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Chen Y, Li M, Wang Y, Fu J, Liu X, Zhang Y, Liu L, Ta S, Lu Z, Li Z, Zhou J, Li X. Association between Severity of Diabetic Retinopathy and Cardiac Function in Patients with Type 2 Diabetes. J Diabetes Res 2023; 2023:6588932. [PMID: 37323224 PMCID: PMC10266918 DOI: 10.1155/2023/6588932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 01/26/2023] [Accepted: 05/05/2023] [Indexed: 06/17/2023] Open
Abstract
Background The purpose of this research was to assess the relationship between the severity of diabetic retinopathy (DR) and indexes of left ventricle (LV) structure and function in type 2 diabetes mellitus (T2DM). Methods Retrospective analysis of 790 patients with T2DM and preserved LV ejection fraction. Retinopathy stages were classified as no DR, early nonproliferative DR, moderate to severe nonproliferative DR, or proliferative DR. The electrocardiogram was used to assess myocardial conduction function. Echocardiography was used to evaluate myocardial structure and function. Results Patients were divided into three groups based on the DR status: no DR group (NDR, n = 475), nonproliferative DR group (NPDR, n = 247), and proliferative DR group (PDR, n = 68). LV interventricular septal thickness (IVST) increased significantly with more severe retinopathy (NDR: 10.00 ± 1.09; NPDR: 10.42 ± 1.21; and PDR: 10.66 ± 1.58; P < 0.001). Multivariate logistic regression analysis showed that the significant correlation of IVST persisted between subjects with no retinopathy and proliferative DR (odds ratio = 1.35, P = 0.026). Indices of myocardial conduction function were assessed by electrocardiogram differences among groups of retinopathy (all P < 0.001). In multiple-adjusted linear regression analyses, the increasing degree of retinopathy was closely correlated with heart rate (β = 1.593, P = 0.027), PR interval (β = 4.666, P = 0.001), and QTc interval (β = 8.807, P = 0.005). Conclusion The proliferative DR was independently associated with worse cardiac structure and function by echocardiography. Furthermore, the severity of retinopathy significantly correlated with abnormalities of the electrocardiogram in patients with T2DM.
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Affiliation(s)
- YanYan Chen
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China
| | - MengYing Li
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China
| | - Yi Wang
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China
| | - JianFang Fu
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China
| | - XiangYang Liu
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China
| | - Ying Zhang
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China
| | - LiWen Liu
- Department of Ultrasound, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China
| | - ShengJun Ta
- Department of Ultrasound, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China
| | - ZuoWei Lu
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China
| | - ZePing Li
- Nanchang University Queen Mary School, Nanchang 330038, China
| | - Jie Zhou
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China
| | - XiaoMiao Li
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China
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Ibrahim ESH, Dennison J, Frank L, Stojanovska J. Diastolic Cardiac Function by MRI-Imaging Capabilities and Clinical Applications. Tomography 2021; 7:893-914. [PMID: 34941647 PMCID: PMC8706325 DOI: 10.3390/tomography7040075] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/01/2021] [Accepted: 12/04/2021] [Indexed: 02/05/2023] Open
Abstract
Most cardiac studies focus on evaluating left ventricular (LV) systolic function. However, the assessment of diastolic cardiac function is becoming more appreciated, especially with the increasing prevalence of pathologies associated with diastolic dysfunction like heart failure with preserved ejection fraction (HFpEF). Diastolic dysfunction is an indication of abnormal mechanical properties of the myocardium, characterized by slow or delayed myocardial relaxation, abnormal LV distensibility, and/or impaired LV filling. Diastolic dysfunction has been shown to be associated with age and other cardiovascular risk factors such as hypertension and diabetes mellitus. In this context, cardiac magnetic resonance imaging (MRI) has the capability for differentiating between normal and abnormal myocardial relaxation patterns, and therefore offers the prospect of early detection of diastolic dysfunction. Although diastolic cardiac function can be assessed from the ratio between early and atrial filling peaks (E/A ratio), measuring different parameters of heart contractility during diastole allows for evaluating spatial and temporal patterns of cardiac function with the potential for illustrating subtle changes related to age, gender, or other differences among different patient populations. In this article, we review different MRI techniques for evaluating diastolic function along with clinical applications and findings in different heart diseases.
