalized to EDV (PFR/EDV), were measured and compared among the three groups. Multivariate linear regression analyses were performed to determine the effects of T2DM on LV diastolic dysfunction in patients with hypertension. Pearson correlation was used to analyse the correlation between the volume-time curve and myocardial strain parameters. Results PFR and PFR/EDV decreased from the control group, through HTN(T2DM −), to HTN(T2DM +) group. PFT in the HTN(T2DM-) group and HTN(T2DM +) group was significantly longer than that in the control group. The LV remodelling index in the HTN(T2DM −) and HTN(T2DM +) groups was higher than that in the normal control group, but there was no significant difference between the HTN(T2DM −) and HTN(T2DM +) groups. Multiple regression analyses controlling for covariates of systolic blood pressure, age, sex, and heart rate demonstrated that T2DM was independently associated with PFR/EDV (β = 0.252, p < 0.05). The volume-time curve method has good repeatability, and there is a significant correlation between volume-time curve parameters (PER/EDV and PFR/EDV) and myocardial peak strain rate, especially circumferential peak strain rate, which exhibited the highest correlation (r = − 0.756 ~ 0.795). Conclusions T2DM exacerbates LV diastolic dysfunction in patients with essential hypertension. The LV filling model changes reflected by the CMR volume-time curve could provide more information for early clinical intervention.

scholarly journals A Randomized Controlled Trial to Study the Effect of Yoga Therapy on Cardiac Function and N Terminal Pro BNP in Heart Failure

2014 ◽  
Vol 9 ◽  
pp. IMI.S13939 ◽  
Author(s):  
Bandi Hari Krishna ◽  
Pravati Pal ◽  
G. K. Pal ◽  
J. Balachander ◽  
E. Jayasettiaseelon ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Function ◽  
Medical Therapy ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Tei Index ◽  
Ventricular Ejection Fraction ◽  
Yoga Therapy ◽  
Standard Medical Therapy

Aims The purpose of this study was to evaluate whether yoga training in addition to standard medical therapy can improve cardiac function and reduce N terminal pro B-type natriuretic peptide (NT pro BNP) in heart failure (HF). Methods 130 patients were recruited and randomized into two groups: Control Group (CG) ( n = 65), Yoga Group (YG). In YG, 44 patients and in CG, 48 patients completed the study. Cardiac function using left ventricular ejection fraction (LVEF), myocardial performance index (Tei index), and NT pro BNP, a biomarker of HF, was assessed at baseline and after 12 weeks. Result Improvement in LVEF, Tei index, and NT pro BNP were statistically significant in both the groups. Furthermore, when the changes in before and after 12 weeks were in percentage, LVEF increased 36.88% in the YG and 16.9% in the CG, Tei index was reduced 27.87% in the YG and 2.79% in the CG, NT pro BNP was reduced 63.75% in the YG and 10.77% in the CG. The between group comparisons from pre to post 12 weeks were significant for YG improvements (LVEF, P < 0.01, Tei index, P < 0.01, NT pro BNP, P < 0.01). Conclusion These results indicate that the addition of yoga therapy to standard medical therapy for HF patients has a markedly better effect on cardiac function and reduced myocardial stress measured using NT pro BNP in patients with stable HF.

scholarly journals Effects of human recombinant growth hormone on exercise capacity, cardiac structure, and cardiac function in patients with adult-onset growth hormone deficiency

2017 ◽  
Vol 45 (6) ◽  
pp. 1708-1719 ◽  
Author(s):  
S Gonzalez ◽  
JD Windram ◽  
T Sathyapalan ◽  
Z Javed ◽  
AL Clark ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Cardiac Function ◽  
Growth Hormone Deficiency ◽  
Exercise Capacity ◽  
Left Ventricular ◽  
Hormone Deficiency ◽  
Control Group ◽  
Cardiac Structure ◽  
Adult Onset ◽  
Risk Of Death

Objective Epidemiological studies suggest that adult-onset growth hormone deficiency (AGHD) might increase the risk of death from cardiovascular causes. Methods This was a 6-month double-blind, placebo-controlled, randomised, cross-over trial followed by a 6-month open-label phase. Seventeen patients with AGHD received either recombinant human growth hormone (rGH) (0.4 mg injection daily) or placebo for 12 weeks, underwent washout for 2 weeks, and were then crossed over to the alternative treatment for a further 12 weeks. Cardiac magnetic resonance imaging, echocardiography, and cardiopulmonary exercise testing were performed at baseline, 12 weeks, 26 weeks, and the end of the open phase (12 months). The results were compared with those of 16 age- and sex-matched control subjects. Results At baseline, patients with AGHD had a significantly higher systolic blood pressure, ejection fraction, and left ventricular mass than the control group, even when corrected for body surface area. Treatment with rGH normalised the insulin-like growth factor 1 concentration without an effect on exercise capacity, cardiac structure, or cardiac function. Conclusion Administration of rGH therapy for 6 to 9 months failed to normalise the functional and structural cardiac differences observed in patients with AGHD when compared with a control group.

The Effect of Gypenosides on Cardiac Function and Expression of Cytoskeletal Genes of Myocardium in Diabetic Cardiomyopathy Rats

2009 ◽  
Vol 37 (06) ◽  
pp. 1059-1068 ◽  
Author(s):  
Min Ge ◽  
Shanfeng Ma ◽  
Liang Tao ◽  
Sudong Guan
Keyword(s):  
Cardiac Function ◽  
Diabetic Cardiomyopathy ◽  
Diastolic Pressure ◽  
Pure Water ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Control Group ◽  
Sprague Dawley ◽  
Gene Expressions ◽  
Ventricular Systolic Pressure

The relationship between changes of cardiac function and the gene expressions of two major myocardial skeleton proteins, titin and nebulin, and the effect of gypenosides on these gene expressions in diabetic cardiomyopathy rat were explored in the present study. Forty Sprague-Dawley rats were randomly divided into three groups: control group, diabetic cardiomyopathy group and gypenosides-treated diabetic cardiomyopathy group. The diabetic cardiomyopathy was induced in rats by injecting streptozotocin (STZ, 55 mg/kg) intraperitoneally. Seven weeks after the rats suffered from diabetes, the rats were treated with gypenosides 100 mg/kg per day orally for six weeks in gypenosides-treated group. In the meanwhile, the pure water was given to diabetic cardiomyopathy and the control groups. Subsequently, the cardiac functions, including left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure (LVEDP), ± dP/dtmax and t–dP/dmaxt, as well as the mRNA content and proteins of titin and nebulin in myocardium were determined. The results indicated that (1) the diabetic cardiomyopathy rats had decreased LVSP and ± dP/dtmax, increased LVEDP, and prolonged t–dP/dtmax than normal rats; (2) LVSP and ± dP/dtmax in diabetic cardiomyopathy rats treated with gypenosides were significantly higher and LVEDP and t–dP/dtmax were significantly lower than those without giving gypenosides; (3) the mRNA contents and proteins of titin and nebulin in diabetic cardiomyopathy rats were remarkably lower than those in the control rats and gypenosides had no effect on mRNA and protein expression levels of titin and nebulin in diabetic cardiomyopathy rats. We conclude that (1) the cardiac function as well as the mRNA expressions of titin and nebulin decreased in diabetic cardiomyopathy rats; (2) gypenosides secure cardiac muscles and their function from diabetic impairment and these beneficial effects of gypenosides are not by changing the expressions of titin and nebulin.

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