High-frequency speckle tracking echocardiography in the assessment of left ventricular function and remodeling after murine myocardial infarction

Bhan, Amit; Sirker, Alexander; Zhang, Juqian; Protti, Andrea; Catibog, Norman; Driver, William; Botnar, Rene; Monaghan, Mark; Shah, Ajay M.

doi:10.1152/ajpheart.00553.2013

Cited by 94 publications

(105 citation statements)

References 36 publications

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“…This can be addressed with the use of the recently developed high-frequency echocardiographic systems, which represent a new platform for ultrasound-based assessment in humans with high temporal and spatial resolutions. 52 It has been recently suggested that blood motion inside the LV is characterized by diastolic vortex formation ( Figure 6B and 6C) that accompanies the redirection of jet flow toward the LV outflow tract and has a crucial role in fluid dynamics and mechanical efficiency of LV contraction. 53 LV vortex formation is closely related to the sequence of LVT and untwist, thus, warranting future studies that focus on these relationships in health and disease.…”

Section: Summary and Future Directionsmentioning

confidence: 93%

Left Ventricular Twist and Torsion

Omar

Vallabhajosyula

Sengupta

2015

Circ: Cardiovascular Imaging

100

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A 52-year-old white man visited his physician because he started experiencing shortness of breath on walking short distances at ground level. He had smoked half a packet of cigarettes daily for 40 years. Physical examination revealed a blood pressure of 147/95 mm Hg. Chest examination and chest x-ray were unremarkable, and ECG showed left atrial abnormality. The patient had normal serum electrolytes, blood sugar, and kidney function tests. A stress echocardiogram was ordered to exclude potential coronary artery disease. His resting echocardiography showed an ejection fraction (EF) of 60%, normal septal and posterior wall thickness, and mild diastolic dysfunction (septal early diastolic mitral annular velocity [e′] of 7 cm/s, early diastolic [E wave] to late diastolic [A wave] transmitral Doppler flow velocity ratio [E/A] of 1.4, E-wave deceleration time of 210 ms, E/e′ ratio of 9, and left atrial volume index of 44 mL/m 2 ; Figure 1A). There were no resting segmental wall motion abnormalities suggestive of ischemia. The patient exercised on a treadmill using Bruce protocol for 4 minutes and 43 s, and achieved 6.6 metabolic equivalent of task and maximum heart rate of 148 bpm (88% of his maximum age predicted heart rate). At peak exercise, the patient developed severe dyspnea and his blood pressure was 213/90 mm Hg. Post exercise echocardiography was acquired within 1 minute of exercise termination and showed EF of 69% and no segmental wall motion abnormalities, with Doppler recordings obtained at recovering heart rate of 125 bpm; showing a septal e′ velocity of 7.3 cm/s, E/A of 1.9, E-wave deceleration time of 110 ms, and E/e′ of 13.7, left atrial volume index of 35 mL/m 2 ( Figure 1B). Ten minutes into the recovery period, the blood pressure returned to basal level (145/80 mm Hg). Compared with resting levels, the increased E/A ratio, shortened E-wave deceleration time and relatively increased E/e′ ratio suggested post exercise worsening of diastolic function with elevation of left ventricular (LV) filling pressures. To investigate the mechanistic basis of diastolic dysfunction in this patient, LV deformation was assessed offline using speckletracking echocardiography (STE). Besides characterizing the longitudinal and circumferential shortening, and radial thickening, the LV rotational deformation, that resembles the wringing of a towel, was also measured (Figures 2 and 3). This wringing deformation, also referred to as LV twist (LVT) and the subsequent recoil that occurs in diastole, referred to as untwist, were abnormal in this patient (Figure 4). At rest, the patient had mild diastolic dysfunction, which was associated with a higher than normal LVT and untwist values, compared with the published age-related normal values, 1,2 and low global longitudinal strain. At peak exercise, there was a significant worsening of the patient's diastolic parameters, which was associated with worsening untwist values and further reduction of global longitudinal strain, whereas LVT remained same in magnitude. The following ...