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Affiliation(s)
- El-Sayed H. Ibrahim
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
- Correspondence:
| | - Jennifer Dennison
- Department of Medicine, Medical College of Wisconsin, Wausau, WI 54401, USA;
| | - Luba Frank
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
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Ibrahim ESH. Editorial for "Cardiac MRI Reveals Late Diastolic Changes in Left Ventricular Relaxation Patterns During Healthy Aging". J Magn Reson Imaging 2020; 53:775-776. [PMID: 33219621 DOI: 10.1002/jmri.27449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 01/27/2023] Open
Affiliation(s)
- El-Sayed H Ibrahim
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Heier M, Stensæth KH, Brunborg C, Seljeflot I, Margeirsdottir HD, Hanssen KF, Dahl-Jørgensen K. Increased arterial stiffness in childhood onset diabetes: a cardiovascular magnetic resonance study. Eur Heart J Cardiovasc Imaging 2018; 19:694-700. [PMID: 28950341 DOI: 10.1093/ehjci/jex178] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 06/19/2017] [Indexed: 11/13/2022] Open
Abstract
Aims Arterial stiffness is a strong predictor of cardiovascular events. We aimed to assess the impact of type 1 diabetes (T1D) on arterial stiffness and cardiac function in young adults. Methods and results Aortic pulse wave velocity (PWV), distensibility, left ventricular (LV) function and LV mass were measured by cardiovascular magnetic resonance imaging (CMR) in 47 T1D patients and 33 healthy controls. All were participants in the Atherosclerosis and Childhood Diabetes study, with baseline values registered 5 years previously. The patients had a mean age of 20.8 years and a median duration of diabetes of 10.0 years. PWV was significantly higher in the diabetes group compared with controls, mean 4.10 (SD = 4.58) vs. 3.90 (SD = 4.04) m/s, P = 0.045. In the diabetes group, insulin pump users at baseline had lower PWV than multiple injection users, mean 3.94 (SD = 0.38) vs. 4.23 (SD = 0.48) m/s, P = 0.028. Also in the diabetes group, multiple regression analysis identified C-reactive protein (CRP), female gender and insulin pump use as independent baseline risk factors for PWV 5 years later. There was no difference in cardiac function or LV mass between the diabetes and control groups. Conclusion In this prospective study, we found increased PWV assessed by CMR in young adults with T1D compared with controls. Also, CRP, female gender and insulin pump use emerged as independent baseline risk factors for PWV 5 years later.
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Affiliation(s)
- Martin Heier
- Pediatric Department, Oslo University Hospital, Ullevål, Postboks 4950 Nydalen, 0424 Oslo, Norway.,Faculty of Medicine, University of Oslo, Postboks 1078 Blindern, Oslo 0316, Norway.,Oslo Diabetes Research Centre, Postboks 4959 Nydalen, Oslo 0424, Norway
| | - Knut Haakon Stensæth
- Department of Radiology and Nuclear Medicine, St Olavs University Hospital, Postboks 3250 Sluppen, Trondheim 7006, Norway.,Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology, Postboks 8905, Trondheim 7491, Norway
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Postboks 1122 Blindern, Oslo 0317, Norway
| | - Ingebjørg Seljeflot
- Faculty of Medicine, University of Oslo, Postboks 1078 Blindern, Oslo 0316, Norway.,Center for Clinical Heart Research and Department of Cardiology, Oslo University Hospital, Kirkeveien 166, Oslo 0407, Norway
| | - Hanna Dis Margeirsdottir
