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Berg J, Jablonowski R, Nordlund D, Ryd D, Heiberg E, Carlsson M, Arheden H. Mild hypothermia attenuates ischaemia/reperfusion injury: insights from serial non-invasive pressure-volume loops. Cardiovasc Res 2023; 119:2230-2243. [PMID: 36734080 PMCID: PMC10578916 DOI: 10.1093/cvr/cvad028] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 10/31/2022] [Accepted: 12/20/2022] [Indexed: 02/04/2023] Open
Abstract
AIMS Mild hypothermia, 32-35°C, reduces infarct size in experimental studies, potentially mediating reperfusion injuries, but human trials have been ambiguous. To elucidate the cardioprotective mechanisms of mild hypothermia, we analysed cardiac performance in a porcine model of ischaemia/reperfusion, with serial cardiovascular magnetic resonance (CMR) imaging throughout 1 week using non-invasive pressure-volume (PV) loops. METHODS AND RESULTS Normothermia and Hypothermia group sessions (n = 7 + 7 pigs, non-random allocation) were imaged with Cardiovascular magnetic resonance (CMR) at baseline and subjected to 40 min of normothermic ischaemia by catheter intervention. Thereafter, the Hypothermia group was rapidly cooled (mean 34.5°C) for 5 min before reperfusion. Additional CMR sessions at 2 h, 24 h, and 7 days acquired ventricular volumes and ischaemic injuries (unblinded analysis). Stroke volume (SV: -24%; P = 0.029; Friedmans test) and ejection fraction (EF: -20%; P = 0.068) were notably reduced at 24 h in the Normothermia group compared with baseline. In contrast, the decreases were ameliorated in the Hypothermia group (SV: -6%; P = 0.77; EF: -6%; P = 0.13). Mean arterial pressure remained stable in Normothermic animals (-3%, P = 0.77) but dropped 2 h post-reperfusion in hypothermic animals (-18%, P = 0.007). Both groups experienced a decrease and partial recovery pattern for PV loop-derived variables over 1 week, but the adverse effects tended to attenuate in the Hypothermia group. Infarct sizes were 10 ± 8% in Hypothermic and 15 ± 8% in Normothermic animals (P = 0.32). Analysis of covariance at 24 h indicated that hypothermia has cardioprotective properties incremental to reducing infarct size, such as higher external power (P = 0.061) and lower arterial elastance (P = 0.015). CONCLUSION Using non-invasive PV loops by CMR, we observed that mild hypothermia at reperfusion alleviates the heart's work after ischaemia/reperfusion injuries during the first week and preserves short-term cardiac performance. This hypothesis-generating study suggests hypothermia to have cardioprotective properties, incremental to reducing infarct size. The primary cardioprotective mechanism was likely an afterload reduction acutely unloading the left ventricle.
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Affiliation(s)
- Jonathan Berg
- Clinical Physiology, Department of Clinical Sciences LundFaculty of Medicine, Lund University, Box 117 221 00 Lund, Sweden
- Skåne University Hospital, Carl-Bertil Laurells gata 9, 214 28 Malmö, Sweden
- Syntach AB, Lund, Sweden
| | - Robert Jablonowski
- Skåne University Hospital, Carl-Bertil Laurells gata 9, 214 28 Malmö, Sweden
| | - David Nordlund
- Skåne University Hospital, Carl-Bertil Laurells gata 9, 214 28 Malmö, Sweden
| | - Daniel Ryd
- Skåne University Hospital, Carl-Bertil Laurells gata 9, 214 28 Malmö, Sweden
| | - Einar Heiberg
- Skåne University Hospital, Carl-Bertil Laurells gata 9, 214 28 Malmö, Sweden
| | - Marcus Carlsson
- Skåne University Hospital, Carl-Bertil Laurells gata 9, 214 28 Malmö, Sweden
| | - Håkan Arheden
- Skåne University Hospital, Carl-Bertil Laurells gata 9, 214 28 Malmö, Sweden
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Seemann F, Bruce CG, Khan JM, Ramasawmy R, Potersnak AG, Herzka DA, Kakareka JW, Jaimes AE, Schenke WH, O'Brien KJ, Lederman RJ, Campbell-Washburn AE. Dynamic pressure-volume loop analysis by simultaneous real-time cardiovascular magnetic resonance and left heart catheterization. J Cardiovasc Magn Reson 2023; 25:1. [PMID: 36642713 PMCID: PMC9841727 DOI: 10.1186/s12968-023-00913-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/05/2023] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Left ventricular (LV) contractility and compliance are derived from pressure-volume (PV) loops during dynamic preload reduction, but reliable simultaneous measurements of pressure and volume are challenging with current technologies. We have developed a method to quantify contractility and compliance from PV loops during a dynamic preload reduction using simultaneous measurements of volume from real-time cardiovascular magnetic resonance (CMR) and invasive LV pressures with CMR-specific signal conditioning. METHODS Dynamic PV loops were derived in 16 swine (n = 7 naïve, n = 6 with aortic banding to increase afterload, n = 3 with ischemic cardiomyopathy) while occluding the inferior vena cava (IVC). Occlusion was performed simultaneously with the acquisition of dynamic LV volume from long-axis real-time CMR at 0.55 T, and recordings of invasive LV and aortic pressures, electrocardiogram, and CMR gradient waveforms. PV loops were derived by synchronizing pressure and volume measurements. Linear regression of end-systolic- and