1
|
Lakatos BK, Rako Z, Szijártó Á, da Rocha BRB, Richter MJ, Fábián A, Gall H, Ghofrani HA, Kremer N, Seeger W, Zedler D, Yildiz S, Yogeswaran A, Merkely B, Tello K, Kovács A. Right ventricular pressure-strain relationship-derived myocardial work reflects contractility: Validation with invasive pressure-volume analysis. J Heart Lung Transplant 2024; 43:1183-1187. [PMID: 38508504 DOI: 10.1016/j.healun.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 03/22/2024] Open
Abstract
Three-dimensional (3D) echocardiography-derived right ventricular (RV) ejection fraction (EF) and global longitudinal strain (GLS) are valuable RV functional markers; nevertheless, they are substantially load-dependent. Global myocardial work index (GMWI) is a novel parameter calculated by the area of the RV pressure-strain loop. By adjusting myocardial deformation to instantaneous pressure, it may reflect contractility. To test this hypothesis, we enrolled 60 patients who underwent RV pressure-conductance catheterization to determine load-independent markers of RV contractility and ventriculo-arterial coupling. Detailed 3D echocardiography was also performed, and we calculated RV EF, RV GLS, and using the RV pressure trace curve, RV GWMI. While neither RV EF nor GLS correlated with Ees, GMWI strongly correlated with Ees. In contrast, RV EF and GLS showed a relationship with Ees/Ea. By dividing the population based on their Reveal Lite 2 risk classification, different characteristics were seen among the subgroups. RV GMWI may emerge as a useful clinical tool for risk stratification and follow-up in patients with RV dysfunction.
Collapse
Affiliation(s)
- Bálint K Lakatos
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
| | - Zvonimir Rako
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Ádám Szijártó
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Bruno R Brito da Rocha
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Manuel J Richter
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Alexandra Fábián
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Henning Gall
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Hossein A Ghofrani
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany; Division of Pulmonology, Department of Internal Medicine, Universities of Giessen, Giessen, Germany; Department of Pneumology, Kerckhoff Heart, Rheuma and Thoracic Centre, Bad Nauheim, Germany
| | - Nils Kremer
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Werner Seeger
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Daniel Zedler
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Selin Yildiz
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Athiththan Yogeswaran
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Khodr Tello
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Attila Kovács
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary; Department of Surgical Research and Techniques, Semmelweis University, Budapest, Hungary
| |
Collapse
|
2
|
Deshmukh T, Selvakumar D, Thavapalachandran S, Archer O, Figtree GA, Feneley M, Grieve SM, Thomas L, Pathan F, Chong JJH. Correlation of Noninvasive Cardiac MRI Measures of Left Ventricular Myocardial Function and Invasive Pressure-Volume Parameters in a Porcine Ischemia-Reperfusion Model. Radiol Cardiothorac Imaging 2024; 6:e230252. [PMID: 38842454 DOI: 10.1148/ryct.230252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Purpose To assess the correlation between noninvasive cardiac MRI-derived parameters with pressure-volume (PV) loop data and evaluate changes in left ventricular function after myocardial infarction (MI). Materials and Methods Sixteen adult female swine were induced with MI, with six swine used as controls and 10 receiving platelet-derived growth factor-AB (PDGF-AB). Load-independent measures of cardiac function, including slopes of end-systolic pressure-volume relationship (ESPVR) and preload recruitable stroke work (PRSW), were obtained on day 28 after MI. Cardiac MRI was performed on day 2 and day 28 after infarct. Global longitudinal strain (GLS) and global circumferential strain (GCS) were measured. Ventriculo-arterial coupling (VAC) was derived from PV loop and cardiac MRI data. Pearson correlation analysis was performed. Results GCS (r = 0.60, P = .01), left ventricular ejection fraction (LVEF) (r = 0.60, P = .01), and cardiac MRI-derived VAC (r = 0.61, P = .01) had a significant linear relationship with ESPVR. GCS (r = 0.75, P < .001) had the strongest significant linear relationship with PRSW, followed by LVEF (r = 0.67, P = .005) and cardiac MRI-derived VAC (r = 0.60, P = .01). GLS was not significantly correlated with ESPVR or PRSW. There was a linear correlation (r = 0.82, P < .001) between VAC derived from cardiac MRI and from PV loop data. GCS (-3.5% ± 2.3 vs 0.5% ± 1.4, P = .007) and cardiac MRI-derived VAC (-0.6 ± 0.6 vs 0.3 ± 0.3, P = .001) significantly improved in the animals treated with PDGF-AB 28 days after MI compared with controls. Conclusion Cardiac MRI-derived parameters of MI correlated with invasive PV measures, with GCS showing the strongest correlation. Cardiac MRI-derived measures also demonstrated utility in assessing therapeutic benefit using PDGF-AB. Keywords: Cardiac MRI, Myocardial Infarction, Pressure Volume Loop, Strain Imaging, Ventriculo-arterial Coupling Supplemental material is available for this article. © RSNA, 2024.
Collapse
Affiliation(s)
- Tejas Deshmukh
- From the Centre for Heart Research, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, Sydney, NSW 2145, Australia (T.D., D.S., S.T., J.J.H.C.); Department of Cardiology, Westmead Hospital, Westmead, Australia (T.D., D.S., S.T., O.A., L.T., J.J.H.C.); Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia (T.D., D.S., S.T., L.T., J.J.H.C.); Cardiovascular Discovery Group, Kolling Institute, University of Sydney and Royal North Shore Hospital, St Leonards, Sydney, Australia (G.A.F.); Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia (M.F.); Cardiac Mechanics Laboratory, Victor Chang Cardiac Research Institute, Darlinghurst, Australia (M.F.); Imaging and Phenotyping Laboratory, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, Australia (S.M.G.); Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Australia (S.M.G.); Nepean Clinical School of Medicine, Charles Perkin Centre Nepean, University of Sydney, Kingswood, Australia (F.P.); and Department of Cardiology, Nepean Hospital, Kingswood, Australia (F.P.)
| | - Dinesh Selvakumar
- From the Centre for Heart Research, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, Sydney, NSW 2145, Australia (T.D., D.S., S.T., J.J.H.C.); Department of Cardiology, Westmead Hospital, Westmead, Australia (T.D., D.S., S.T., O.A., L.T., J.J.H.C.); Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia (T.D., D.S., S.T., L.T., J.J.H.C.); Cardiovascular Discovery Group, Kolling Institute, University of Sydney and Royal North Shore Hospital, St Leonards, Sydney, Australia (G.A.F.); Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia (M.F.); Cardiac Mechanics Laboratory, Victor Chang Cardiac Research Institute, Darlinghurst, Australia (M.F.); Imaging and Phenotyping Laboratory, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, Australia (S.M.G.); Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Australia (S.M.G.); Nepean Clinical School of Medicine, Charles Perkin Centre Nepean, University of Sydney, Kingswood, Australia (F.P.); and Department of Cardiology, Nepean Hospital, Kingswood, Australia (F.P.)
| | - Sujitha Thavapalachandran
- From the Centre for Heart Research, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, Sydney, NSW 2145, Australia (T.D., D.S., S.T., J.J.H.C.); Department of Cardiology, Westmead Hospital, Westmead, Australia (T.D., D.S., S.T., O.A., L.T., J.J.H.C.); Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia (T.D., D.S., S.T., L.T., J.J.H.C.); Cardiovascular Discovery Group, Kolling Institute, University of Sydney and Royal North Shore Hospital, St Leonards, Sydney, Australia (G.A.F.); Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia (M.F.); Cardiac Mechanics Laboratory, Victor Chang Cardiac Research Institute, Darlinghurst, Australia (M.F.); Imaging and Phenotyping Laboratory, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, Australia (S.M.G.); Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Australia (S.M.G.); Nepean Clinical School of Medicine, Charles Perkin Centre Nepean, University of Sydney, Kingswood, Australia (F.P.); and Department of Cardiology, Nepean Hospital, Kingswood, Australia (F.P.)
| | - Oliver Archer
- From the Centre for Heart Research, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, Sydney, NSW 2145, Australia (T.D., D.S., S.T., J.J.H.C.); Department of Cardiology, Westmead Hospital, Westmead, Australia (T.D., D.S., S.T., O.A., L.T., J.J.H.C.); Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia (T.D., D.S., S.T., L.T., J.J.H.C.); Cardiovascular Discovery Group, Kolling Institute, University of Sydney and Royal North Shore Hospital, St Leonards, Sydney, Australia (G.A.F.); Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia (M.F.); Cardiac Mechanics Laboratory, Victor Chang Cardiac Research Institute, Darlinghurst, Australia (M.F.); Imaging and Phenotyping Laboratory, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, Australia (S.M.G.); Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Australia (S.M.G.); Nepean Clinical School of Medicine, Charles Perkin Centre Nepean, University of Sydney, Kingswood, Australia (F.P.); and Department of Cardiology, Nepean Hospital, Kingswood, Australia (F.P.)
| | - Gemma A Figtree
- From the Centre for Heart Research, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, Sydney, NSW 2145, Australia (T.D., D.S., S.T., J.J.H.C.); Department of Cardiology, Westmead Hospital, Westmead, Australia (T.D., D.S., S.T., O.A., L.T., J.J.H.C.); Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia (T.D., D.S., S.T., L.T., J.J.H.C.); Cardiovascular Discovery Group, Kolling Institute, University of Sydney and Royal North Shore Hospital, St Leonards, Sydney, Australia (G.A.F.); Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia (M.F.); Cardiac Mechanics Laboratory, Victor Chang Cardiac Research Institute, Darlinghurst, Australia (M.F.); Imaging and Phenotyping Laboratory, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, Australia (S.M.G.); Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Australia (S.M.G.); Nepean Clinical School of Medicine, Charles Perkin Centre Nepean, University of Sydney, Kingswood, Australia (F.P.); and Department of Cardiology, Nepean Hospital, Kingswood, Australia (F.P.)