- Faculty of Medicine, University of Oslo, Postboks 1078 Blindern, Oslo 0316, Norway.,Oslo Diabetes Research Centre, Postboks 4959 Nydalen, Oslo 0424, Norway.,Pediatric Department, Akershus University Hospital, Sykehusveien 25, Lørenskog 1478, Norway
| | - Kristian F Hanssen
- Faculty of Medicine, University of Oslo, Postboks 1078 Blindern, Oslo 0316, Norway.,Oslo Diabetes Research Centre, Postboks 4959 Nydalen, Oslo 0424, Norway.,Department of Endocrinology, Oslo University Hospital, Aker, Trondheimsveien 235, Oslo 0586, Norway
| | - Knut Dahl-Jørgensen
- Pediatric Department, Oslo University Hospital, Ullevål, Postboks 4950 Nydalen, 0424 Oslo, Norway.,Faculty of Medicine, University of Oslo, Postboks 1078 Blindern, Oslo 0316, Norway.,Oslo Diabetes Research Centre, Postboks 4959 Nydalen, Oslo 0424, Norway
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5
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Lüers C, Trippel TD, Seeländer S, Wachter R, Hasenfuss G, Lindhorst R, Bobenko A, Nolte K, Pieske B, Edelmann F. Arterial stiffness and elevated left ventricular filling pressure in patients at risk for the development or a previous diagnosis of HF—A subgroup analysis from the DIAST-CHF study. ACTA ACUST UNITED AC 2017; 11:303-313. [DOI: 10.1016/j.jash.2017.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 03/10/2017] [Accepted: 03/18/2017] [Indexed: 12/28/2022]
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Bell V, McCabe EL, Larson MG, Rong J, Merz AA, Osypiuk E, Lehman BT, Stantchev P, Aragam J, Benjamin EJ, Hamburg NM, Vasan RS, Mitchell GF, Cheng S. Relations Between Aortic Stiffness and Left Ventricular Mechanical Function in the Community. J Am Heart Assoc 2017; 6:JAHA.116.004903. [PMID: 28069573 PMCID: PMC5523643 DOI: 10.1161/jaha.116.004903] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Aortic stiffness impairs optimal ventricular–vascular coupling and left ventricular systolic function, particularly in the long axis. Left ventricular global longitudinal strain (GLS) has recently emerged as a sensitive measure of early cardiac dysfunction. In this study, we investigated the relation between aortic stiffness and GLS in a large community‐based sample. Methods and Results In 2495 participants (age 39–90 years, 57% women) of the Framingham Offspring and Omni cohorts, free of cardiovascular disease, we performed tonometry to measure arterial hemodynamics and echocardiography to assess cardiac function. Aortic stiffness was evaluated as carotid–femoral pulse wave velocity and as characteristic impedance, and GLS was calculated using speckle tracking–based measurements. In multivariable analyses adjusting for age, sex, height, systolic blood pressure, augmentation index, left ventricular structure, and additional cardiovascular risk factors, increased carotid–femoral pulse wave velocity (B±SE: 0.122±0.030% strain per SD, P<0.0001) and characteristic impedance (0.090±0.029, P=0.002) were both associated with worse GLS. We observed effect modification by sex on the relation between characteristic impedance and GLS (P=0.004); in sex‐stratified multivariable analyses, the relation between greater characteristic impedance and worse GLS persisted in women (0.145±0.039, P=0.0003) but not in men (P=0.73). Conclusions Multiple measures of increased aortic stiffness were cross‐sectionally associated with worse GLS after adjusting for hemodynamic variables. Parallel reductions in left ventricular long axis shortening and proximal aortic longitudinal strain in individuals with a stiffened proximal aorta, from direct mechanical ventricular‐vascular coupling, offers an alternative explanation for the observed relations.
