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Effects of injecting fibronectin and antifibronectin antibodies on cushion mesenchyme formation in the chick. An in vivo study.

During heart development in the chick some of the endocardial cells that cover the cushion areas leave the cushion endocardium, seed the underlying cardiac jelly, and are transformed into mesenchyme. Cushion mesenchymal (CM) cells migrate from the endocardium toward the myocardium using the cardiac jelly as substratum. Developing cushions have been microinjected with fibronectin (FN), antifibronectin antibodies (AbFN), and four synthetic peptide probes. Two of these peptides (P7 and P10) contained the sequence Arg-Gly-Asp-Ser (RGDS), while the other two (P15 and PColl) did not. Cushion area, individual cell area, cell density, cell orientation and a factor of form were evaluated in both experimental and control cushions. CM cell migration was inhibited by FN and AbFN, only partially inhibited by P10 and unaffected by P7. Cushions injected with P15 and PColl were unaffected. These results can be explained by steric modifications of the extracellular matrix, that may render cardiac jelly nonpermissive for CM cell migration, or by interaction of the substances injected at the endocardial cell surface. Migrating CM cells do not present any preferential orientation in any particular direction. CM cell migration seems to depend upon intrinsic migratory behaviour and the presence of FN at the CM cell surface. The enforcement of the direction of CM cell migration does not appear to rely upon matrix signals but be the result of randomly migrating cells becoming distributed more evenly in the matrix.

Amino Acid Sequence↗

Ultrastructural aspects of atrium development: demonstration of endocardial discontinuities and immunolabeling of atrial natriuretic factor in the Syrian hamster.

The endocardium ultrastructure of 13 embryonic day old hamsters was examined, especially in relationship with the atrial myocytes. The endothelial morphology was described, including the junctional attachments and their relationships with subjacent atrial myocytes. Characteristic atrial myocytes organelles were identified: myofibrils, atrial granules, lipidic inclusions, and polysomes. Immunogold labeling demonstrated that atrial natriuretic factor (ANF)-containing granules were already present in the differentiating cardiomyocytes, even before the myofibrils were completely organized. At this stage of development, while the endothelium was a narrow barrier between the blood and the cardiomyocytes, it displayed fenestrations, but also epithelial discontinuities. In addition it also contains immunoreactive-ANF products. In light of the current knowledge about ANF processing it was proposed that the endocardium lining could be an obligated passageway for transport or activating proANF into ANF before its release into the blood stream. In addition the endocardial gaps could suggest that, until about 13 to 14 days of fetal development, heart atrial tissue could be more susceptible to the effects of pathogenetic compounds than in a later state of development.

Animals↗

Localization of spectrin isoforms in the adult mouse heart.

The distribution of two isoforms of spectrin in the adult mouse heart was investigated by Western blotting and immunocytochemistry by use of monospecific antibodies to erythrocyte spectrin and nonerythroid brain spectrin (240/235). Western blotting revealed proteins analogous to both isoforms of alpha-spectrin in adult heart. Light-microscopic immunocytochemistry indicated that erythroid spectrin was distributed throughout the myocardium, with immunofluorescence localized to plasma membranes, Z-lines, and intercalated discs. Antibodies to brain spectrin (240/235) exhibited staining throughout the heart, with a generally diffuse distribution except for the prominent immunoreactivity associated with the intercalated discs. Nonerythroid spectrin immunofluorescence was detected in the endothelial cells of the endocardium and the mesothelial cell lining of the epicardium. Erythrocyte spectrin was not detected in the endocardium or the epicardium. The identification and localization of spectrin isoforms in the mammalian heart suggest the importance of spectrin proteins in the structural integrity and proper function of cardiac cells and tissues. This is the first demonstration of two different alpha-spectrin subunits in the mammalian heart.

Animals↗

The pattern of sarcomere lengths through the left ventricular free wall: differences between open and closed-chest rats.

