Imaging the cardiovascular system: seeing is believing

Cardiac fibroblast-dependent extracellular matrix accumulation is associated with diastolic stiffness in type 2 diabetes

Cardiovascular complications are a leading cause of death in patients with type 2 diabetes mellitus (T2DM). Diastolic dysfunction is one of the earliest manifestations of diabetes-induced changes in left ventricular (LV) function, and results from a reduced rate of relaxation and increased stiffness. The mechanisms responsible for increased stiffness are not completely understood. Chronic hyperglycemia, advanced glycation endproducts (AGEs), and increased levels of proinflammatory and profibrotic cytokines are molecular pathways known to be involved in regulating extracellular matrix (ECM) synthesis and accumulation resulting in increased LV diastolic stiffness. Experiments were conducted using a genetically-induced mouse model of T2DM generated by a point mutation in the leptin receptor resulting in nonfunctional leptin receptors (db/db murine model). This study correlated changes in LV ECM and stiffness with alterations in basal activation of signaling cascades and expression of profibrotic markers within primary cultures of cardiac fibroblasts from diabetic (db/db) mice with nondiabetic (db/wt) littermates as controls. Primary cultures of cardiac fibrobroblasts were maintained in 25 mM glucose (hyperglycemic-HG; diabetic db/db) media or 5 mM glucose (normoglycemic-NG, nondiabetic db/wt) media. The cells then underwent a 24-hour exposure to their opposite (NG; diabetic db/db) media or 5 mM glucose (HG, nondiabetic db/wt) media. Protein analysis demonstrated significantly increased expression of type I collagen, TIMP-2, TGF-β, PAI-1 and RAGE in diabetic db/db cells as compared to nondiabetic db/wt, independent of glucose media concentration. This pattern of protein expression was associated with increased LV collagen accumulation, myocardial stiffness and LV diastolic dysfunction. Isolated diabetic db/db fibroblasts were phenotypically distinct from nondiabetic db/wt fibroblasts and exhibited a profibrotic phenotype in normoglycemic conditions.

A detailed atlas of chick heart development in vivo

Various model organisms such as mouse, xenopus, or zebrafish embryos have been studied in the past to gain insight into the complex processes driving normal and abnormal development of the vertebrate heart. Despite the fact that the chicken embryo has been a favored classic model system used by embryologists and cardiovascular scientists for centuries to illustrate the principles of basic vertebrate embryology and cardiovascular development, so far, no one has provided a thorough documentation of heart development in this model from early visual stages to the stage of a completely formed heart with (a) images and (b) video recordings of beating hearts. However, in vivo documentation of heart development stages is indispensable because the initially tubular embryonic heart not only undergoes dramatic morphological changes, but also intriguing functional changes during cardiogenesis, which, only if they follow and remain within the normal developmental pathway, lead to the establishment of the normal four-chambered heart. In this work we present the first reference catalogue of cardiac development in vivo with (1) 25 plates of high resolution colour images in different views from Hamburger-Hamilton (HH)-stage 12 (day 2, relatively straight heart tube, early myocardial contractions) through HH-stage 35 (day 9, four-chambered heart) in end-diastole and end-systole, including a plate with an overview of all these stages; (2) collection of 82 video recordings of beating hearts in different views corresponding to the stages shown in the plates.

Integration of an optical coherence tomography (OCT) system into an examination incubator to facilitate in vivo imaging of cardiovascular development in higher vertebrate embryos under stable physiological conditions

High-resolution in vivo imaging of higher vertebrate embryos over short or long time periods under constant physiological conditions is a technically challenging task for researchers working on cardiovascular development. In chick embryos, for example, various studies have shown that without appropriate maintenance of temperature, as one of the main environmental factors, the embryonic heart rate drops rapidly and often results in an increase in regurgitant flow. Hemodynamic parameters are critical stimuli for cardiovascular development that, for a correct evaluation of their developmental significance, should be documented under physiological conditions. However, previous studies were mostly carried out outside of an incubator or under suboptimal environmental conditions. Here we present, to the best of our knowledge, the first detailed description of an optical coherence tomography (OCT) system integrated into an examination incubator to facilitate real-time in vivo imaging of cardiovascular development under physiological environmental conditions. We demonstrate the suitability of this OCT examination incubator unit for use in cardiovascular development studies by examples of proof of principle experiments. We, furthermore, point out the need for use of examination incubators for physiological OCT examinations by documenting the effects of room climate (22°C) on the performance of the cardiovascular system of chick embryos (HH-stages 16/17). Upon exposure to room climate, chick embryos showed a fast drop in the heart rate and striking changes in the cardiac contraction behaviour and the blood flow through the vitelline circulation. We have documented these changes for the first time by M-mode OCT and Doppler M-mode OCT.

Imaging aspects of cardiovascular disease at the cell and molecular level

Cell and molecular imaging has a long and distinguished history. Erythrocytes were visualized microscopically by van Leeuwenhoek in 1674, and microscope technology has evolved mightily since the first single-lens instruments, and now incorporates many types that do not use photons of light for image formation. The combination of these instruments with preparations stained with histochemical and immunohistochemical markers has revolutionized imaging by allowing the biochemical identification of components at subcellular resolution. The field of cardiovascular disease has benefited greatly from these advances for the characterization of disease etiologies. In this review, we will highlight and summarize the use of microscopy imaging systems, including light microscopy, electron microscopy, confocal scanning laser microscopy, laser scanning cytometry, laser microdissection, and atomic force microscopy in conjunction with a variety of histochemical techniques in studies aimed at understanding mechanisms underlying cardiovascular diseases at the cell and molecular level.

Chapter 5: Imaging in depth: controversies and opportunities

One enduring challenge of biological imaging is achieving depth of penetration-into cells, tissues, and animals. How deeply can we probe and with what resolution and efficacy? These are critical issues as microscopists seek to push ever deeper, while resolving structural details and observing specific molecular events. In this guide to depth-appropriate modalities, standard optical platforms such as confocal and two-photon microscopes are considered along with complementary imaging modalities that range in depth of penetration. After an introduction to basic techniques, the trade-offs and limitations that distinguish competing technologies are considered, with emphasis on the visualization of subcellular structures and dynamic events. Not surprisingly, there are differences of opinion regarding imaging technologies, as highlighted in a section on point-scanning and Nipkow-disk style confocal microscopes. Confocal microscopy is then contrasted with deconvolution and multi-photon imaging modalities. It is also important to consider the detectors used by current instruments (such as PMTs and CCD cameras). Ultimately specimen properties, in conjunction with instrumentation, determine the depth at which subcellular operations and larger-scale biological processes can be visualized. Relative advantages are mentioned in the context of experiment planning and instrument-purchase decisions. Given the rate at which new optical techniques are being invented, this report should be viewed as a snapshot of current capabilities, with the goal of providing a framework for thinking about new developments.

Construction and establishment of a new environmental chamber to study real-time cardiac development

Heart development, especially the critical phase of cardiac looping, is a complex and intricate process that has not yet been visualized "live" over long periods of time. We have constructed and established a new environmental incubator chamber that provides stable conditions for embryonic development with regard to temperature, humidity, and oxygen levels. We have integrated a video microscope in the chamber to visualize the developing heart in real time and present the first "live" recordings of a chick embryo in shell-less culture acquired over a period of 2 days. The time-lapse images we show depict a significant time window that covers the most critical and typical morphogenetic events during normal cardiac looping. Our system is of interest to researchers in the field of embryogenesis, as it can be adapted to a variety of animal models for organogenesis studies including heart and limb development.