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Section: Summary and Future Directionsmentioning

confidence: 93%

Left Ventricular Twist and Torsion

Omar

Vallabhajosyula

Sengupta

2015

Circ: Cardiovascular Imaging

100

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“…Nevertheless, echocardiography in the present study was only performed with a short-axis view. A parasternal long-axis view with measurements of the area and volume change over the entire LV following MI would further enable the quantitative assessment and interpretation of regional and global cardiac function and elasticity in the remodeling murine hearts [45]. Putative mechanisms involved in FGF2/IL-10 coacervate mediated ischemic heart repair have been summarized with a schematic depiction in Supplemental Figure 3.…”

Section: Discussionmentioning

confidence: 99%

Controlled dual delivery of fibroblast growth factor-2 and Interleukin-10 by heparin-based coacervate synergistically enhances ischemic heart repair

et al. 2015

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Myocardial infarction (MI) causes myocardial necrosis, triggers chronic inflammatory responses, and leads to pathological remodeling. Controlled delivery of a combination of angiogenic and immunoregulatory proteins may be a promising therapeutic approach for MI. We investigated the bioactivity and therapeutic potential of an injectable, heparin-based coacervate co-delivering an angiogenic factor, fibroblast growth factor-2 (FGF2), and an anti-inflammatory cytokine, Interleukin-10 (IL-10) in a spatially and temporally controlled manner. Coacervate delivery of FGF2 and IL-10 preserved their bioactivities on cardiac stromal cell proliferation in vitro. Upon intramyocardial injection into a mouse MI model, echocardiography revealed that FGF2/IL-10 coacervate treated groups showed significantly improved long-term LV contractile function and ameliorated LV dilatation. FGF2/IL-10 coacervate substantially augmented LV myocardial elasticity. Additionally, FGF2/IL-10 coacervate notably enhanced long-term revascularization, especially at the infarct area. In addition, coacervate loaded with 500 ng FGF2 and 500 ng IL-10 significantly reduced LV fibrosis, considerably preserved infarct wall thickness, and markedly inhibited chronic inflammation at the infarct area. These results indicate that FGF2/IL-10 coacervate has notably greater therapeutic potential than coacervate containing only FGF2. Overall, our data suggest therapeutically synergistic effects of FGF-2/IL-10 coacervate, particularly coacervate with FGF2 and 500 ng IL-10, for the treatment of ischemic heart disease.

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“…Strain is an early and sensitive indicator of LV global and regional systolic dysfunction, [10, 23, 24] and one goal of this study was to assess whether prior studies overlooked early indicators of loss of function in the Rad −/− heart. The Rad −/− heart exhibits increased fibrosis [2, 3, 8] yet improved EF.…”

Section: Discussionmentioning

confidence: 99%

Rad-deletion Phenocopies Tonic Sympathetic Stimulation of the Heart

Levitan

Manning

Withers

et al. 2016

J. of Cardiovasc. Trans. Res.

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Sympathetic stimulation modulates L-type calcium channel (LTCC) gating to contribute to increased systolic heart function. Rad is a monomeric G-protein that interacts with LTCC. Genetic deletion of Rad (Rad−/−) renders LTCC in a sympathomimetic state. The study goal was to use a clinically inspired pharmacological stress echocardiography test, including analysis of global strain, to determine whether Rad−/− confers tonic positive inotropic heart function. Sarcomere dynamics and strain showed partial parallel isoproterenol (ISO) responsiveness for wild-type (WT) and for Rad−/−. Rad−/− basal inotropy was elevated compared to WT but was less responsiveness to ISO. Rad protein levels were lower in human patients with end-stage non-ischemic heart failure. These results show that Rad reduction provides a stable inotropic response rooted in sarcomere level function. Thus, reduced Rad levels in heart failure patients may be a compensatory response to need for increased output in the setting of HF. Rad deletion suggests a future therapeutic direction for inotropic support.

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High-frequency speckle tracking echocardiography in the assessment of left ventricular function and remodeling after murine myocardial infarction

Cited by 94 publications

References 36 publications

Left Ventricular Twist and Torsion

Left Ventricular Twist and Torsion

Controlled dual delivery of fibroblast growth factor-2 and Interleukin-10 by heparin-based coacervate synergistically enhances ischemic heart repair

Rad-deletion Phenocopies Tonic Sympathetic Stimulation of the Heart

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