Sarcomere lengths were measured with an optical microscope at five sites through the free wall of the open-chest rat left ventricle. After pentobarbital anesthesia the hearts were arrested with 5 mM cadmium chloride and 0.9% saline and fixed with formaldehyde solution. Serial sections (250 microns thick) were cut from endocardium to epicardium with a freezing microtome. Selected sections were sonified, mixed with a gelatin-water solution, and placed on a glass slide. There was a progressive increase in mean sarcomere lengths with increasing intraventricular pressures though the sarcomeres did not significantly exceed their optimum length. There was a distinct and statistically significant difference in the pattern of sarcomere lengths through the ventricular wall between our previous closed-chest study and the present open-chest study. In this open-chest animals, there was an almost linear pattern of increasing sarcomere lengths from endocardium to epicardium over the range of semiphysiologic diastolic intraventricular pressures (6, 12, and 24 cm H2O -- 0.59, 1.18, 2.35 kPa). These results appear to caution against extrapolations on ventricular function derived from open chest studies to the normal physiologic conditions.

Animals↗

Novel ultrasonic fusion imaging method based on cyclic variation in myocardial backscatter.

Quantitative ultrasonic tissue characterisation of the myocardium based on integrated backscatter (IB) has the potential of becoming an effective method for detecting and evaluating myocardial ischaemia. To facilitate IB-based clinical applications, a new imaging method has been developed that combines the anatomical information of a B-mode image with the contractile performance of a selected myocardial region. To produce such a fusion image, a region of interest (ROI) in a B-mode cardiac image was first selected by the user. Algorithms for detection of the endocardium and epicardium were developed, and the resulting mean distance between the computer-detected curve and the manually traced curve was 0.83mm for the endocardium and 0.58mm for the epicardium. The cyclic variation of IB (CVIB) of each myocardial tissue element within the ROI was then calculated over one cardiac cycle. Finally, a grey-scale B-mode image at the end of diastole was displayed as a still image, and the pixels representing the myocardial tissue in the ROI colour-coded according to the corresponding CVIB over the past heart cycle. Both the B-mode image and the colour-coded region were refreshed (up-dated) at the next end-of-diastole. Preliminary results from normal (CVIB= 10-12dB) and ischaemic (CVIB = 5-7 dB) canine hearts are presented that demonstrate the utility of this new imaging method.

Diagnosis, Computer-Assisted↗

Interstitial cells from the atrial and ventricular sides of the bovine mitral valve respond differently to denuding endocardial injury.

The mitral valve has atrial and ventricular sides, each lined by endocardial cells. The valve stroma contains alpha smooth muscle actin positive interstitial cells, collagen, glycosaminoglycans, and elastic tissue. To eliminate the effect of endocardium on wound repair in bovine mitral valve organ culture, the endocardium was removed from both sides of the valve. At 6 days, organ cultures of these preparations revealed surface cells on the ventricular side but not in the atrial side. Ventricular surface cells were negative for Factor VIII-related antigen, and positive for alpha smooth muscle actin. Immunoperoxidase staining for proliferating cell nuclear antigen/cyclin, a marker for cell proliferation, revealed a positive labeling index of (mean +/- standard deviation) 0.08 +/- 0.16% for interstitial cells from the atrial side and 0.14 +/- 0.19% for ventricular side interstitial cells in uncultured preparations (not significant), and 0.44 +/- 0.69% for atrial side interstitial cells and 2.25 +/- 1.64% for ventricular side interstitial cells in the cultured preparations (significant, P < 0.0006). The results suggest that in organ culture, interstitial cells from the ventricular side of the mitral valve respond to a denuding endocardial injury by proliferating and migrating onto the adjacent surface whereas interstitial cells from the atrial side do not. This difference in the response to injury of interstitial cells from the atrial and ventricular sides of the valve may reflect differences in phenotype or may be due to effects of extracellular matrix on interstitial cell behavior. The latter is possible because of differences in the extracellular matrix of the atrial and ventricular sides of the valve.

Actins↗

A comparative study of radiofrequency ablation in unipolar and bipolar fashion.

