Influence of Angiotensin-Converting Enzyme I/D Gene Polymorphism on the Right Ventricular Myocardial Performance Index in Patients With a First Acute Anterior Myocardial Infarction

Öztürk, Önder; Ülgen, Mehmet Sıddık; Tekeş, Selahattin; Öztürk, Ünal; Toprak, Nizamettin

doi:10.1253/circj.69.211

Cited by 13 publications

(17 citation statements)

References 23 publications

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“…In addition, the Tei index closely correlates with patient prognosis, 2-5,13 hemodynamics, [14][15][16] and others. [17][18][19][20][21][22] The present study confirmed these previous findings and further demonstrated the usefulness of the Tei index in the UM-X7.1 hamster model of CHF.…”

Section: Discussionsupporting

confidence: 88%

Prediction of Prognosis in the UM-X7.1 Hamster Model of Congestive Heart Failure Using the Tei Index

Shiro

Ikeda

et al. 2005

Circ J

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ardiac function is difficult to evaluate in small animal models of congestive heart failure (CHF). The Tei index, defined as the sum of isovolume contraction time (ICT) and isovolume relaxation time (IRT) divided by ejection time (ET), can express both systolic and diastolic function. Therefore, global left ventricular (LV) function can be determined and the prognosis of patients with cardiac dysfunction or CHF can be predicted. [1][2][3][4][5] Because of its simplicity, the Tei index can be applicable to even small animal models of CHF. 6 However, the ability of the Tei index to predict the outcome in a small animal model of CHF has not been fully investigated. Therefore, we postulated that the Tei index could also predict the prognosis of animal models of CHF. The present study investigates the relationship between the Tei index and survival in an animal model of CHF. Methods Animal ModelThe study included 48 male UM-X7.1 hamsters at an average age of 19.7±0.4 weeks. Heart function is normal in this model at 15 weeks of age, but cardiac dysfunction be- Circulation Journal Vol.69, August 2005comes significant without overt CHF at 20 weeks. CHF becomes overt at 27 weeks, and cardiac death occurs between 27 and 44 weeks. 7-9 Therefore, these animals have significant cardiac dysfunction but without obvious CHF at 20 weeks of age. The institutional committee of Kagoshima University approved the study protocol. Doppler EchocardiographyStandard 2-dimensional and Doppler echocardiography Background Cardiac function is difficult to evaluate in small animal models of heart disease. The Doppler Tei index is a simple and non-invasive measure that can express global cardiac function even in small animal models of congestive heart failure. However, its ability to predict prognosis has not been evaluated. Methods and ResultsWe tested the hypothesis that cardiac functional indices, such as the Tei index, can predict the prognosis of hamsters with cardiac dysfunction. The Tei index, defined as the sum of the isovolume contraction and relaxation time divided by ejection time, and the percent fractional shortening of the left ventricle was measured in 48 anesthetized male hamsters (19.7±0.4 weeks old) with cardiac dysfunction (UM-X7.1), using Doppler and 2-dimensional echocardiography. The hamsters were separated into 2 groups based on the median Tei index (0.50) and % fractional shortening (FS) (21%). Kaplan-Meier analysis determined the survival rates of the groups. Both the Tei index and %FS enabled significant distinction of better and poorer survival (p<0.01), and the survival curves were less overlapped when the animals were separated according to the Tei index. Conclusion The Tei index can predict prognosis in a small animal model of heart failure. (Circ J 2005; 69: 991 -993)

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Section: Discussionsupporting

confidence: 88%

Prediction of Prognosis in the UM-X7.1 Hamster Model of Congestive Heart Failure Using the Tei Index

Shiro

Ikeda

et al. 2005

Circ J

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“…The results given in the present paper correspond to the clinical study by Moller et al, which demonstrated that an abnormal RV Tei index was present in 80% of patients with MI (13). Ozturk et al also found a significant increase in this index after anterior ST-elevation MI (14). In that study, the alteration of RV Tei index was more pronounced in patients with anterior MI.…”

Section: Discussionmentioning

confidence: 52%

Right Ventricular Involvement in either Anterior or Inferior Myocardial Infarction