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Affiliation(s)
| | - Elizabeth L McCabe
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Martin G Larson
- Department of Biostatistics, Boston University School of Public Health, Boston, MA.,Framingham Heart Study, Framingham, MA
| | - Jian Rong
- Framingham Heart Study, Framingham, MA
| | - Allison A Merz
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | | | | | | | | | - Emelia J Benjamin
- Department of Epidemiology, Boston University School of Public Health, Boston, MA.,Framingham Heart Study, Framingham, MA.,Preventive Medicine and Cardiology Sections, Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA
| | - Naomi M Hamburg
- Preventive Medicine and Cardiology Sections, Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA.,Evans Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Ramachandran S Vasan
- Department of Epidemiology, Boston University School of Public Health, Boston, MA.,Framingham Heart Study, Framingham, MA.,Preventive Medicine and Cardiology Sections, Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA
| | | | - Susan Cheng
- Framingham Heart Study, Framingham, MA .,Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
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7
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Nauta FJH, Kamman AV, Ibrahim ESH, Agarwal PP, Yang B, Kim K, Williams DM, van Herwaarden JA, Moll FL, Eagle KA, Trimarchi S, Patel HJ, Figueroa CA. Assessment of CardiOvascular Remodelling following Endovascular aortic repair through imaging and computation: the CORE prospective observational cohort study protocol. BMJ Open 2016; 6:e012270. [PMID: 27856475 PMCID: PMC5128949 DOI: 10.1136/bmjopen-2016-012270] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Thoracic aortic stent grafts are orders of magnitude stiffer than the native aorta. These devices have been associated with acute hypertension, elevated pulse pressure, cardiac remodelling and reduced coronary perfusion. However, a systematic assessment of such cardiovascular effects of thoracic endovascular aortic repair (TEVAR) is missing. The CardiOvascular Remodelling following Endovascular aortic repair (CORE) study aims to (1) quantify cardiovascular remodelling following TEVAR and compare echocardiography against MRI, the reference method; (2) validate computational modelling of cardiovascular haemodynamics following TEVAR using clinical measurements, and virtually assess the impact of more compliant stent grafts on cardiovascular haemodynamics; and (3) investigate diagnostic accuracy of ECG and serum biomarkers for cardiac remodelling compared to MRI. METHODS AND ANALYSIS This is a prospective, nonrandomised, observational cohort study. We will use MRI, CT, echocardiography, intraluminal pressures, ECG, computational modelling and serum biomarkers to assess cardiovascular remodelling in two groups of patients with degenerative thoracic aneurysms or penetrating aortic ulcers: (1) patients managed with TEVAR and (2) control patients managed with medical therapy alone. Power analysis revealed a minimum total sample size of 20 patients (α=0.05, power=0.97) to observe significant left ventricular mass increase following TEVAR after 1 year. Consequently, we will include 12 patients in both groups. Advanced MRI sequences will be used to assess myocardial and aortic strain and distensibility, myocardial perfusion and aortic flow. ECG, echocardiography and serum biomarkers will be collected and compared against the imaging data. Computational models will be constructed from each patient imaging data, analysed and validated. All measurements will be collected at baseline (prior to TEVAR) and 1-year follow-up. The expected study period is 3 years. ETHICS AND DISSEMINATION This study has been approved by the University of Michigan IRB. The results will be disseminated through scientific journals and conference presentations. TRIAL REGISTRATION NUMBER NCT02735720.
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Affiliation(s)
- Foeke J H Nauta
- Cardiovascular Center, University of Michigan Health System, Ann Arbor, Michigan, USA
- Department of Vascular Surgery, Thoracic Aortic Research Center, Policlinico San Donato IRCCS, University of Milan, Milan, Italy
| | - Arnoud V Kamman
- Cardiovascular Center, University of Michigan Health System, Ann Arbor, Michigan, USA
- Department of Vascular Surgery, Thoracic Aortic Research Center, Policlinico San Donato IRCCS, University of Milan, Milan, Italy
| | - El-Sayed H Ibrahim
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Prachi P Agarwal
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Bo Yang
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Karen Kim
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - David M Williams
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Joost A van Herwaarden
- Department of Vascular Surgery, University of Utrecht, Utrecht, Midden-Nederland, The Netherlands
| | - Frans L Moll
- Department of Vascular Surgery, University of Utrecht, Utrecht, Midden-Nederland, The Netherlands
| | - Kim A Eagle
- Cardiovascular Center, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Santi Trimarchi
- Department of Vascular Surgery, Thoracic Aortic Research Center, Policlinico San Donato IRCCS, University of Milan, Milan, Italy