In this study we compared the effects of radiofrequency (RF) energy applied to the swine endocardium in a unipolar fashion and in a bipolar one with two different interelectrode distances (5 mm, 10 mm). RF energy (500 kHz) delivered to the swine endocardium was divided into eight categories: 100 J, 101-200 J, 201-300 J, 301-400 J, 401-500 J, 501-600 J, 601-1000 J, and > 1000 J. The results showed that when RF energy was applied in a bipolar fashion, the lesions involved the catheter/tissue interface and partly the interelectrode spacing, while in a unipolar fashion. They were found in the catheter/tissue interface only. At any energy level, there were no statistically significant differences in lesion depths among all the three fashions, and the lesion surface areas produced by the bipolar fashion (with 5 mm or 10 mm interelectrode spacing) were all greater than those by the unipolar fashion (P < 0.05). When the delivered energy was under 500 joules, a greater lesion surface area was found in 5 mm bipolar fashion than in 10mm bipolar fashion (P < 0.05), while energy exceeded 500 joules, the differences in the lesion surface areas were no longer significant between these two bipolar fashions.

Animals↗

Distribution of endoglin in early human development reveals high levels on endocardial cushion tissue mesenchyme during valve formation.

Endoglin is a component of the receptor complex for transforming growth factor (TGF)-beta1 and TGF-beta3. We analysed its expression by immunohistochemistry in human embryos at 4-8 weeks of gestation and in hearts ranging from 4-13 weeks old. We compared endoglin distribution with that of TGF-beta receptors type I (TbetaR-I), type II (TbetaR-II) and betaglycan. Endoglin was found on endothelial cells in all tissues examined, consistent with its expression in adult blood vessels. TbetaR-I, TbetaR-II and betaglycan were observed on most cell types and had an overall similar pattern of distribution. Endoglin was detected on the endocardium as early as 4 weeks, but was absent from myocardium. It was present at high levels on the endocardial cushion tissue mesenchyme from 5-8 weeks' gestation, during heart septation and valve formation, and subsequently decreased as the valves matured. Endoglin expression in heart extracts was confirmed by Western blot analysis. TbetaR-I, TbetaR-II and betaglycan were mostly found on cardiac myocytes, but were detectable at low levels on endocardium. They were expressed transiently on cushion mesenchyme, albeit at much lower levels than endoglin. All four components of the TGF-beta receptor complex were detected by RT-PCR in embryonic heart. Thus transient up-regulation of the components of the TGF-beta receptor complex, and particulartly of endoglin, is associated with heart septation and valve formation during early human development.

Activin Receptors, Type I↗

Reduction in ventricular endocardial and epicardial potentials during acute increments in left ventricular dimensions.

Unipolar potentials were recorded from the endocardium (Endo-Pot) and the epicardium (Epi-Pot) of the left and right ventricles of anesthetized open-chested dogs during acute changes in left ventricular dimension by blood transfusion. A pair of implanted ultrasonic crystals were used to detail changes in left ventricular (LV) anteroposterior diameter. When the diameter increased by an average of 11 per cent, LV Endo-Pot decreased by 28 per cent and LV Epi-Pot decreased by 15 per cent. Right ventricular Endo-Pot and Epi-Pot concurrently decreased by similar magnitude (-36 per cent). The relationship between potentials and LV diameter showed negative linearity over the ranges examined, and was not influenced by changes in hematocrit. No inverse relation between changes in Endo-Pot and Epi-Pot was observed. It is suggested that potentials when recorded directly from the endocardium or epicardium mainly reflect the electrical activity of the tissues in the immediate vicinity of the electrode. It is postulated that an increase in ventricular volume by producing stretching and thinning of ventricular walls, reduces the effective tissue mass represented in the electrode signal, thereby accounting for a reduction in both endo and epicardial potentials. Although the precise mechanisms of changes in ventricular potentials remains unclear, such changes, nevertheless, may indicate, in clinical circumstances, an acute shift in left ventricular volume.

Action Potentials↗

Effect of verapamil on conduction delay produced by myocardial ischemia and reperfusion.