| | - Michael Feneley
- From the Centre for Heart Research, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, Sydney, NSW 2145, Australia (T.D., D.S., S.T., J.J.H.C.); Department of Cardiology, Westmead Hospital, Westmead, Australia (T.D., D.S., S.T., O.A., L.T., J.J.H.C.); Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia (T.D., D.S., S.T., L.T., J.J.H.C.); Cardiovascular Discovery Group, Kolling Institute, University of Sydney and Royal North Shore Hospital, St Leonards, Sydney, Australia (G.A.F.); Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia (M.F.); Cardiac Mechanics Laboratory, Victor Chang Cardiac Research Institute, Darlinghurst, Australia (M.F.); Imaging and Phenotyping Laboratory, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, Australia (S.M.G.); Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Australia (S.M.G.); Nepean Clinical School of Medicine, Charles Perkin Centre Nepean, University of Sydney, Kingswood, Australia (F.P.); and Department of Cardiology, Nepean Hospital, Kingswood, Australia (F.P.)
| | - Stuart M Grieve
- From the Centre for Heart Research, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, Sydney, NSW 2145, Australia (T.D., D.S., S.T., J.J.H.C.); Department of Cardiology, Westmead Hospital, Westmead, Australia (T.D., D.S., S.T., O.A., L.T., J.J.H.C.); Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia (T.D., D.S., S.T., L.T., J.J.H.C.); Cardiovascular Discovery Group, Kolling Institute, University of Sydney and Royal North Shore Hospital, St Leonards, Sydney, Australia (G.A.F.); Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia (M.F.); Cardiac Mechanics Laboratory, Victor Chang Cardiac Research Institute, Darlinghurst, Australia (M.F.); Imaging and Phenotyping Laboratory, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, Australia (S.M.G.); Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Australia (S.M.G.); Nepean Clinical School of Medicine, Charles Perkin Centre Nepean, University of Sydney, Kingswood, Australia (F.P.); and Department of Cardiology, Nepean Hospital, Kingswood, Australia (F.P.)
| | - Liza Thomas
- From the Centre for Heart Research, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, Sydney, NSW 2145, Australia (T.D., D.S., S.T., J.J.H.C.); Department of Cardiology, Westmead Hospital, Westmead, Australia (T.D., D.S., S.T., O.A., L.T., J.J.H.C.); Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia (T.D., D.S., S.T., L.T., J.J.H.C.); Cardiovascular Discovery Group, Kolling Institute, University of Sydney and Royal North Shore Hospital, St Leonards, Sydney, Australia (G.A.F.); Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia (M.F.); Cardiac Mechanics Laboratory, Victor Chang Cardiac Research Institute, Darlinghurst, Australia (M.F.); Imaging and Phenotyping Laboratory, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, Australia (S.M.G.); Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Australia (S.M.G.); Nepean Clinical School of Medicine, Charles Perkin Centre Nepean, University of Sydney, Kingswood, Australia (F.P.); and Department of Cardiology, Nepean Hospital, Kingswood, Australia (F.P.)
| | - Faraz Pathan
- From the Centre for Heart Research, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, Sydney, NSW 2145, Australia (T.D., D.S., S.T., J.J.H.C.); Department of Cardiology, Westmead Hospital, Westmead, Australia (T.D., D.S., S.T., O.A., L.T., J.J.H.C.); Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia (T.D., D.S., S.T., L.T., J.J.H.C.); Cardiovascular Discovery Group, Kolling Institute, University of Sydney and Royal North Shore Hospital, St Leonards, Sydney, Australia (G.A.F.); Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia (M.F.); Cardiac Mechanics Laboratory, Victor Chang Cardiac Research Institute, Darlinghurst, Australia (M.F.); Imaging and Phenotyping Laboratory, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, Australia (S.M.G.); Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Australia (S.M.G.); Nepean Clinical School of Medicine, Charles Perkin Centre Nepean, University of Sydney, Kingswood, Australia (F.P.); and Department of Cardiology, Nepean Hospital, Kingswood, Australia (F.P.)
| | - James J H Chong
- From the Centre for Heart Research, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, Sydney, NSW 2145, Australia (T.D., D.S., S.T., J.J.H.C.); Department of Cardiology, Westmead Hospital, Westmead, Australia (T.D., D.S., S.T., O.A., L.T., J.J.H.C.); Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia (T.D., D.S., S.T., L.T., J.J.H.C.); Cardiovascular Discovery Group, Kolling Institute, University of Sydney and Royal North Shore Hospital, St Leonards, Sydney, Australia (G.A.F.); Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia (M.F.); Cardiac Mechanics Laboratory, Victor Chang Cardiac Research Institute, Darlinghurst, Australia (M.F.); Imaging and Phenotyping Laboratory, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, Australia (S.M.G.); Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Australia (S.M.G.); Nepean Clinical School of Medicine, Charles Perkin Centre Nepean, University of Sydney, Kingswood, Australia (F.P.); and Department of Cardiology, Nepean Hospital, Kingswood, Australia (F.P.)
| |
Collapse
|
3
|
Lakatos BK, Ladányi Z, Fábián A, Ehrenberger R, Turschl T, Bagyura Z, Evrard B, Vandroux D, Goudelin M, Lindner S, Britsch S, Dürschmied D, Zima E, Csikós GR, Túróczi Z, Soltész Á, Németh E, Kovács A, Édes FI, Merkely B. Non-invasive assessment of left ventricular contractility by myocardial work index in veno-arterial membrane oxygenation patients: rationale and design of the MIX-ECMO multicentre observational study. Front Cardiovasc Med 2024; 11:1399874. [PMID: 38863897 PMCID: PMC11165188 DOI: 10.3389/fcvm.2024.1399874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/01/2024] [Indexed: 06/13/2024] Open
Abstract
Introduction and aims Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an increasingly utilized therapeutic choice in patients with cardiogenic shock, however, high complication rate often counteracts with its beneficial cardiopulmonary effects. The assessment of left ventricular (LV) function in key in the management of this population, however, the most commonly used measures of LV performance are substantially load-dependent. Non-invasive myocardial work is a novel LV functional measure which may overcome this limitation and estimate LV function independent of the significantly altered loading conditions of VA-ECMO therapy. The Usefulness of Myocardial Work IndeX in ExtraCorporeal Membrane Oxygenation Patients (MIX-ECMO) study aims to examine the prognostic role of non-invasive myocardial work in VA-ECMO-supported patients. Methods The MIX-ECMO is a multicentric, prospective, observational study. We aim to enroll 110 patients 48-72 h after the initiation of VA-ECMO support. The patients will undergo a detailed echocardiographic examination and a central echocardiography core laboratory will quantify conventional LV functional measures and non-invasive myocardial work parameters. The primary endpoint will be failure to wean at 30 days as a composite of cardiovascular mortality, need for long-term mechanical circulatory support or heart transplantation at 30 days, and besides that other secondary objectives will also be investigated. Detailed clinical data will also be collected to compare LV functional measures to parameters with established prognostic role and also to the Survival After Veno-arterial-ECMO (SAVE) score. Conclusions The MIX-ECMO study will be the first to determine if non-invasive myocardial work has added prognostic value in patients receiving VA-ECMO support.
Collapse
Affiliation(s)
| | | | - Alexandra Fábián
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Réka Ehrenberger
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Tímea Turschl
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Zsolt Bagyura
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Bruno Evrard
- Medical-Surgical ICU, Dupuytren Teaching Hospital, Limoges, France
- Inserm CIC 1435, Dupuytren Teaching Hospital, Limoges, France
| | - David Vandroux
- Cardiothoracic Intensive Care Unit, Dupuytren University Hospital, Limoges, France
- Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Marine Goudelin
- Medical-Surgical ICU, Dupuytren Teaching Hospital, Limoges, France
| | - Simon Lindner
- Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for AngioScience (ECAS), German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/ Mannheim, and Centre for Cardiovascular Acute Medicine Mannheim (ZKAM), Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Simone Britsch
- Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for AngioScience (ECAS), German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/ Mannheim, and Centre for Cardiovascular Acute Medicine Mannheim (ZKAM), Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Daniel Dürschmied
- Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for AngioScience (ECAS), German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/ Mannheim, and Centre for Cardiovascular Acute Medicine Mannheim (ZKAM), Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Endre Zima
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | | | - Zsolt Túróczi
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Ádám Soltész
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Endre Németh
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Attila Kovács
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Department of Experimental and Surgical Techniques, Semmelweis University, Budapest, Hungary
| | | | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| |
Collapse
|
4
|
Kikuchi Y, Onohara D, Silverman M, King CL, Tom SK, Govin R, Guyton RA, Padala M. Mitral regurgitation increases systolic strains in remote zone and worsens left ventricular dyssynchrony in a swine model of ischemic cardiomyopathy. Front Cardiovasc Med 2024; 11:1397079. [PMID: 38863901 PMCID: PMC11165204 DOI: 10.3389/fcvm.2024.1397079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/14/2024] [Indexed: 06/13/2024] Open
Abstract
Background Ischemic mitral regurgitation (IMR) imposes volume overload on the left ventricle (LV), accelerating adverse LV remodeling. In this study, we sought to investigate the impact of volume overload due to IMR on regional myocardial contractile mechanics. Methods Ten Yorkshire swine were induced with myocardial infarction (MI) by occluding the left circumflex coronary artery (LCx). Cardiac MRI was performed at baseline (BL) and 2.5 months (2.5M) post-MI. IMR was quantified with epicardial echocardiography 3 months post-MI. The animals were then assigned to 2 groups: no/mild MR (nmMR, n = 4) and moderate/severe MR (msMR, n = 6). MRI images were analyzed to assess infarction size, end-diastolic and end-systolic volume (EDV and ESV, respectively), ejection fraction (EF), longitudinal strain (LS), circumferential strain (CS), and systolic dyssynchrony index (SDI). The myocardial region was divided into infarction, border, and remote zones based on the LCx-supplied region. Results There was no difference in the infarction size. Group-wise comparison of LS and CS between BL and 2.5M demonstrated that LS and CS in the infarction zone and the border zone decreased at 2.5M in both groups. However, LS and CS in the remote zone were elevated only in the msMR group (LS: -9.81 ± 3.96 vs. -12.58 ± 5.07, p < 0.01; CS; -12.78 ± 3.81 vs. -16.09 ± 3.33, p < 0.01) at 2.5M compared to BL. The SDI of CS was significantly elevated in the msMR group (0.1255 vs. 0.0974, p = 0.015) at 2.5M compared to BL. Conclusions Elevated LS and CS in the remote zone were observed in moderate/severe MR and ventricular dyssynchrony. These elevated cardiac strains, coupled with ventricular dyssynchrony, may contribute to the progression of MR, thereby accelerating heart failure.