Abtahi¹,

Farmanesh²,

Moaref³

et al. 2016

Int Cardiovasc Res J

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A B S T R A C T Background:Unlike left ventricular function, less attention has been paid to Right Ventricular (RV) function after Myocardial Infarction (MI). Objectives: The current study aimed to compare RV function in patients with inferior and anterior MI. Patients and Methods: During the study period, 60 patients consecutively presented to the Emergency Department with chest pain were divided into two groups based on their electrocardiographic findings. Accordingly, 25 patients had inferior MI (IMI group) and 35 ones had anterior MI (AMI group). Echocardiography was performed 48 hours after starting the standard therapy. Conventional echocardiographic parameters and Tissue Doppler Imaging (TDI) measurements were acquired from the standard views. Student t-test and the chi-square test were respectively used for comparisons of the normally distributed continuous and categorical variables in the two groups. Besides, P < 0.05 was considered to be statistically significant. Results:The ratio of early diastolic velocity of the tricuspid flow to early diastolic velocity of the tricuspid annulus in the lateral side (E/E') was significantly higher in the AMI group compared to the IMI group (6.73 ± 1.64 vs. 5.68 ± 1.32, P = 0.01). In addition, abnormal E/E' ratio of the tricuspid valve was present in 27 (77%) and 14 (56%) patients in the anterior and inferior MI groups, respectively. Besides, the RV Tei index was significantly higher in the AMI group compared to the IMI group (0.65 ± 0.11 vs. 0.58 ± 0.13, P = 0.02). Overall, 28 patients (80%) with anterior infarction and 12 patients (48%) with inferior infarction had abnormal RV Tei index. However, no significant difference was found between the two groups regarding other variables. Conclusions: RV dysfunction commonly occurs after a first acute ST-elevation MI. However, RV functional changes are more pronounced in patients with anterior MI.

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“…16 In a previous study, we reported higher LVMPI and RVMPI in patients with the DD genotype than in patients with the ID genotype of the ACE gene after anterior AMI. 17 Although there have been several association studies of the polymorphism of AT1R (A/C1166) in clinical endpoints, such as MI, 18 hypertension, 11 aortic stiffness, 19 and LV mass, 20 AMI has not been studied before.…”

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confidence: 99%

Association Between A/C1166 Gene Polymorphism of the Angiotensin II Type 1 Receptor and Biventricular Functions in Patients With Acute Myocardial Infarction

Ülgen

Öztürk

Yazıcı

et al. 2006

Circ J

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cute myocardial infarction (AMI) is characterized by loss of contractile tissue and changes in ventricular geometry. 1 The presence of congestive heart failure or left ventricular (LV) systolic dysfunction is probably the most important risk factor in patients with AMI. 2 The development of right ventricular (RV) dysfunction has been reported following LV myocardial infarction (MI), 3,4 and is also associated with increased risk of shock, arrhythmia, and death. 5,6 After MI, the process of LV remodeling begins rapidly, usually within the first few hours after an infarct, and continues to progress. 7 Furthermore, it is known that the renin -angiotensin -aldosterone system (RAS) and angiotensin-converting enzyme (ACE) activity contribute to the remodeling process. 8 Angiotensin II (ATII) is the final effector of the RAS. It is a vasoactive peptide and leads to growth promotion, fibroblast proliferation, and the most potent vasoactive and salt-retaining effector peptide of the RAS, which is involved in blood pressure homeostasis and cardiovascular pathophysiology. Two subtypes of cell surface receptors, ATII type 1 receptor (AT1R) and ATII type 2 receptor Circulation Journal Vol. 70, October 2006 (AT2R), have been identified. Most of the actions of ATII are mediated by AT1, which is particularly prominent in the myocardium. 9,10 Although a number of polymorphisms of the AT1R gene have been identified, one of the most widely studied is an A-C substitution at position 1166 (A/C1166). 11 Two-dimensional (D) and Doppler echocardiography is a reliable tool for the diagnosis of systolic and diastolic dysfunction. The Doppler echocardiographic myocardial performance index (MPI) called the "Tei index", combining time intervals of LV contraction and relaxation, has been shown to be a powerful predictor of death and congestive heart failure after MI. 12,13 This index can be obtained easily, is reproducible and independent of the ventricular geometry, and has been shown to have potential for clinical application in the assessment of overall cardiac function in various disorders. 14 Poulsen et al recently reported that the LVMPI was a powerful predictor of death or congestive heart failure after MI, 15 and Moller et al showed that the RVMPI was increased in the acute phase of MI and was significantly correlated with indices of RV systolic dysfunction. 16 In a previous study, we reported higher LVMPI and RVMPI in patients with the DD genotype than in patients with the ID genotype of the ACE gene after anterior AMI. 17 Although there have been several association studies of the polymorphism of AT1R (A/C1166) in clinical endpoints, such as MI, 18 hypertension, 11 aortic stiffness, 19 and LV mass, 20 to our knowledge the relationship between AT1R polymorphism and biventricular function in anterior Methods and ResultsThe study group comprised 132 consecutive patients who were admitted to the coronary care unit with their first acute anterior MI. Systolic and diastolic diameters, volumes, inflow properties, ejection fraction an...

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Influence of Angiotensin-Converting Enzyme I/D Gene Polymorphism on the Right Ventricular Myocardial Performance Index in Patients With a First Acute Anterior Myocardial Infarction

Cited by 13 publications

References 23 publications

Prediction of Prognosis in the UM-X7.1 Hamster Model of Congestive Heart Failure Using the Tei Index

Prediction of Prognosis in the UM-X7.1 Hamster Model of Congestive Heart Failure Using the Tei Index

Right Ventricular Involvement in either Anterior or Inferior Myocardial Infarction

Association Between A/C1166 Gene Polymorphism of the Angiotensin II Type 1 Receptor and Biventricular Functions in Patients With Acute Myocardial Infarction

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