| | - Himanshu J Patel
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - C Alberto Figueroa
- Departments of Biomedical Engineering and Surgery, University of Michigan, Ann Arbor, Michigan, USA
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Wang X, Chen T, Zhang S, Schaerer J, Qian Z, Huh S, Metaxas D, Axel L. Meshless deformable models for 3D cardiac motion and strain analysis from tagged MRI. Magn Reson Imaging 2015; 33:146-60. [PMID: 25157446 PMCID: PMC4876045 DOI: 10.1016/j.mri.2014.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 05/28/2014] [Accepted: 08/08/2014] [Indexed: 12/12/2022]
Abstract
Tagged magnetic resonance imaging (TMRI) provides a direct and noninvasive way to visualize the in-wall deformation of the myocardium. Due to the through-plane motion, the tracking of 3D trajectories of the material points and the computation of 3D strain field call for the necessity of building 3D cardiac deformable models. The intersections of three stacks of orthogonal tagging planes are material points in the myocardium. With these intersections as control points, 3D motion can be reconstructed with a novel meshless deformable model (MDM). Volumetric MDMs describe an object as point cloud inside the object boundary and the coordinate of each point can be written in parametric functions. A generic heart mesh is registered on the TMRI with polar decomposition. A 3D MDM is generated and deformed with MR image tagging lines. Volumetric MDMs are deformed by calculating the dynamics function and minimizing the local Laplacian coordinates. The similarity transformation of each point is computed by assuming its neighboring points are making the same transformation. The deformation is computed iteratively until the control points match the target positions in the consecutive image frame. The 3D strain field is computed from the 3D displacement field with moving least squares. We demonstrate that MDMs outperformed the finite element method and the spline method with a numerical phantom. Meshless deformable models can track the trajectory of any material point in the myocardium and compute the 3D strain field of any particular area. The experimental results on in vivo healthy and patient heart MRI show that the MDM can fully recover the myocardium motion in three dimensions.
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Affiliation(s)
- Xiaoxu Wang
- Shenzhen Institute of Advance Technology, CAS, Xueyuan Ave. 1068, Xili, Nanshan, Shenzhen, Guangdong, China, 518055.
| | - Ting Chen
- Radiology Department, New York University, 660 first Avenue, New York, NY, 10016, USA
| | - Shaoting Zhang
- Department of Computer Science, Rutgers University, 110 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
| | - Joël Schaerer
- CREATIS, INSA LYON, Bâtiment Blaise Pascal, 7 Avenue Jean Capelle, 69621, Villeurbanne Cedex, France
| | - Zhen Qian
- Department of Computer Science, Rutgers University, 110 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
| | - Suejung Huh
- Department of Computer Science, Rutgers University, 110 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
| | - Dimitris Metaxas
- Department of Computer Science, Rutgers University, 110 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
| | - Leon Axel
- Radiology Department, New York University, 660 first Avenue, New York, NY, 10016, USA
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Le VP, Stoka KV, Yanagisawa H, Wagenseil JE. Fibulin-5 null mice with decreased arterial compliance maintain normal systolic left ventricular function, but not diastolic function during maturation. Physiol Rep 2014; 2:e00257. [PMID: 24760511 PMCID: PMC4002237 DOI: 10.1002/phy2.257] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The large arteries serve as compliant vessels that store energy during systole and return it during diastole. This function is made possible by the elastic fibers in the arterial wall that are assembled during late embryonic and early postnatal development from various proteins, including fibulin‐5. Mice and humans with insufficient amounts of fibulin‐5 have reduced arterial compliance as adults. Reduced compliance of the large arteries is correlated with hypertension, reduced cardiac function, and an increased risk of death from cardiac and cardiovascular disease. The goal of this study was to quantify arterial compliance, blood pressure, and left ventricular (LV) function from early postnatal development to young adulthood in fibulin‐5 null (Fbln5−/−) mice to determine the effects of reduced arterial compliance during this critical period of elastic fiber assembly. We find that ascending aorta compliance is reduced as early as postnatal day (P) 7 and carotid artery compliance is reduced by P21 in Fbln5−/− mice. We did not find significant increases in systolic blood pressure by P60, but pulse pressures are increased by P21 in Fbln5−/− mice. LV systolic function, as measured by ejection fraction and fractional shortening, is unaffected in Fbln5−/− mice. However, LV diastolic function, as measured by tissue Doppler imaging, is compromised at all ages in Fbln5−/− mice. We propose that Fbln5−/− mice represent a suitable model for further studies to determine mechanistic relationships between arterial compliance and LV diastolic function.