Collapse
Affiliation(s)
- Yuta Kikuchi
- Cardiothoracic Research Laboratories, Carlyle Fraser Heart Center at Emory University Hospital Midtown, Atlanta, GA, United States
| | - Daisuke Onohara
- Cardiothoracic Research Laboratories, Carlyle Fraser Heart Center at Emory University Hospital Midtown, Atlanta, GA, United States
| | - Michael Silverman
- Cardiothoracic Research Laboratories, Carlyle Fraser Heart Center at Emory University Hospital Midtown, Atlanta, GA, United States
- Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta GA, United States
| | - Chase L. King
- Cardiothoracic Research Laboratories, Carlyle Fraser Heart Center at Emory University Hospital Midtown, Atlanta, GA, United States
- Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta GA, United States
| | - Stephanie K. Tom
- Cardiothoracic Research Laboratories, Carlyle Fraser Heart Center at Emory University Hospital Midtown, Atlanta, GA, United States
- Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta GA, United States
| | - Riya Govin
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Robert A. Guyton
- Cardiothoracic Research Laboratories, Carlyle Fraser Heart Center at Emory University Hospital Midtown, Atlanta, GA, United States
| | - Muralidhar Padala
- Cardiothoracic Research Laboratories, Carlyle Fraser Heart Center at Emory University Hospital Midtown, Atlanta, GA, United States
| |
Collapse
|
5
|
Frederiksen PH, Linde L, Gregers E, Udesen NLJ, Helgestad OK, Banke A, Dahl JS, Povlsen AL, Jensen LO, Larsen JP, Lassen J, Schmidt H, Ravn HB, Moller JE. Association between speckle tracking echocardiography and pressure-volume loops during cardiogenic shock development. Open Heart 2024; 11:e002512. [PMID: 38782543 PMCID: PMC11116883 DOI: 10.1136/openhrt-2023-002512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/16/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The relationship between speckle tracking assessed global longitudinal strain (GLS) and Doppler-based echocardiography with basic physiological markers of cardiac function derived from pressure-volume loops is poorly elucidated. OBJECTIVE We aimed to describe the association between LS and Doppler-based echocardiography and direct measurements of central haemodynamic parameters from conductance catheter-based pressure-volume loops in an animal model with increasing left ventricular (LV) dysfunction. METHODS 12 Danish landrace female pigs (75-80 kg) were used. All instrumentations were performed percutaneously, including the conductance catheter in the LV. Progressive LV dysfunction was induced by embolisation through the left main coronary artery with microspheres every 3 min until a >50% reduction in cardiac output (CO) or mixed venous saturation (SvO2), compared with baseline, or SvO2 <30%. Echocardiography was performed at baseline and 90 s after each injection. RESULTS With progressive LV dysfunction, mean CO decreased from 5.6±0.9 L/min to 2.1±0.9 L/min, and mean SvO2 deteriorated from 61.1±7.9% to 35.3±6.1%. Mean LS and LV outflow tract velocity time integral (LVOT VTI) declined from -13.8±3.0% to -6.1±2.0% and 16.9±2.6 cm to 7.8±1.8 cm, respectively. LS and LVOT VTI showed the strongest correlation to stroke work in unadjusted linear regression (r2=0.53 and r2=0.49, respectively). LS correlated significantly with stroke volume, end-systolic elastance, systolic blood pressure, ventriculo-arterial coupling and arterial elastance. CONCLUSION In an animal model of acute progressive LV dysfunction, echocardiographic and conductance catheter-based measurements changed significantly. LS and LVOT VTI displayed the earliest and the largest alterations with increased myocardial damage and both correlated strongest with stroke work.
Collapse
Affiliation(s)
- Peter Hartmund Frederiksen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Louise Linde
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Emilie Gregers
- Department of Cardiology, Copenhagen University Hospital, Kobenhavn, Denmark
| | | | - Ole K Helgestad
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Ann Banke
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | | | - Amalie L Povlsen
- Department of Cardiothoracic Anaesthesiology, Odense University Hospital, Odense, Denmark
| | - Lisette Okkels Jensen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Jeppe P Larsen
- Department of Cardiothoracic Anaesthesiology, Odense University Hospital, Odense, Denmark
| | - Jens Lassen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Henrik Schmidt
- Department of Cardiothoracic Anaesthesiology, Odense University Hospital, Odense, Denmark
| | - Hanne Berg Ravn
- University of Southern Denmark, Odense, Denmark
- Department of Cardiothoracic Anaesthesiology, Odense University Hospital, Odense, Denmark
| | - Jacob Eifer Moller
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
- Department of Cardiology, Copenhagen University Hospital, Kobenhavn, Denmark
| |
Collapse
|
6
|
Surkova E, Lakatos BK, Fábián A, Kovács A, Senior R, Li W. Myocardial work of the systemic right ventricle and its association with outcomes. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024; 40:1105-1114. [PMID: 38507153 DOI: 10.1007/s10554-024-03081-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 03/09/2024] [Indexed: 03/22/2024]
Abstract
We aimed to evaluate clinical and prognostic significance of myocardial work parameters of the systemic right ventricle (SRV). Thirty-eight patients with the SRV underwent echocardiographic assessment of the SRV systolic function including 3D-echocardiography derived ejection fraction, 2D longitudinal strain and myocardial work analysis. The study endpoint was the combination of all-cause mortality and heart transplantation. Global constructive work (GCW) and global work index (GWI) demonstrated moderate correlation with the 3DE-derived SRV ejection fraction (EF) (Rho 0.64, p < 0.0001 and Rho 0.63, p < 0.0001, respectively). GCW showed the strongest correlation with the BNP level (Rho - 0.77, p < 0.0001), closely followed by GWI, 4-chamber longitudinal strain and 3DE EF (all Rho - 0.73, p < 0.0001). GCW and GWI were significantly lower in patients with moderate or severe tricuspid regurgitation compared with less than moderate regurgitation (1226 ± 439 vs 1509 ± 264 mmHg%, p = 0.02, and 984 ± 348 vs 1259 ± 278 mmHg%, p = 0.01, respectively). During a follow-up of 3.5 (2.8-3.9) years, seven patients (18%) died and one received transplantation (3%). They had significantly lower GCW and GWI compared with patients who did not reach the study endpoint (908 ± 255 vs 1433 ± %, p < 0.001 and 721 ± 210 vs 1173 ± 315 mmHg%, p < 0.001, respectively). In Cox regression analysis, GCW, GWI, 3DE SRV volumes and EF were the best-fit models based on the Akaike Information Criterion, outperforming longitudinal strain parameters. GWI and GCW, novel echocardiographic parameters of myocardial work, provided reliable quantification of the SRV systolic function. GWI, GCW and 3DE-derived SRV parameters were closely associated with all-cause mortality and heart transplantation in patients with the SRV.
Collapse
Affiliation(s)
- Elena Surkova
- Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas' NHS Foundation Trust, Sydney Street, Chelsea, London, SW3 6NP, UK.
| | - Bálint Károly Lakatos
- Heart and Vascular Center, Semmelweis University, 68, Varosmajor Str., Budapest, 1122, Hungary
| | - Alexandra Fábián
- Heart and Vascular Center, Semmelweis University, 68, Varosmajor Str., Budapest, 1122, Hungary
| | - Attila Kovács
- Heart and Vascular Center, Semmelweis University, 68, Varosmajor Str., Budapest, 1122, Hungary
| | - Roxy Senior
- Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas' NHS Foundation Trust, Sydney Street, Chelsea, London, SW3 6NP, UK
- National Heart Lung Institute, Imperial College London, Guy Scadding Building, Dovehouse St, Chelsea, London, SW3 6LY, UK
| | - Wei Li
- Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas' NHS Foundation Trust, Sydney Street, Chelsea, London, SW3 6NP, UK
- National Heart Lung Institute, Imperial College London, Guy Scadding Building, Dovehouse St, Chelsea, London, SW3 6LY, UK
| |
Collapse
|
7
|
Gamarra A, Díez-Villanueva P, Salamanca J, Aguilar R, Mahía P, Alfonso F. Development and Clinical Application of Left Ventricular-Arterial Coupling Non-Invasive Assessment Methods. J Cardiovasc Dev Dis 2024; 11:141. [PMID: 38786963 PMCID: PMC11122267 DOI: 10.3390/jcdd11050141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
The constant and dynamic interaction between ventricular function and arterial afterload, known as ventricular-arterial coupling, is key to understanding cardiovascular pathophysiology. Ventricular-arterial coupling has traditionally been assessed invasively as the ratio of effective arterial elastance over end-systolic elastance (Ea/Ees), calculated from information derived from pressure-volume loops. Over the past few decades, numerous invasive and non-invasive simplified methods to estimate the elastance ratio have been developed and applied in clinical investigation and practice. The echocardiographic assessment of left ventricular Ea/Ees, as proposed by Chen and colleagues, is the most widely used method, but novel echocardiographic approaches for ventricular-arterial evaluation such as left ventricle outflow acceleration, pulse-wave velocity, and the global longitudinal strain or global work index have arisen since the former was first published. Moreover, multimodal imaging or artificial intelligence also seems to be useful in this matter. This review depicts the progressive development of these methods along with their academic and clinical application. The left ventricular-arterial coupling assessment may help both identify patients at risk and tailor specific pharmacological or interventional treatments.