end-diastolic- pressure-volume relationships enabled calculation of contractility. PV loops measurements in the CMR environment were compared to conductance PV loop catheter measurements in 5 animals. Long-axis 2D LV volumes were validated with short-axis-stack images. RESULTS Simultaneous PV acquisition during IVC-occlusion was feasible. The cardiomyopathy model measured lower contractility (0.2 ± 0.1 mmHg/ml vs 0.6 ± 0.2 mmHg/ml) and increased compliance (12.0 ± 2.1 ml/mmHg vs 4.9 ± 1.1 ml/mmHg) compared to naïve animals. The pressure gradient across the aortic band was not clinically significant (10 ± 6 mmHg). Correspondingly, no differences were found between the naïve and banded pigs. Long-axis and short-axis LV volumes agreed well (difference 8.2 ± 14.5 ml at end-diastole, -2.8 ± 6.5 ml at end-systole). Agreement in contractility and compliance derived from conductance PV loop catheters and in the CMR environment was modest (intraclass correlation coefficient 0.56 and 0.44, respectively). CONCLUSIONS Dynamic PV loops during a real-time CMR-guided preload reduction can be used to derive quantitative metrics of contractility and compliance, and provided more reliable volumetric measurements than conductance PV loop catheters.
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Affiliation(s)
- Felicia Seemann
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood, Institute, National Institutes of Health, 10 Center Drive, Building 10 Rm B1D47, Bethesda, MD, 20892, USA.
| | - Christopher G Bruce
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood, Institute, National Institutes of Health, 10 Center Drive, Building 10 Rm B1D47, Bethesda, MD, 20892, USA
| | - Jaffar M Khan
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood, Institute, National Institutes of Health, 10 Center Drive, Building 10 Rm B1D47, Bethesda, MD, 20892, USA
| | - Rajiv Ramasawmy
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood, Institute, National Institutes of Health, 10 Center Drive, Building 10 Rm B1D47, Bethesda, MD, 20892, USA
| | - Amanda G Potersnak
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood, Institute, National Institutes of Health, 10 Center Drive, Building 10 Rm B1D47, Bethesda, MD, 20892, USA
| | - Daniel A Herzka
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood, Institute, National Institutes of Health, 10 Center Drive, Building 10 Rm B1D47, Bethesda, MD, 20892, USA
| | - John W Kakareka
- Instrumentation Development and Engineering Application Solutions, Division of Intramural Research, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Andrea E Jaimes
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood, Institute, National Institutes of Health, 10 Center Drive, Building 10 Rm B1D47, Bethesda, MD, 20892, USA
| | - William H Schenke
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood, Institute, National Institutes of Health, 10 Center Drive, Building 10 Rm B1D47, Bethesda, MD, 20892, USA
| | - Kendall J O'Brien
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood, Institute, National Institutes of Health, 10 Center Drive, Building 10 Rm B1D47, Bethesda, MD, 20892, USA
| | - Robert J Lederman
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood, Institute, National Institutes of Health, 10 Center Drive, Building 10 Rm B1D47, Bethesda, MD, 20892, USA
| | - Adrienne E Campbell-Washburn
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood, Institute, National Institutes of Health, 10 Center Drive, Building 10 Rm B1D47, Bethesda, MD, 20892, USA
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Salehin N, Villarreal C, Teranikar T, Dubansky B, Lee J, Chuong CJ. Assessing Pressure-Volume Relationship in Developing Heart of Zebrafish In-Vivo. Ann Biomed Eng 2021; 49:2080-2093. [PMID: 33532949 DOI: 10.1007/s10439-021-02731-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
During embryogenesis, the developing heart transforms from a linear peristaltic tube into a multi-chambered pulsatile pump with blood flow-regulating valves. In this work, we report how hemodynamic parameters evolve during the heart's development, leading to its rhythmic pumping and blood flow regulation as a functioning organ. We measured the time course of intra-ventricular pressure from zebrafish embryos at 3, 4, and 5 days post fertilization (dpf) using the servo null method. We also measured the ventricular volume and monitored the opening/closing activity of the AV and VB valves using 4D selective plane illumination microscopy (SPIM). Our results revealed significant increases in peak systolic pressure, stroke volume and work, cardiac output, and power generation, and a total peripheral resistance decrease from zebrafish at 4, 5 dpf versus 3 dpf. These data illustrate that the early-stage zebrafish heart's increasing efficiency is synchronous with the expected changes in valve development, chamber morphology and increasing vascular network complexity. Such physiological measurements in tractable laboratory model organisms are critical for understanding how gene variants may affect phenotype. As the zebrafish emerges as a leading biomedical model organism, the ability to effectively measure its physiology is critical to its translational relevance.