Changes in conduction times induced by ischemia (delta CT) have been shown to be quantitatively related to genesis of spontaneous ischemic ventricular fibrillation (VF). We studied conduction delay encountered by premature impulses in epicardium and endocardium in both anterograde and retrograde directions during ischemia and reperfusion in eight control and in eight verapamil treated dogs. Acute myocardial ischemia was produced by single-stage ligation of left anterior descending artery below second diagonal initially, and 30 minutes later below first diagonal branch. In treated dogs, verapamil was given, 0.15 mg/kg intravenous bolus, immediately after first ligation and was followed by an infusion of 7.5 micrograms/kg/min. Thus post-treated segment and pretreated segment were obtained in the same animal. delta CT was compared between control and treated dogs in four myocardial zones: (1) normal, (2) ischemic including pre- and post-treated segments, (3) reperfused, and (4) border of reperfusion or ischemia. Results showed that ischemia-induced conduction delay was significantly less in verapamil treated dogs throughout period of ischemia and reperfusion, both in epicardium and endocardium. In addition, in the border of ischemia retrograded conduction showed significantly less depression during ischemia and reperfusion. The protective effect of verapamil was impressive both in pretreated and post-treated segments of ischemic myocardium. We conclude that verapamil offers significant protective action with regard to ischemia-induced conduction delay. Since delta CT is quantitatively related to ischemic VF, verapamil can be antiventricular fibrillatory in myocardial ischemia.

Animals↗

The relationship between ventricular arrhythmias and ischemia-induced conduction delay in closed-chest animals within 24 hours of myocardial infarction.

To investigate the myocardial conduction characteristics of premature impulses during the first 24 hours following coronary ligation and its relationship to late infarction ventricular arrhythmias, transmural electrodes were positioned in the normal and ischemic myocardium in nine dogs. Cardiac conduction in ischemic myocardium was delayed 15 minutes post coronary occlusion both in the epicardium and endocardium, both in the anterograde (base to apex) and retrograde (apex to base) direction, and was maintained at the same level throughout the experiment. Conduction across the border of ischemic myocardium from ischemic to the normal segment was also delayed, especially in the endocardium. Spontaneous ventricular arrhythmias recorded on Holter tapes showed significant increase in the number of premature ventricular complexes and ventricular tachyarrhythmias 9 hours after infarction. Thus our findings suggest that spontaneous arrhythmias occurring in the late phase of acute myocardial infarction (AMI) are independent of the ischemia-induced conduction delay and an alternate mechanism such as abnormal automaticity may be responsible for late ventricular arrhythmias.

Animals↗

Contrasting incidence, inducibility, and transmural sites of origin of ventricular arrhythmias during acute coronary occlusion and reperfusion.

The incidence, inducibility, and sites of origin of ventricular arrhythmias were studied in 16 open-chest dogs. The dogs were placed on cardiopulmonary bypass. Electrograms from ischemic endocardium and epicardium and normal epicardium were recorded with bipolar composite electrodes. Burst pacing was used to induce arrhythmias. Dogs were studied in the control state, 15 minutes after left anterior descending coronary artery occlusion, and during reperfusion performed after 20 minutes of occlusion. Ventricular fibrillation was seen more commonly (in 8 of 14 dogs) during reperfusion than during occlusion (in 4 of 13 dogs). Continuous fragmented electrical activity was first recorded on the ischemic zone epicardium in six of eight episodes during occlusion arrhythmias and on the endocardium in 25 of 33 episodes during reperfusion. These data may relate to the effects of varying degrees of ischemia and reperfusion on conduction characteristics of the respective layers.

Animals↗

Effect of myocyte necrosis on strength, strain, and stiffness of isolated myocardial strips.