Collapse
Affiliation(s)
- Alvaro Gamarra
- Cardiology Department, Hospital Universitario de la Princesa, 28006 Madrid, Spain; (A.G.); (J.S.); (R.A.); (F.A.)
| | - Pablo Díez-Villanueva
- Cardiology Department, Hospital Universitario de la Princesa, 28006 Madrid, Spain; (A.G.); (J.S.); (R.A.); (F.A.)
| | - Jorge Salamanca
- Cardiology Department, Hospital Universitario de la Princesa, 28006 Madrid, Spain; (A.G.); (J.S.); (R.A.); (F.A.)
| | - Rio Aguilar
- Cardiology Department, Hospital Universitario de la Princesa, 28006 Madrid, Spain; (A.G.); (J.S.); (R.A.); (F.A.)
| | - Patricia Mahía
- Cardiology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain;
| | - Fernando Alfonso
- Cardiology Department, Hospital Universitario de la Princesa, 28006 Madrid, Spain; (A.G.); (J.S.); (R.A.); (F.A.)
| |
Collapse
|
8
|
Dorobantu DM, Amir NH, Wadey CA, Sharma C, Stuart AG, Williams CA, Pieles GE. The Role of Speckle-Tracking Echocardiography in Predicting Mortality and Morbidity in Patients With Congenital Heart Disease: A Systematic Review and Meta-analysis. J Am Soc Echocardiogr 2024; 37:216-225. [PMID: 37972793 DOI: 10.1016/j.echo.2023.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Speckle-tracking echocardiography (STE) is now routinely included in cardiac evaluations, but its role in predicting mortality and morbidity in congenital heart disease (CHD) is not well described. We conducted a systematic review to evaluate the prognostic value of STE in patients with CHD. METHODS The EMBASE, Medline, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from inception to January 2023 for terms related to all CHD, STE, and prognosis. Meta-analysis of association of right ventricle and left ventricle strain (RV Sl and LV Sl, respectively) with major adverse cardiovascular events (MACEs) was performed in atrial switch transposition of the great arteries (asTGA)/congenitally corrected TGA (ccTGA), tetralogy of Fallot (ToF), and congenital aortic stenosis (cAS)/bicuspid aortic valve (BAV). P-value combination analysis was additionally performed for all CHD groups. RESULTS A total of 33 studies (30 cohorts, n = 8,619 patients, children, and adults) were included. Meta-analysis showed the following parameters as being associated with MACE: RV Sl in asTGA/ccTGA (hazard ratio [HR] = 1.1/%; CI, [1.03; 1.18]), RV Sl and LV Sl in ToF (HR = 1.14/%; CI, [1.03; 1.26] and HR = 1.14/%; CI, [1.08; 1.2], respectively), and LV Sl in cAS/BAV (HR = 1.19/%; CI, [1.15; 1.23]). The RV Sl and strain rate were associated with outcomes also in single ventricle/hypoplastic left heart syndrome (at all palliation stages except before Norwood stage 1) and LV Sl in Ebstein's anomaly. CONCLUSIONS This systematic review and meta-analysis showed that biventricular strain and strain rate were associated with outcomes in a variety of CHD, highlighting the need for updated recommendations on the use of STE in the current guidelines, specific to disease types.
Collapse
Affiliation(s)
- Dan M Dorobantu
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom; Department of Population and Translational Health Science, University of Bristol, Bristol, United Kingdom
| | - Nurul H Amir
- Department of Population and Translational Health Science, University of Bristol, Bristol, United Kingdom; Faculty of Sport Science and Recreation, Universiti Teknologi Majlis Amanah Rakyat, Arau, Malaysia
| | - Curtis A Wadey
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom
| | - Chetanya Sharma
- Congenital Heart Unit, Bristol Heart Institute and Royal Hospital for Children, Bristol, United Kingdom
| | - A Graham Stuart
- Department of Population and Translational Health Science, University of Bristol, Bristol, United Kingdom; Congenital Heart Unit, Bristol Heart Institute and Royal Hospital for Children, Bristol, United Kingdom
| | - Craig A Williams
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom.
| | - Guido E Pieles
- Congenital Heart Unit, Bristol Heart Institute and Royal Hospital for Children, Bristol, United Kingdom; Institute of Sport, Exercise and Health, University College London, London, United Kingdom; Athlete Health and Performance Research Centre and the Sports Medicine Department, Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| |
Collapse
|
9
|
Kılınç E, Yildirim SA, Ulugöl H, Büyüköner EE, Güçyetmez B, Toraman F. The evaluation of cardiac functions in deep Trendelenburg position during robotic-assisted laparoscopic prostatectomy. Front Med (Lausanne) 2023; 10:1273180. [PMID: 37822468 PMCID: PMC10563763 DOI: 10.3389/fmed.2023.1273180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 09/11/2023] [Indexed: 10/13/2023] Open
Abstract
Objective This study aimed to demonstrate the reliability of the cardiac cycle efficiency value through its correlation with longitudinal strain by observing the effect of the deep Trendelenburg position. Design A prospective, observational study. Setting Single center. Participants Between May and September 2022, the hemodynamic parameters of 30 patients who underwent robotic assisted laparoscopic prostatectomy under general anesthesia were prospectively evaluated. Measurements and main results All invasive cardiac monitoring parameters and longitudinal strain achieved transesophageal echocardiography were recorded in pre-deep Trendelenburg position (T3) and 10th minute of deep Trendelenburg position (T4). Delta values were calculated for the cardiac cycle efficiency and longitudinal strain (values at T4 minus values at T3). The estimated power was calculated as 0.99 in accordance with the cardiac cycle efficiency values at T3 and T4 (effect size: 0.85 standard deviations of the mean difference: 0.22, alpha: 0.05). At T4, heart rate, pulse pressure variation, cardiac cycle efficiency, dP/dt and longitudinal strain were significantly lower than those at T3 (p = 0.009, p < 0.001, p < 0.001, and p < 0.001, respectively). There was a positive correlation between the delta-cardiac cycle efficiency and delta-longitudinal strain (R2 = 0.36, p < 0.001). Conclusion Although the absence of significant changes in mean arterial pressure and cardiac index after Trendelenburg position suggests that cardiac workload has not changed, changes in cardiac cycle efficiency and longitudinal strain indicate increased cardiac workload due to increased ventriculo-arterial coupling.
Collapse
Affiliation(s)
- Emir Kılınç
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Acibadem University, Istanbul, Türkiye
| | - Serap Aktas Yildirim
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Acibadem University, Istanbul, Türkiye
| | - Halim Ulugöl
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Acibadem University, Istanbul, Türkiye
| | - Elif Eroğlu Büyüköner
- Department of Cardiology, Faculty of Medicine, Acibadem University, Istanbul, Türkiye
| | - Bülent Güçyetmez
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Acibadem University, Istanbul, Türkiye
| | - Fevzi Toraman
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Acibadem University, Istanbul, Türkiye
| |
Collapse
|
10
|
Sayour NV, Tóth VÉ, Nagy RN, Vörös I, Gergely TG, Onódi Z, Nagy N, Bödör C, Váradi B, Ruppert M, Radovits T, Bleckwedel F, Zelarayán LC, Pacher P, Ágg B, Görbe A, Ferdinandy P, Varga ZV. Droplet Digital PCR Is a Novel Screening Method Identifying Potential Cardiac G-Protein-Coupled Receptors as Candidate Pharmacological Targets in a Rat Model of Pressure-Overload-Induced Cardiac Dysfunction. Int J Mol Sci 2023; 24:13826. [PMID: 37762130 PMCID: PMC10531061 DOI: 10.3390/ijms241813826] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
The identification of novel drug targets is needed to improve the outcomes of heart failure (HF). G-protein-coupled receptors (GPCRs) represent the largest family of targets for already approved drugs, thus providing an opportunity for drug repurposing. Here, we aimed (i) to investigate the differential expressions of 288 cardiac GPCRs via droplet digital PCR (ddPCR) and bulk RNA sequencing (RNAseq) in a rat model of left ventricular pressure-overload; (ii) to compare RNAseq findings with those of ddPCR; and (iii) to screen and test for novel, translatable GPCR drug targets in HF. Male Wistar rats subjected to transverse aortic constriction (TAC, n = 5) showed significant systolic dysfunction vs. sham operated animals (SHAM, n = 5) via echocardiography. In TAC vs. SHAM hearts, RNAseq identified 69, and ddPCR identified 27 significantly differentially expressed GPCR mRNAs, 8 of which were identified using both methods, thus showing a correlation between the two methods. Of these, Prostaglandin-F2α-receptor (Ptgfr) was further investigated and localized on cardiomyocytes and fibroblasts in murine hearts via RNA-Scope. Antagonizing Ptgfr via AL-8810 reverted angiotensin-II-induced cardiomyocyte hypertrophy in vitro. In conclusion, using ddPCR as a novel screening method, we were able to identify GPCR targets in HF. We also show that the antagonism of Ptgfr could be a novel target in HF by alleviating cardiomyocyte hypertrophy.
Collapse
Affiliation(s)
- Nabil V. Sayour
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; (N.V.S.)
- HCEMM-SU Cardiometabolic Immunology Research Group, 1085 Budapest, Hungary
- MTA-SE Momentum Cardio-Oncology and Cardioimmunology Research Group, Semmelweis University, 1085 Budapest, Hungary
| | - Viktória É. Tóth
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; (N.V.S.)
- HCEMM-SU Cardiometabolic Immunology Research Group, 1085 Budapest, Hungary
- MTA-SE Momentum Cardio-Oncology and Cardioimmunology Research Group, Semmelweis University, 1085 Budapest, Hungary
| | - Regina N. Nagy
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; (N.V.S.)
| | - Imre Vörös
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; (N.V.S.)
- HCEMM-SU Cardiometabolic Immunology Research Group, 1085 Budapest, Hungary
- MTA-SE Momentum Cardio-Oncology and Cardioimmunology Research Group, Semmelweis University, 1085 Budapest, Hungary
| | - Tamás G. Gergely
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; (N.V.S.)