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Affiliation(s)
- Victoria P Le
- Department of Biomedical Engineering, Saint Louis University, St. Louis, Missouri
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11
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Kim EK, Chang SA, Jang SY, Kim Y, Kim SM, Oh JK, Choe YH, Kim DK. Assessment of regional aortic stiffness with cardiac magnetic resonance imaging in a healthy Asian population. Int J Cardiovasc Imaging 2013; 29 Suppl 1:57-64. [PMID: 23504214 DOI: 10.1007/s10554-013-0206-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 03/10/2013] [Indexed: 01/21/2023]
Abstract
The aim of this study was to determine the normal values for aortic pulse wave velocity (PWV) and distensibility using cine and phase contrast cardiac magnetic resonance imaging (CMRI) in patients without cardiovascular risk factors. PWV and distensibility are indispensible predictors of global and regional cardiovascular risk. Regional heterogeneity in aortic stiffness plays an important role in the pathogenesis of cardiovascular disease. Contrary to global estimates of aortic PWV that are commonly measured with tonometry, CMRI has emerged as an important method for estimating regional PWV and distensibility. A total of 124 Korean patients, aged 20-79 years and free of cardiovascular risk factors, were categorized by age decade. Using cine and phase contrast sequences, the cross-sectional area for distensibility and average blood flow were measured at four aortic levels: the ascending, upper descending thoracic, lower thoracic and abdominal aorta. Regional PWV was determined in four aortic segments: proximal, descending thoracic, abdominal aorta and across the entire aorta. Distensibility at the four levels of the aorta from the ascending to distal (4.4 ± 2.5, 4.0 ± 1.6, 5.2 ± 1.9, and 3.3 ± 1.7 × 10(-3) mm/Hg, respectively) was higher in women (P < 0.001) and decreased with age. The regional PWV was highest in the descending thoracic aorta and increased with age. The present study is the first to show the heterogeneity in aortic PWV and distensibility, as well to provide normal values for these parameters using CMRI in an Asian sample.
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Affiliation(s)
- Eun Kyoung Kim
- Division of Cardiology, Department of Medicine, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Ma L, Gul R, Habibi J, Yang M, Pulakat L, Whaley-Connell A, Ferrario CM, Sowers JR. Nebivolol improves diastolic dysfunction and myocardial remodeling through reductions in oxidative stress in the transgenic (mRen2) rat. Am J Physiol Heart Circ Physiol 2012; 302:H2341-51. [PMID: 22447938 DOI: 10.1152/ajpheart.01126.2011] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Angiotensin II contributes to myocardial tissue remodeling and interstitial fibrosis through NADPH oxidase-mediated generation of oxidative stress in the progression of heart failure. Recent data have suggested that nebivolol, a third-generation β-blocker, improves diastolic dysfunction by targeting nitric oxide (NO) and metabolic pathways that decrease interstitial fibrosis. We sought to determine if targeting NO would improve diastolic function in a model of tissue renin-angiotensin system overactivation. We used the transgenic (TG) (mRen2)27 rat, which overexpresses the murine renin transgene and manifests insulin resistance and left ventricular dysfunction. We treated 6- to 7-wk-old TG (mRen2)27 rats and age-matched Sprague-Dawley control rats with nebivolol (10 mg·kg(-1)·day(-1)) or placebo via osmotic minipumps for a period of 21 days. Compared with Sprague-Dawley control rats, TG (mRen2)27 rats displayed a prolonged diastolic relaxation time and reduced initial filling rate associated with increased interstitial fibrosis and left ventricular hypertrophy. These findings were temporally related to increased NADPH oxidase activity and subunits p47(phox) and Rac1 and increased total ROS and peroxynitrite formation in parallel with reductions in the antioxidant heme oxygenase as well as the phosphorylation/activation of endothelial NO synthase and PKB/Akt. Treatment with nebivolol restored diastolic function and interstitial fibrosis through increases in the phosphorylation of 5'-AMP-activated protein kinase, Akt, and endothelial NO synthase and reductions in oxidant stress. These results support that targeting NO with nebivolol treatment improves diastolic dysfunction through reducing myocardial oxidative stress by enhancing 5'-AMP-activated protein kinase and Akt activation of NO biosynthesis.
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Affiliation(s)
- Lixin Ma
- Department of Radiology, University of Missouri School of Medicine, Columbia, USA
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