Cardiac rupture accounts for 8% to 10% of patient deaths after acute myocardial infarction, suggesting that myocyte necrosis weakens the ventricular wall in the initial days after occlusion. To test this theory, permanent occlusion of the left anterior descending coronary artery was performed in dogs. Twenty-four hours after occlusion, the tensile strength, strain at rupture, and stiffness of necrotic epicardium, midmyocardium, endocardium, subepicardium, and the visceral pericardium (VP) were quantified and compared with those of noninfarcted cardiac tissue. The relationship between tensile strength, stiffness, and collagen content was also examined. These material properties did not differ between necrotic and normal myocardium in any of the layers, indicating that myocyte necrosis, per se, does not weaken the myocardium. In both necrotic and normal tissue, marked transmural heterogeneity was observed; tensile strength of the endo- and epicardium (21.3 +/- 3.3 and 21.3 +/- 3.2 gm/mm2) was significantly greater (p less than 0.01) than that of the midmyocardium (4.0 +/- 0.3 gm/mm2) and subepicardium (5.0 +/- 0.5 gm/mm2), whereas the VP was substantially stronger (greater than 100 gm/mm2) than any myocardial layer. Similar results were obtained for stiffness. In contrast, strain at rupture did not vary significantly among myocardial layers and ranged from 0.40 +/- 0.03 (VP) to 0.53 +/- 0.03 (endocardium). Both tensile strength and stiffness of the myocardial layers were found to correlate directly with their collagen content: the higher the hydroxyproline concentration, the greater the tensile strength (r = 0.83). These results support the concept that the collagen fibroskeleton is an important determinant of the material properties of the myocardium. As myocyte necrosis, per se, did not affect tensile strength, we tentatively conclude that cardiac rupture may be a consequence of a defect or weakness in the collagenous framework of the heart.

Animals↗

Postnatal endocardial fibroelastosis of the valve of the foramen ovale.

The valve of the foramen ovale of the heart changes at birth from a prenatal shunting device for the transseptal flow of systemic venous return to a postnatal active barrier to backflow of left atrial blood at higher pressure. To investigate the morphologic response to this functional change in the valve of the foramen ovale, we examined 200 hearts from embryos, fetuses and autopsy patients spanning over a millionfold range of heart weights (0.001 to 1,230 g). The relation of valve thickness to log heart weight was studied by a stepwise linear regression procedure that fitted the data to two linear regressions, one including observations made before birth and the other including observations made after birth. Analysis of variance tables demonstrated that the data are significantly better explained (p < 0.001) by two linear regressions that abruptly separate from one another at the time of birth than by a single linear regression. Histologic study showed that the prenatal valve consists of a thin myocardial layer with delicate endocardium. The postnatal thickening of the valve tissue occurs mainly by fibroelastotic thickening of the endocardium. The endocardial fibroelastosis of the valve develops after it closes and becomes a component of the left atrial wall. The observations support the concept that fibroelastosis is a nonspecific response of the lining of the cardiovascular system to increased mural tension.

Adolescent↗

Regional myocardial lidocaine concentration following continuous intravenous infusion early and later after myocardial infarction.

The regional concentration of lidocaine using a double constant infusion technique (250 micrograms/kg/min x 15 minutes followed by 35 micrograms/kg/mg/min x 120 minutes) was studied immediately (2 hours) in seven dogs and 24 hours (six dogs) after myocardial infarction. Tissue levels were determined by gas chromatography and related to regional myocardial blood flow as determined by the radioactive microsphere technique in multiple samples. At 2 hours after infarction a significantly higher lidocaine concentration (4.1 +/- 0.42 micrograms/g) was found in zones with greatly reduced blood flow (regional myocardial blood flow less than 0.2 ml/min per g) when compared with that (2.6 +/- 0.19 micrograms/g) in zones with normal blood flow (regional myocardial blood flow greater than 0.8 ml/min per g) (p less than 0.01). In contrast, in the 24 hour model the opposite situation was observed. Although the concentration of lidocaine in the infarct zone was substantial, a significant decline in lidocaine tissue concentration was found in the zones of lowest blood flow (regional myocardial blood flow less than 0.2 ml/min per g) when compared with that in normal zones (1.76 +/- 0.21 versus 3.38 +/- 0.21 micrograms/g, p less than 0.001). In addition, no significant differences in lidocaine concentrations were found between endocardium and epicardium in any of the groups other than those related to regional myocardial blood flow. Thus, with the double constant infusion technique, lidocaine reached normal and ischemic myocardium in concentrations equivalent to therapeutic plasma concentrations, even in lower infarct blood flow zones, with no significant differences between endocardium and epicardium. Of perhaps greater significance, the age of the ischemic insult is an important determinant of lidocaine tissue distribution in infarcted myocardium.

Animals↗

Fibronectin distribution during early chick embryo heart development.