- HCEMM-SU Cardiometabolic Immunology Research Group, 1085 Budapest, Hungary
- MTA-SE Momentum Cardio-Oncology and Cardioimmunology Research Group, Semmelweis University, 1085 Budapest, Hungary
| | - Zsófia Onódi
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; (N.V.S.)
- HCEMM-SU Cardiometabolic Immunology Research Group, 1085 Budapest, Hungary
- MTA-SE Momentum Cardio-Oncology and Cardioimmunology Research Group, Semmelweis University, 1085 Budapest, Hungary
| | - Noémi Nagy
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, 1085 Budapest, Hungary
| | - Csaba Bödör
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, 1085 Budapest, Hungary
| | - Barnabás Váradi
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; (N.V.S.)
- HCEMM-SU Cardiometabolic Immunology Research Group, 1085 Budapest, Hungary
| | - Mihály Ruppert
- Heart and Vascular Center, Semmelweis University, 1085 Budapest, Hungary
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, 1085 Budapest, Hungary
| | - Federico Bleckwedel
- Institute of Pharmacology and Toxicology, University Medical Center Goettingen (UMG), 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK) Partner Site, 37075 Goettingen, Germany
| | - Laura C. Zelarayán
- Institute of Pharmacology and Toxicology, University Medical Center Goettingen (UMG), 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK) Partner Site, 37075 Goettingen, Germany
| | - Pal Pacher
- Laboratory of Cardiovascular Physiology and Tissue Injury, National Institute on Alcohol Abuse and Alcoholism, National Institute of Health, Rockville, MD 20852, USA
| | - Bence Ágg
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; (N.V.S.)
- MTA-SE System Pharmacology Research Group, Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary
- Pharmahungary Group, 6720 Szeged, Hungary
| | - Anikó Görbe
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; (N.V.S.)
- Pharmahungary Group, 6720 Szeged, Hungary
| | - Péter Ferdinandy
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; (N.V.S.)
- MTA-SE System Pharmacology Research Group, Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary
- Pharmahungary Group, 6720 Szeged, Hungary
| | - Zoltán V. Varga
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; (N.V.S.)
- HCEMM-SU Cardiometabolic Immunology Research Group, 1085 Budapest, Hungary
- MTA-SE Momentum Cardio-Oncology and Cardioimmunology Research Group, Semmelweis University, 1085 Budapest, Hungary
| |
Collapse
|
11
|
Chen J, Cheng C, Fan L, Xu X, Chen J, Feng Y, Tang Y, Yang C. Assessment of left heart dysfunction to predict doxorubicin cardiotoxicity in children with lymphoma. Front Pediatr 2023; 11:1163664. [PMID: 37215605 PMCID: PMC10196234 DOI: 10.3389/fped.2023.1163664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 04/11/2023] [Indexed: 05/24/2023] Open
Abstract
Objectives The objectives of this study were to assess the changes in the left myocardial function after chemotherapy for childhood lymphoma and observe the predictive or monitor value for cancer treatment-related cardiac dysfunction (CTRCD) by speckle-tracking echocardiography. Methods A total of 23 children with histopathological diagnoses of lymphoma were included, with age-matched normal controls. Comparative analysis of clinical serological tests and left heart strain parameters in children with lymphoma, including left ventricular global longitudinal strain (LVGLS); global myocardial work (GMW) indices, which include global work index (GWI), global constructive work (GCW), global wasted work, and global work efficiency; and the LS of subendocardial, middle, and subepicardial layer myocardium during left ventricular systole were measured: left atrial strain of reservoir phase (LASr), left atrial strain of conduit phase (LAScd), and left atrial strain of contraction phase (LASct). Results One-way ANOVA showed that GLS, GWI, GCW, LASr, and LAScd were closely associated with CTRCD and multivariate logistic regression analysis showed that GLS was the most sensitive predictor for detecting patients at lofty risk of anthracycline-related cardiotoxicity. Both before and after chemotherapy, GLS in the left ventricle showed a pattern of basal segment < middle segment < apical segment and subepicardial < middle < subendocardial layer (p < 0.05), and the degree of decrease also showed a regular pattern of epicardial layer < middle layer < subendocardial layer while the difference was not significant (p > 0.05). After chemotherapy, maximum flow rate in early mitral relaxation/left atrial systolic maximum flow rate (E/A) and left atrial volume index of each group were in the normal range, and the values of LASr, LAScd, and LASct slightly increased in the second cycle and decreased significantly in the fourth cycle after chemotherapy, reaching the lowest level; LASr and LAScd were positively correlated with GLS. Conclusion LVGLS is a more sensitive and earlier indicator to predict CTRCD compared with conventional echocardiography-related parameters and serological markers, and GLS of each myocardial layer showed a certain regularity. Left atrial strain can be used for early monitoring of cardiotoxicity in children with lymphoma after chemotherapy.
Collapse
Affiliation(s)
- Jiaqi Chen
- Department of Ultrasound, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Chunyue Cheng
- Department of Ultrasound, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Fan
- Department of Ultrasound, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Xiaochuan Xu
- Department of Ultrasound, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Jing Chen
- Department of Ultrasound, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Yang Feng
- Department of Ultrasound, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Yi Tang
- Department of Ultrasound, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Chunjiang Yang
- Department of Ultrasound, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| |
Collapse
|
12
|
Xu R, Ding Z, Li H, Shi J, Cheng L, Xu H, Wu J, Zou Y. Identification of early cardiac dysfunction and heterogeneity after pressure and volume overload in mice by high-frequency echocardiographic strain imaging. Front Cardiovasc Med 2023; 9:1071249. [PMID: 36712248 PMCID: PMC9880208 DOI: 10.3389/fcvm.2022.1071249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/30/2022] [Indexed: 01/15/2023] Open
Abstract
Object Aortic stenosis and regurgitation are clinically important conditions characterized with different hypertrophic types induced by pressure or volume overload, respectively, but with comparable cardiac function in compensated stage. Speckle-tracking based strain imaging has been applied to assess subtle alterations in cardiac abnormality, but its application in differentiating these two types of ventricular hypertrophy is still sparse. Here, we performed strain imaging analysis of cardiac remodeling in these two loading conditions. Methods C57BL/6J mice were subjected to transverse aortic constriction (TAC)-induced pressure overload or aortic regurgitation (AR)-induced volume overload. Conventional echocardiography and strain imaging were comprehensively assessed to detect stimulus-specific alterations in TAC and AR hearts. Results Conventional echocardiography did not detect significant changes in left ventricular systolic (ejection fraction and fractional shortening) and diastolic (E/E') function in either TAC or AR mice. On the contrary, global strain analysis revealed global longitudinal strain and strain rate were remarkably impaired in TAC while preserved in AR mice, although global radial, and circumferential strain and strain rate were significantly reduced in both models. Regional strain analysis in the long axis demonstrated that longitudinal strain and strain rate in all or most segments were decreased in TAC but maintained or slightly dented in AR mice, while radial strain and strain rate indicated overt decline in both models. Moreover, decreased radial and circumferential strain and strain rate were observed in most segments of TAC and AR mice in the short axis. Conclusion Strain imaging is superior to conventional echocardiography to detect subtle changes in myocardial deformation, with longitudinal strain and strain rate indicating distinct functional changes in pressure versus volume overload myocardial hypertrophy, making it potentially an advanced approach for early detection and differential diagnosis of cardiac dysfunction.
Collapse
Affiliation(s)
- Ran Xu
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital and Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Zhiwen Ding
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital and Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Hao Li
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Shi
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital and Institutes of Biomedical Sciences, Fudan University, Shanghai, China,Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Leilei Cheng
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital and Institutes of Biomedical Sciences, Fudan University, Shanghai, China,Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Huixiong Xu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jian Wu
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital and Institutes of Biomedical Sciences, Fudan University, Shanghai, China,*Correspondence: Jian Wu,
| | - Yunzeng Zou
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital and Institutes of Biomedical Sciences, Fudan University, Shanghai, China,Yunzeng Zou,
| |
Collapse
|
13
|
Mohammed El Maghawry L, Shehata IE, Muhammad Abdullah Elbelbesy R, Abdelrashid MA, ZeinElabdeen SG. Tissue Tracking of Segmental strain as a predictor of Latent dynamic left ventricular outflow tract obstruction. Indian Heart J 2022; 74:414-419. [PMID: 36113780 PMCID: PMC9647661 DOI: 10.1016/j.ihj.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 11/23/2022] Open
Abstract
Background Left ventricular outflow tract obstruction (LVOTO) is commonly observed in patients with hypertrophic cardiomyopathy (HCM) or left ventricular hypertrophy (LVH). Some patients develop LVOTO provoked by physical exertion, and hence termed dynamic LVOTO (DLVOTO). However, its precise prevalence and mechanism are still unclear. Aim Two-dimensional speckle tracking echocardiography (2D STE) seems to be helpful for the detection of early LV structural abnormalities. This study aimed to examine the possible role of segmental as well as global longitudinal strain in identifying DLVOTO non-HCM patients as detected by dobutamine stress echocardiography (DSE). Methods and results Two hundred and fifty patients without structural heart disease had undergone conventional transthoracic echocardiography, 2D STE, and DSE. All patients with non-ischemic evidence were divided into two groups according to the DSE results; DLVOTO (+) and DLVOTO (−). Among 250 patients, 50 patients (36%) had shown DLVOTO after DSE (15 males, 35 females; mean age 55±7years). They were compared with 90 non -LVOTO obstruction patients (43 males, 47 females; mean age 57±6years). Based on multivariate logistic regression analysis, the independent predictors of provoked DLVOTO during DSE were resting basal septal longitudinal strain BS-LS average (p < 0.001), resting LA reservoir strain (p < 0.001), and systolic LVOT diameter (p = 0.03). Resting BS-LS average with cut-off - 17.5% was recognized as a critical indicator of DLVOTO, with sensitivity 78%, and specificity 95% (better than systolic LVOT diameter of sensitivity 76%, and specificity 15% and resting LA reservoir strain which showed poor AUC at ROC curve 0.007). Conclusion We demonstrate that provoked LVOTO during DSE in non HCM symptomatic patients is directly correlated to resting regional LS, where the increased BS-LS of ≥ −17.5% was a key determinant of LVOT gradient provocation. Assessment of baseline BS-LS average might be a bedside simple tool for detection of patients with DLVOTO not able to do DSE.