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Affiliation(s)
- Nabid Salehin
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76010, USA
| | - Cameron Villarreal
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76010, USA
| | - Tanveer Teranikar
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76010, USA
| | - Benjamin Dubansky
- Department of Biological Sciences, University of North Texas, Denton, TX, 76201, USA
| | - Juhyun Lee
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76010, USA
| | - Cheng-Jen Chuong
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76010, USA.
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Louwe MC, Karper JC, de Vries MR, Nossent AY, Bastiaansen AJ, van der Hoorn JW, Willems van Dijk K, Rensen PC, Steendijk P, Smit JW, Quax PH. RP105 deficiency aggravates cardiac dysfunction after myocardial infarction in mice. Int J Cardiol 2014; 176:788-93. [PMID: 25156852 DOI: 10.1016/j.ijcard.2014.07.086] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Revised: 07/24/2014] [Accepted: 07/26/2014] [Indexed: 12/24/2022]
Abstract
BACKGROUND Toll-like receptor-4 (TLR4), a receptor of the innate immune system, is suggested to have detrimental effects on cardiac function after myocardial infarction (MI). RP105 (CD180) is a TLR4 homolog lacking the intracellular signaling domain that competitively inhibits TLR4-signaling. Thus, we hypothesized that RP105 deficiency, by amplifying TLR4 signaling, would lead to aggravated cardiac dysfunction after MI. METHODS AND RESULTS First, whole blood from RP105-/- and wild-type (WT) male C57Bl/6N mice was stimulated with LPS, which induced a strong inflammatory TNFα response in RP105-/- mice. Then, baseline heart function was assessed by left ventricular pressure-volume relationships which were not different between RP105-/- and WT mice. Permanent ligation of the left anterior descending coronary artery was performed to induce MI. Infarct sizes were analyzed by (immuno)histology and did not differ. Fifteen days post MI heart function was assessed and RP105-/- mice had significantly higher heart rate (+21%, P<0.01), end systolic volume index (+57%, P<0.05), end systolic pressure (+22%, P<0.05) and lower relaxation time constant tau (-12%, P<0.05), and a tendency for increased end diastolic volume index (+42%, P<0.06), compared to WT mice. In the area adjacent to the infarct zone, compared to the healthy myocardium, levels of RP105, TLR4 and the endogenous TLR4 ligand fibronectin-EDA were increased as well as the number of macrophages, however this was not different between both groups. CONCLUSION Deficiency of the endogenous TLR4 inhibitor RP105 leads to an enhanced inflammatory status and more pronounced cardiac dilatation after induction of MI, underscoring the role of the TLR4 pathway in post-infarction remodeling.
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Borgdorff MA, Bartelds B, Dickinson MG, Steendijk P, Berger RMF. A cornerstone of heart failure treatment is not effective in experimental right ventricular failure. Int J Cardiol 2013; 169:183-9. [PMID: 24067600 DOI: 10.1016/j.ijcard.2013.08.102] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 08/20/2013] [Accepted: 08/29/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Right ventricular (RV) failure due to increased pressure load causes significant morbidity and mortality in patients with congenital heart diseases and pulmonary arterial hypertension. It is unknown whether renin-angiotensin-aldosterone-system (RAAS) inhibition (the cornerstone of left ventricular failure treatment) is effective in RV failure. We investigated the effects of combination treatment of aldosterone-blocker eplerenone+angiotensin II receptor blocker losartan (Ep/Lo) on RV remodeling and function in a model of RV failure due to increased pressure load. METHODS AND RESULTS Rats (n=48) were randomized for pulmonary artery banding (PAB) or sham surgery and for losartan (20 mg/kg/d)+eplerenone (100 mg/kg/d) treatment (Ep/Lo) or vehicle (VEH). RV function was assessed by echocardiography and pressure-volume analysis at 5 and 11 weeks, or at the occurrence of clinical RV failure symptoms necessitating termination. PAB resulted in RV failure in all rats, as defined by reduced cardiac output, RV stroke volume, increased RV end diastolic pressure and liver congestion as well as RV fibrosis, hypertrophy and reduced capillary density. Clinical RV failure necessitated termination in 5/12 PAB-VEH rats. Angiotensin II type 1-receptor expression in the RV was reduced in PAB rats indicating local RAAS activation. Treatment of PAB rats with Ep/Lo significantly lowered arterial pressures, but had no significant effect on RV function, remodeling or survival compared to PAB-VEH rats. CONCLUSIONS RAAS inhibition does not beneficially affect experimental RV failure due to chronic pressure load. This is of high clinical relevance, because it indicates that the RV response to RAAS inhibition might fundamentally differ from that of the LV.
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Affiliation(s)
- Marinus A Borgdorff
- Center for Congenital Heart Diseases, Pediatric Cardiology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, The Netherlands.
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