The distribution of fibronectin (FN) during early stages of chick embryo heart development has been studied by indirect immunofluorescence methods. The cardiac extracellular matrix (cardiac jelly) was almost devoid of FN-positive material throughout the period studied (stages 8-18). Intensely extracellular fluorescent material was only demonstrated at the heart midline and in the dorsal mesocardium. Fluorescence associated with the basal surface of the myocardium was demonstrated first at the time of fusion of the two heart tubes. While the heart remains attached to the embryonic trunk by the dorsal mesocardium, two different myocardial basal zones can be distinguished according to the intensity of fluorescence: an intensely stained dorsal zone and a much less fluorescent ventral zone. The endocardium did not present a strongly fluorescent basement membrane until stage 13. The intensity of fluorescence of the endocardial basal surface varied according to the rostrocaudal levels of the heart and also to the development stage of the embryo. The levels of fluorescence increased in myocardium and endocardium at the onset of trabeculation but decreased as trabeculation was completed. The quantitative and qualitative variations of FN distribution have been associated with a number of developmental events.

Animals↗

Endocardial localization and characterization of natriuretic peptide binding sites in human fetal and adult heart.

Specific, high affinity binding sites for 125I-human-alpha-atrial natriuretic peptide-(1-28)) (125I-hANP-(1-28)) were identified in human fetal and adult heart and the binding characterized using quantitative in vitro autoradiography. Binding sites were localized to atrial and ventricular endocardium, aorta, pulmonary arteries and epicardial mesothelium. Kinetic studies indicated a Kd value of 32 pM for ventricular endocardial 125I-hANP-(1-28) binding. The binding was completely inhibited by an excess (1 microM) of unlabelled hANP-(1-28), human brain natriuretic peptide-(1-32) (hBNP-(1-32)) and by the 'clearance receptor' specific ring-deleted analogue, C-ANP-(4-23). Competitive inhibition studies indicated a relative inhibitory potency for hBNP-(1-32) and C-ANP-(4-23) of 6% and 3% respectively. The data suggest that a distinct natriuretic peptide receptor subtype is expressed in the endocardium and in addition to a possible clearance function, may represent a site for feedback regulation and peptide interaction.

Analysis of Variance↗

Geometric changes allow normal ejection fraction despite depressed myocardial shortening in hypertensive left ventricular hypertrophy.

OBJECTIVES: This study of hypertensive left ventricular hypertrophy 1) assessed myocardial shortening in both the circumferential and long-axis planes, and 2) investigated the relation between geometry and systolic function. BACKGROUND: In hypertensive left ventricular hypertrophy, whole-heart studies have suggested normal systolic function on the basis of ejection fraction-systolic stress relations. By contrast, isolated muscle data show that contractility is depressed. It occurred to use that this discrepancy could be related to geometric factors (relative wall thickness). METHODS: We studied 43 patients with hypertensive left ventricular hypertrophy and normal ejection fraction (mean +/- SD 69 +/- 13%) and 50 clinically normal subjects. By echocardiography, percent myocardial shortening was measured in two orthogonal planes; circumferential shortening was measured at the endocardium and at the midwall, and long-axis shortening was derived from mitral annular motion (apical four-chamber view). Circumferential shortening was related to end-systolic circumferential stress and long-axis shortening to meridional stress. RESULTS: Endocardial circumferential shortening was higher than normal (42 +/- 10% vs. 37 +/- 5%, p < 0.01) and midwall circumferential shortening lower than normal in the left ventricular hypertrophy group (18 +/- 3% vs. 21 +/- 3%, p < 0.01). Differences between endocardial and midwall circumferential shortening are directly related to differences in relative wall thickness. Long-axis shortening was also depressed in the left ventricular hypertrophy group (18 +/- 6% in the left ventricular hypertrophy group, 21 +/- 5% in control subjects, p < 0.05). Midwall circumferential shortening and end-systolic circumferential stress relations in the normal group showed the expected inverse relation; those for approximately 33% of the left ventricular hypertrophy group were > 2 SD of normal relations, indicating depressed myocardial function. There was no significant relation between long-axis shortening and meridional stress, indicating that factors other than afterload influence shortening in this plane. CONCLUSIONS: High relative wall thickness allows preserved ejection fraction and normal circumferential shortening at the endocardium despite depressed myocardial shortening in two orthogonal planes.

Adult↗