Collapse
|
14
|
Lu Y, Xiang M, Xin L, Zhang Y, Wang Y, Shen Z, Li L, Cui X. Qiliqiangxin Modulates the Gut Microbiota and NLRP3 Inflammasome to Protect Against Ventricular Remodeling in Heart Failure. Front Pharmacol 2022; 13:905424. [PMID: 35721118 PMCID: PMC9201726 DOI: 10.3389/fphar.2022.905424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 04/13/2022] [Indexed: 02/03/2023] Open
Abstract
Aims: Pathological left ventricular (LV) remodeling induced by multiple causes often triggers fatal cardiac dysfunction, heart failure (HF), and even cardiac death. This study is aimed to investigate whether qiliqiangxin (QL) could improve LV remodeling and protect against HF via modulating gut microbiota and inhibiting nod-like receptor pyrin domain 3 (NLRP3) inflammasome activation. Methods: Rats were respectively treated with QL (100 mg/kg/day) or valsartan (1.6 mg/kg/day) by oral gavage after transverse aortic constriction or sham surgery for 13 weeks. Cardiac functions and myocardial fibrosis were assessed. In addition, gut microbial composition was assessed by 16S rDNA sequencing. Furthermore, rats’ hearts were harvested for histopathological and molecular analyses including immunohistochemistry, immunofluorescence, terminal-deoxynucleotidyl transferase-mediated 2’-deoxyuridine 5’-triphosphated nick end labeling, and Western blot. Key findings: QL treatment preserved cardiac functions including LV ejection fractions and fractional shortening and markedly improved the LV remodeling. Moreover, HF was related to the gut microbial community reorganization like a reduction in Lactobacillus, while QL reversed it. Additionally, the protein expression levels like IL-1β, TNF-α, NF-κB, and NLRP3 were decreased in the QL treatment group compared to the model one. Conclusion: QL ameliorates ventricular remodeling to some extent in rats with HF by modulating the gut microbiota and NLRP3 inflammasome, which indicates the potential therapeutic effects of QL on those who suffer from HF.
Collapse
Affiliation(s)
- Yingdong Lu
- Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Mi Xiang
- Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Laiyun Xin
- Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,First Clinical Medical School, Shandong University of Chinese Medicine, Jinan, China
| | - Yang Zhang
- Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,First Clinical Medical School, Shandong University of Chinese Medicine, Jinan, China
| | - Yuling Wang
- Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zihuan Shen
- Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Li Li
- Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiangning Cui
- Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
15
|
Pilz PM, Ward JE, Chang WT, Kiss A, Bateh E, Jha A, Fisch S, Podesser BK, Liao R. Large and Small Animal Models of Heart Failure With Reduced Ejection Fraction. Circ Res 2022; 130:1888-1905. [PMID: 35679365 DOI: 10.1161/circresaha.122.320246] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Heart failure (HF) describes a heterogenous complex spectrum of pathological conditions that results in structural and functional remodeling leading to subsequent impairment of cardiac function, including either systolic dysfunction, diastolic dysfunction, or both. Several factors chronically lead to HF, including cardiac volume and pressure overload that may result from hypertension, valvular lesions, acute, or chronic ischemic injuries. Major forms of HF include hypertrophic, dilated, and restrictive cardiomyopathy. The severity of cardiomyopathy can be impacted by other comorbidities such as diabetes or obesity and external stress factors. Age is another major contributor, and the number of patients with HF is rising worldwide in part due to an increase in the aged population. HF can occur with reduced ejection fraction (HF with reduced ejection fraction), that is, the overall cardiac function is compromised, and typically the left ventricular ejection fraction is lower than 40%. In some cases of HF, the ejection fraction is preserved (HF with preserved ejection fraction). Animal models play a critical role in facilitating the understanding of molecular mechanisms of how hearts fail. This review aims to summarize and describe the strengths, limitations, and outcomes of both small and large animal models of HF with reduced ejection fraction that are currently used in basic and translational research. The driving defect is a failure of the heart to adequately supply the tissues with blood due to impaired filling or pumping. An accurate model of HF with reduced ejection fraction would encompass the symptoms (fatigue, dyspnea, exercise intolerance, and edema) along with the pathology (collagen fibrosis, ventricular hypertrophy) and ultimately exhibit a decrease in cardiac output. Although countless experimental studies have been published, no model completely recapitulates the full human disease. Therefore, it is critical to evaluate the strength and weakness of each animal model to allow better selection of what animal models to use to address the scientific question proposed.
Collapse
Affiliation(s)
- Patrick M Pilz
- Stanford Cardiovascular Institute, Stanford University School of Medicine, CA (P.M.P., E.B., R.L.).,Ludwig Boltzmann Institute at the Center for Biomedical Research, Medical University of Vienna, Austria (P.M.P., A.K., B.K.P.)
| | - Jennifer E Ward
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, MA (J.E.W., S.F., R.L.)
| | - Wei-Ting Chang
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Taiwan (W.-T.C.).,Department of Cardiology, Chi-Mei Medical Center, Taiwan (W.-T.C.)
| | - Attila Kiss
- Ludwig Boltzmann Institute at the Center for Biomedical Research, Medical University of Vienna, Austria (P.M.P., A.K., B.K.P.)
| | - Edward Bateh
- Stanford Cardiovascular Institute, Stanford University School of Medicine, CA (P.M.P., E.B., R.L.)
| | - Alokkumar Jha
- Stanford Cardiovascular Institute, Stanford University School of Medicine, CA (P.M.P., E.B., R.L.)
| | - Sudeshna Fisch
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, MA (J.E.W., S.F., R.L.)
| | - Bruno K Podesser
- Ludwig Boltzmann Institute at the Center for Biomedical Research, Medical University of Vienna, Austria (P.M.P., A.K., B.K.P.)
| | - Ronglih Liao
- Stanford Cardiovascular Institute, Stanford University School of Medicine, CA (P.M.P., E.B., R.L.).,Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, MA (J.E.W., S.F., R.L.)
| |
Collapse
|
16
|
Verbeke J, Calle S, Kamoen V, De Buyzere M, Timmermans F. Prognostic value of myocardial work and global longitudinal strain in patients with heart failure and functional mitral regurgitation. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2022; 38:803-812. [PMID: 34802090 DOI: 10.1007/s10554-021-02474-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
In patients with heart failure and functional mitral regurgitation (FMR), the assessment of left ventricular (LV) function is important for risk stratification and decision making. As LV ejection fraction (LVEF) might not be an optimal metric for LV systolic performance in this population, alternatives such as global longitudinal strain (GLS) and global myocardial work index (GWI) have been proposed. In the present study, we investigated the prognostic value of GLS and GWI and compared these measures to other LV systolic performance parameters. A prospective and consecutive cohort of 181 patients (median age 72 years, 76% male) with LVEF < 50% and FMR underwent comprehensive echocardiographic examination including speckle tracking echocardiography and grading of FMR severity. During a median follow-up of 42 months, 72 cardiovascular (CV) events occurred. In univariate analysis, LVEF, GLS, GWI, mitral S', LV outflow tract time velocity integral, forward LVEF and LV ejection time were associated with CV events. After multivariate adjustment only GLS (hazard ratio (HR) = 0.884, p = 0.015) and GWI (HR = 0.927, p = 0.034) remained independently associated with CV events. There was no difference in the incremental prognostic value of GWI compared to GLS (delta -2 log likelihood = 0.8; p = 0.37). In this cohort of heart failure patients with FMR, GLS and GWI were independently associated with cardiovascular events, whereas other systolic performance parameters were not. However, GWI did not outperform GLS, and further research is required to determine the value of these strain-based measures in clinical practice.
Collapse
Affiliation(s)
- Jonas Verbeke
- Department of Cardiology, Ghent University Hospital, Ghent University, 10-K12; C. Heymanslaan, 10, 9000, Ghent, Belgium.
| | - Simon Calle
- Department of Cardiology, Ghent University Hospital, Ghent University, 10-K12; C. Heymanslaan, 10, 9000, Ghent, Belgium
| | - Victor Kamoen
- Department of Cardiology, Ghent University Hospital, Ghent University, 10-K12; C. Heymanslaan, 10, 9000, Ghent, Belgium
| | - Marc De Buyzere
- Department of Cardiology, Ghent University Hospital, Ghent University, 10-K12; C. Heymanslaan, 10, 9000, Ghent, Belgium
| | - Frank Timmermans
- Department of Cardiology, Ghent University Hospital, Ghent University, 10-K12; C. Heymanslaan, 10, 9000, Ghent, Belgium
| |
Collapse
|
17
|
Onódi Z, Ruppert M, Kucsera D, Sayour AA, Tóth VE, Koncsos G, Novák J, Brenner GB, Makkos A, Baranyai T, Giricz Z, Görbe A, Leszek P, Gyöngyösi M, Horváth IG, Schulz R, Merkely B, Ferdinandy P, Radovits T, Varga ZV. AIM2-driven inflammasome activation in heart failure. Cardiovasc Res 2021; 117:2639-2651. [PMID: 34117866 DOI: 10.1093/cvr/cvab202] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 02/24/2020] [Accepted: 06/10/2021] [Indexed: 12/26/2022] Open
Abstract
AIMS Interleukin-1β (IL-1β) is an important pathogenic factor in cardiovascular diseases including chronic heart failure (HF). The CANTOS trial highlighted that inflammasomes as primary sources of IL-1 β are promising new therapeutic targets in cardiovascular diseases. Therefore, we aimed to assess inflammasome activation in failing hearts to identify activation patterns of inflammasome subtypes as sources of IL-1β. METHODS AND RESULTS Out of the four major inflammasome sensors tested, expression of the inflammasome protein absent in melanoma 2 (AIM2) and NLR family CARD domain-containing protein 4 (NLRC4) increased in human HF regardless of the aetiology (ischaemic or dilated cardiomyopathy), while the NLRP1/NALP1 and NLRP3 (NLR family, pyrin domain containing 1 and 3) inflammasome showed no change in HF samples. AIM2 expression was primarily detected in monocytes/macrophages of failing hearts. Translational animal models of HF (pressure or volume overload, and permanent coronary artery ligation in rat, as well as ischaemia/reperfusion-induced HF in pigs) demonstrated activation pattern of AIM2 similar to that of observed in end-stages of human HF. In vitro AIM2 inflammasome activation in human Tohoku Hospital Pediatrics-1 (THP-1) monocytic cells and human AC16 cells was significantly reduced by pharmacological blockade of pannexin-1 channels by the clinically used uricosuric drug probenecid. Probenecid was also able to reduce pressure overload-induced mortality and restore indices of disease severity in a rat chronic HF model in vivo. CONCLUSIONS This is the first report showing that AIM2 and NLRC4 inflammasome activation contribute to chronic inflammation in HF and that probenecid alleviates chronic HF by reducing inflammasome activation. The present translational study suggests the possibility of repositioning probenecid for HF indications.
Collapse
Affiliation(s)
- Zsófia Onódi
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- HCEMM-SU Cardiometabolic Immunology Research Group, Budapest, Hungary
| | - Mihály Ruppert
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Dániel Kucsera
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- HCEMM-SU Cardiometabolic Immunology Research Group, Budapest, Hungary
| | - Alex Ali Sayour
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Viktória E Tóth
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- HCEMM-SU Cardiometabolic Immunology Research Group, Budapest, Hungary
| | - Gábor Koncsos
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
| | - Julianna Novák
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- HCEMM-SU Cardiometabolic Immunology Research Group, Budapest, Hungary
| | - Gábor B Brenner
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- Pharmahungary Group, Szeged, Hungary
- MTA-SE System Pharmacology Research Group, Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
| | - András Makkos
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- Pharmahungary Group, Szeged, Hungary
- MTA-SE System Pharmacology Research Group, Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
| | - Tamás Baranyai
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
| | - Zoltán Giricz
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- Pharmahungary Group, Szeged, Hungary
| | - Anikó Görbe
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- Pharmahungary Group, Szeged, Hungary
- MTA-SE System Pharmacology Research Group, Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
| | - Przemyslaw Leszek
- Department of Heart Failure and Transplantology, Cardinal Stefan Wyszyński National Institute of Cardiology, Warszawa, Poland
| | - Mariann Gyöngyösi
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Iván G Horváth
- Heart Institute, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | - Rainer Schulz
- Institute of Physiology, Justus Liebig University Giessen, Giessen, Germany
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Péter Ferdinandy
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- Pharmahungary Group, Szeged, Hungary
- MTA-SE System Pharmacology Research Group, Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Zoltán V Varga
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- HCEMM-SU Cardiometabolic Immunology Research Group, Budapest, Hungary
- Pharmahungary Group, Szeged, Hungary
| |
Collapse
|
18
|
Sayour AA, Ruppert M, Oláh A, Benke K, Barta BA, Zsáry E, Ke H, Horváth EM, Merkely B, Radovits T. Left Ventricular SGLT1 Protein Expression Correlates with the Extent of Myocardial Nitro-Oxidative Stress in Rats with Pressure and Volume Overload-Induced Heart Failure. Antioxidants (Basel) 2021; 10:antiox10081190. [PMID: 34439438 PMCID: PMC8388925 DOI: 10.3390/antiox10081190] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 12/30/2022] Open
Abstract
Myocardial sodium-glucose cotransporter 1 (SGLT1) has been shown to be upregulated in humans with heart failure (HF) with or without diabetes. In vitro studies have linked SGLT1 to increased nitro-oxidative stress in cardiomyocytes. We aimed to assess the relation between left ventricular (LV) SGLT1 expression and the extent of nitro-oxidative stress in two non-diabetic rat models of chronic heart failure (HF) evoked by either pressure (TAC, n = 12) or volume overload (ACF, n = 12). Sham-operated animals (Sham-T and Sham-A, both n = 12) served as controls. Both TAC and ACF induced characteristic LV structural and functional remodeling. Western blotting revealed that LV SGLT1 protein expression was significantly upregulated in both HF models (both p < 0.01), whereas the phosphorylation of ERK1/2 was decreased only in ACF; AMPKα activity was significantly reduced in both models. The protein expression of the Nox4 NADPH oxidase isoform was increased in both TAC and ACF compared with respective controls (both p < 0.01), showing a strong positive correlation with SGLT1 expression (r = 0.855, p < 0.001; and r = 0.798, p = 0.001, respectively). Furthermore, SGLT1 protein expression positively correlated with the extent of myocardial nitro-oxidative stress in failing hearts assessed by 3-nitrotyrosin (r = 0.818, p = 0.006) and 4-hydroxy-2-nonenal (r = 0.733, p = 0.020) immunostaining. Therefore, LV SGLT1 protein expression was upregulated irrespective of the nature of chronic hemodynamic overload, and correlated significantly with the expression of Nox4 and with the level of myocardial nitro-oxidative stress, suggesting a pathophysiological role of SGLT1 in HF.
Collapse
Affiliation(s)
- Alex Ali Sayour
- Heart and Vascular Center, Department of Cardiology, Semmelweis University, Városmajor Str. 68, H-1122 Budapest, Hungary; (M.R.); (A.O.); (K.B.); (B.A.B.); (E.Z.); (B.M.); (T.R.)
- Correspondence:
| | - Mihály Ruppert
- Heart and Vascular Center, Department of Cardiology, Semmelweis University, Városmajor Str. 68, H-1122 Budapest, Hungary; (M.R.); (A.O.); (K.B.); (B.A.B.); (E.Z.); (B.M.); (T.R.)
| | - Attila Oláh
- Heart and Vascular Center, Department of Cardiology, Semmelweis University, Városmajor Str. 68, H-1122 Budapest, Hungary; (M.R.); (A.O.); (K.B.); (B.A.B.); (E.Z.); (B.M.); (T.R.)
| | - Kálmán Benke
- Heart and Vascular Center, Department of Cardiology, Semmelweis University, Városmajor Str. 68, H-1122 Budapest, Hungary; (M.R.); (A.O.); (K.B.); (B.A.B.); (E.Z.); (B.M.); (T.R.)
| | - Bálint András Barta
- Heart and Vascular Center, Department of Cardiology, Semmelweis University, Városmajor Str. 68, H-1122 Budapest, Hungary; (M.R.); (A.O.); (K.B.); (B.A.B.); (E.Z.); (B.M.); (T.R.)
| | - Eszter Zsáry
- Heart and Vascular Center, Department of Cardiology, Semmelweis University, Városmajor Str. 68, H-1122 Budapest, Hungary; (M.R.); (A.O.); (K.B.); (B.A.B.); (E.Z.); (B.M.); (T.R.)
| | - Haoran Ke
- Department of Physiology, Semmelweis University, Tűzoltó Str. 37-47, H-1094 Budapest, Hungary; (H.K.); (E.M.H.)
| | - Eszter Mária Horváth
- Department of Physiology, Semmelweis University, Tűzoltó Str. 37-47, H-1094 Budapest, Hungary; (H.K.); (E.M.H.)
| | - Béla Merkely
- Heart and Vascular Center, Department of Cardiology, Semmelweis University, Városmajor Str. 68, H-1122 Budapest, Hungary; (M.R.); (A.O.); (K.B.); (B.A.B.); (E.Z.); (B.M.); (T.R.)
| | - Tamás Radovits
- Heart and Vascular Center, Department of Cardiology, Semmelweis University, Városmajor Str. 68, H-1122 Budapest, Hungary; (M.R.); (A.O.); (K.B.); (B.A.B.); (E.Z.); (B.M.); (T.R.)
| |
Collapse
|
19
|
Left Ventricular Pressure-Strain-Volume Loops for the Noninvasive Assessment of Volume Overload-Induced Myocardial Dysfunction. JACC Cardiovasc Imaging 2021; 14:1868-1871. [PMID: 33865766 DOI: 10.1016/j.jcmg.2021.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/17/2021] [Accepted: 03/04/2021] [Indexed: 11/20/2022]
|
20
|
Lakatos BK, Ruppert M, Tokodi M, Oláh A, Braun S, Karime C, Ladányi Z, Sayour AA, Barta BA, Merkely B, Radovits T, Kovács A. Myocardial work index: a marker of left ventricular contractility in pressure- or volume overload-induced heart failure. ESC Heart Fail 2021; 8:2220-2231. [PMID: 33754487 PMCID: PMC8120402 DOI: 10.1002/ehf2.13314] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/15/2021] [Accepted: 03/02/2021] [Indexed: 12/11/2022] Open
Abstract
Aims While global longitudinal strain (GLS) is considered to be a sensitive marker of left ventricular (LV) function, it is significantly influenced by loading conditions. We hypothesized that global myocardial work index (GMWI), a novel marker of LV function, may show better correlation with load‐independent markers of LV contractility in rat models of pressure‐induced or volume overload‐induced heart failure. Methods and results Male Wistar rats underwent either transverse aortic constriction (TAC; n = 12) or aortocaval fistula creation (ACF; n = 12), inducing LV pressure or volume overload, respectively. Sham procedures were performed to establish control groups (n = 12/12). Echocardiographic loops were obtained to determine GLS and GMWI. Pressure‐volume analysis with transient occlusion of the inferior caval vein was carried out to calculate preload recruitable stroke work (PRSW), a load‐independent ‘gold‐standard’ parameter of LV contractility. Myocardial samples were collected to assess interstitial and perivascular fibrosis area and also myocardial atrial‐type natriuretic peptide (ANP) and brain‐type natriuretic peptide (BNP) relative mRNA expression. Compared with controls, GLS was substantially lower in the TAC group (−7.0 ± 2.8 vs. −14.5 ± 2.5%; P < 0.001) and was only mildly reduced in the ACF group (−13.2 ± 2.4 vs. −15.4 ± 2.0%, P < 0.05). In contrast with these findings, PRSW and GMWI were comparable with sham in TAC (110 ± 26 vs. 116 ± 68 mmHg; 1687 ± 275 mmHg% vs. 1537 ± 662 mmHg%; both P = NS), while it was found to be significantly reduced in ACF (58 ± 14 vs. 111 ± 40 mmHg; 1328 ± 411 vs. 1934 ± 308 mmHg%, both P < 0.01). In the pooled population, GMWI (r = 0.70; P < 0.001) but not GLS (r = −0.23; P = 0.12) showed a strong correlation with PRSW. GLS correlated with interstitial (r = 0.61; P < 0.001) and perivascular fibrosis area (r = 0.54; P < 0.001), and also with myocardial ANP (r = 0.85; P < 0.001) and BNP relative mRNA expression (r = 0.75; P < 0.001), while GMWI demonstrated no or only marginal correlation with these parameters. Conclusions Being significantly influenced by loading conditions, GLS may not be a reliable marker of LV contractility in heart failure induced by pressure or volume overload. GMWI better reflects contractility in haemodynamic overload states, making it a more robust marker of systolic function, while GLS should be considered as an integrative marker, incorporating systolic function, haemodynamic loading state, and adverse tissue remodelling of the LV.
Collapse
Affiliation(s)
- Bálint Károly Lakatos
- Heart and Vascular Center, Semmelweis University, Városmajor St. 68, Budapest, H-1122, Hungary
| | - Mihály Ruppert
- Heart and Vascular Center, Semmelweis University, Városmajor St. 68, Budapest, H-1122, Hungary
| | - Márton Tokodi
- Heart and Vascular Center, Semmelweis University, Városmajor St. 68, Budapest, H-1122, Hungary
| | - Attila Oláh
- Heart and Vascular Center, Semmelweis University, Városmajor St. 68, Budapest, H-1122, Hungary
| | - Szilveszter Braun
- Heart and Vascular Center, Semmelweis University, Városmajor St. 68, Budapest, H-1122, Hungary
| | - Christian Karime
- Heart and Vascular Center, Semmelweis University, Városmajor St. 68, Budapest, H-1122, Hungary
| | - Zsuzsanna Ladányi
- Heart and Vascular Center, Semmelweis University, Városmajor St. 68, Budapest, H-1122, Hungary
| | - Alex Ali Sayour
- Heart and Vascular Center, Semmelweis University, Városmajor St. 68, Budapest, H-1122, Hungary
| | - Bálint András Barta
- Heart and Vascular Center, Semmelweis University, Városmajor St. 68, Budapest, H-1122, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Városmajor St. 68, Budapest, H-1122, Hungary
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, Városmajor St. 68, Budapest, H-1122, Hungary
| | - Attila Kovács
- Heart and Vascular Center, Semmelweis University, Városmajor St. 68, Budapest, H-1122, Hungary
| |
Collapse
|
21
|
Fábián A, Lakatos BK, Tokodi M, Kiss AR, Sydó N, Csulak E, Kispál E, Babity M, Szűcs A, Kiss O, Merkely B, Kovács A. Geometrical remodeling of the mitral and tricuspid annuli in response to exercise training: a 3-D echocardiographic study in elite athletes. Am J Physiol Heart Circ Physiol 2021; 320:H1774-H1785. [PMID: 33666507 DOI: 10.1152/ajpheart.00877.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Intense exercise exposes the heart to significant hemodynamic demands, resulting in adaptive changes in cardiac morphology and function. Nevertheless, the athletic adaptation of the atrioventricular valves remains to be elucidated. Our study aimed to characterize the geometry of mitral (MA) and tricuspid (TA) annuli in elite athletes using 3-D echocardiography. Thirty-four athletes presented with functional mitral regurgitation (FMR) were retrospectively identified and compared with 34 athletes without mitral regurgitation (MR) and 34 healthy, sedentary volunteers. 3-D echocardiographic datasets were used to quantify MA and TA geometry and leaflet tenting by dedicated softwares. MA and TA areas, as well as tenting volumes, were higher in athletes compared with controls. MA area was significantly higher in athletes with MR compared with those without (8.2 ± 1.0 vs. 7.2 ± 1.0 cm2/m2, P < 0.05). Interestingly, athletes with MR also presented with a significantly higher TA area (7.2 ± 1.1 vs. 6.5 ± 1.1 cm2/m2, P < 0.05). Nonplanar angle describing the MA's saddle shape was less obtuse in athletes without MR, whereas the values of athletes with MR were comparable with controls. The exercise-induced relative increases in left ventricular (35 ± 25%) and left atrial (40 ± 29%) volumes were similar; however, the increment in the MA area was disproportionately higher (63 ± 23%, overall P < 0.001). The relative increase in TA area (40 ± 23%) was also higher compared with the increment in right ventricular volume (34 ± 25%, P < 0.05). Atrioventricular annuli undergo a disproportionate remodeling in response to regular exercise. Athletic adaptation is characterized by both annular enlargement and increased leaflet tenting of both valves. There are differences in MA geometry in athletes presented with versus without FMR.NEW & NOTEWORTHY We have characterized the annular geometry of mitral and tricuspid valves in elite athletes using 3-D echocardiography. We have found that exercise-induced remodeling of the atrioventricular annuli comprises a disproportionate dilation of annular dimensions and increased leaflet tenting of both valves. Moreover, we have demonstrated a more pronounced saddle shape of the mitral annulus in athletes without mitral regurgitation, which was not present in those who had mild regurgitation.
Collapse
Affiliation(s)
- Alexandra Fábián
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | | | - Márton Tokodi
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - Anna Réka Kiss
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - Nóra Sydó
- Semmelweis University Heart and Vascular Center, Budapest, Hungary.,Department of Sports Medicine, Semmelweis University, Budapest, Hungary
| | - Emese Csulak
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - Erika Kispál
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - Máté Babity
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - Andrea Szűcs
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - Orsolya Kiss
- Semmelweis University Heart and Vascular Center, Budapest, Hungary.,Department of Sports Medicine, Semmelweis University, Budapest, Hungary
| | - Béla Merkely
- Semmelweis University Heart and Vascular Center, Budapest, Hungary.,Department of Sports Medicine, Semmelweis University, Budapest, Hungary
| | - Attila Kovács
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| |
Collapse
|
22
|
Bussmann N, Franklin O, McCallion N, McNamara PJ, El-Khuffash A. The impact preload on left ventricular three-plane deformation measurements in extremely premature infants. Early Hum Dev 2021; 153:105291. [PMID: 33310351 DOI: 10.1016/j.earlhumdev.2020.105291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/10/2020] [Accepted: 12/03/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Left Ventricular (LV) deformation analysis using two-dimensional speckle tracking echocardiography (STE) is an emerging modality in premature infants. AIMS To assess the impact of increased preload on LV deformation in three planes: longitudinal, circumferential and radial in premature infants. STUDY DESIGN AND SUBJECTS Infants recruited to the PDA RCT (ISRCTN 13281214) and survived to discharge were included with the cohort divided into infants who closed their patent ductus arteriosus (PDA) by Day 8 (Low preload, PDA Closed) and those who maintained ductal patency (high preload, PDA Open). OUTCOME MEASURES Longitudinal, circumferential and radial strain and systolic strain rate (SRs) were measured at 36 h, Days 4 & 8 and 36 weeks. RESULTS 61 infants were included. The PDA open Group had a lower gestation (26.4 vs. 27.4 weeks, p < 0.01) with a median PDA exposure of 30 days (vs. 2 days, p < 0.01), and demonstrated echocardiography evidence of pulmonary overcirculation. There was higher LV longitudinal strain and SRs over the first 3 scans in the PDA Open Group. Circumferential strain was higher over the first 2 scans while circumferential SRs was higher at 36 h. Radial Strain and SRs were only higher on Day 4. CONCLUSION Increased preload is associated with higher strain and systolic strain rate values in the premature population indicating that preload has a significant effect on deformation measurements in this population across all three planes.
Collapse
Affiliation(s)
- Neidin Bussmann
- Department of Neonatology, The Rotunda Hospital, Dublin, Ireland
| | - Orla Franklin
- Department of Paediatric Cardiology, Our Lady's Children's Hospital Crumlin, Ireland
| | - Naomi McCallion
- Department of Neonatology, The Rotunda Hospital, Dublin, Ireland; Department of Paediatrics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Patrick J McNamara
- Division of Neonatology, Stead Family Children's Hospital, Iowa City, IA, USA; Department of Pediatrics, University of Iowa, IA, USA; Department of Cardiology, University of Iowa, IA, USA
| | - Afif El-Khuffash
- Department of Neonatology, The Rotunda Hospital, Dublin, Ireland; Department of Paediatrics, The Royal College of Surgeons in Ireland, Dublin, Ireland.
| |
Collapse
|
23
|
Vriz O, Fadl Elmula FEM, Antonini-Canterin F. Noninvasive Assessment of Ventricular-Arterial Coupling in Heart Failure. Heart Fail Clin 2021; 17:245-254. [PMID: 33673948 DOI: 10.1016/j.hfc.2020.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The heart and the arterial system are anatomically and functionally linked together. Noninvasive assessment of ventricular-arterial coupling (VAC) can be done using different methods that are promising tools to assess individual hemodynamics and tailor treatment in patients with heart failure (HF). Moreover, different methods available can be appropriately used in different settings such as acute and chronic HF. VAC parameters also can add incremental value over the conventional risk factors in predicting cardiac outcome.
Collapse
Affiliation(s)
- Olga Vriz
- Heart Centre, King Faisal Specialist Hospital and Research Centre, Zahrawi Street, Al Maather, Al Maazer, Riyadh 12713, Saudi Arabia; Alfaisal University, School of Medicine, Riyadh, Saudi Arabia.
| | - Fadl-Elmula M Fadl Elmula
- Heart Centre, King Faisal Specialist Hospital and Research Centre, Zahrawi Street, Al Maather, Al Maazer, Riyadh 12713, Saudi Arabia
| | | |
Collapse
|