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Echocardiographic assessment of cardiac function in conscious and anesthetized mice.

Using a high-frequency linear transducer (15L8), we studied 1) the feasibility of performing echocardiography in nonanesthetized mice compared with mice given pentobarbital sodium (Pento) or a mixture of ketamine and xylazine and 2) the feasibility of echocardiographic evaluation of left ventricular (LV) hypertrophy, dilatation, and function in mice with two-kidney, one-clip hypertension or myocardial infarction (MI). Heart rate (HR) in awake mice was 658 +/- 9 beats/min; Pento and ketamine plus xylazine reduced HR to 377 +/- 11 and 293 +/- 19 beats/min, respectively, associated with a significant decrease in shortening fraction (SF), ejection fraction (EF), and cardiac output (CO) and an increase in LV end-diastolic (LVEDD) and end-systolic dimensions (LVESD). Mice with 4 wk of two-kidney, one-clip hypertension had increased LV mass (15.62 +/- 0. 62 vs. 22.17 +/- 1.79 mg) without altered LV dimensions, SF, EF, or CO. Mice studied 4 wk post-MI exhibited obvious LV dilatation and systolic dysfunction, as evidenced by increased LVEDD and LVESD and decreased SF, EF, and CO. Our findings clearly show the adverse impact of anesthesia on basal cardiac function and the difficulty in interpreting data obtained from anesthetized mice. We believe this is the first study to demonstrate the feasibility of using echocardiography to assess cardiovascular function in the nonanesthetized mouse.

Adjuvants, Anesthesia↗

Enhanced secretion of cardiac hepatocyte growth factor from an infarct region is associated with less severe ventricular enlargement and improved cardiac function.

OBJECTIVES: We hypothesized that the hepatocyte growth factor (HGF) may play a cardioprotective role in human myocardial infarction (MI). BACKGROUND: The HGF is a novel, multifunctional growth factor implicated in wound healing, angiogenesis and promotion of cell survival. Recent animal studies have demonstrated the existence of an HGF system in the heart, where it is activated in response to myocardial ischemia and reperfusion. METHODS: We studied 40 patients with acute myocardial infarction (AMI), who underwent coronary reperfusion therapy upon admission. Approximately four weeks later, left ventricular (LV) catheterization was repeated to determine the LV ejection fraction (EF), end-diastolic volume index (EDVI) and pressure (EDP). The levels of HGF and brain natriuretic peptide (BNP) were measured by collecting blood samples from cardiac veins draining the infarcted region (MI region) and those draining the noninfarcted region (non-MI region). The ratio of the HGF level in the MI region to that in the non-MI region (= MI/non-MI ratio) was calculated in each patient as an index of the MI-related HGF secretion. The MI/non-MI ratio for BNP was also calculated. RESULTS: The MI/non-MI ratio for HGF correlated inversely with LVEDP (r = -0.644, p < 0.0001) and LVEDVI (r = -0.843, p < 0.0001) and positively with LVEF (r = 0.763, p < 0.0001). These correlations were completely opposite in direction from those for BNP and LVEDP (r = 0.678, p < 0.0001), LVEDVI (r = 0.783, p < 0.0001) and LVEF (r = -0.805, p < 0.0001). These findings indicate that cardiac HGF acts in contrast to BNP, a biochemical marker for the development of LV remodeling. CONCLUSIONS: Enhanced secretion of cardiac HGF from the MI region is associated with an attenuation of ventricular enlargement and an improvement in cardiac function. The HGF system may modulate the process of ventricular remodeling and thus have important clinical implications.

Biomarkers↗

Salutary effects of androstenediol on cardiac function and splanchnic perfusion after trauma-hemorrhage.

Recent studies have shown that dehydroepiandrosterone (DHEA) administration after trauma-hemorrhage (T-H) improves cardiovascular function and decreases cytokine production in male animals. Although androstenediol, one of the metabolites of DHEA, is reported to have estrogen-like activity, it remains unknown whether androstenediol per se has any salutary effects on cytokines and cardiovascular function after T-H. To examine this effect, male Sprague-Dawley rats underwent laparotomy and were bled to and maintained at a mean arterial blood pressure of 35-40 mmHg for approximately 90 min. The animals were resuscitated with four times the volume of maximal bleedout volume in the form of Ringer lactate. Androstenediol (1 mg/kg body wt i.v.) or vehicle was administered at the end of resuscitation. Twenty-four hours after resuscitation, cardiac function and organ blood flow were measured by using (85)Sr-microspheres. Circulating levels of nitrate/nitrite and IL-6 were also determined. Cardiovascular function and organ blood flow were significantly depressed after T-H. However, these parameters were restored by androstenediol treatment. The elevated plasma IL-6 levels after T-H were also lowered by androstenediol treatment. In contrast, plasma levels of nitrate/nitrite were the highest in the androstenediol-treated T-H animals. Because androstenediol administration after T-H decreases cytokine production and improves cardiovascular function, this agent appears to be a novel and useful adjunct for restoring the depressed cardiovascular function and for cytokine production in males after adverse circulatory conditions.

Anabolic Agents↗

Protective effects of panaxadiol saponins on cardiac functions in burned rats.

AIM: To study the effects of panaxadiol saponins (PDS) on burn rat heart functions and try to find its mechanisms. METHODS: A 35% skin-full-thickness burn was produced by using napalm in Wistar rats. PDS 30 mg kg-1 was injected i.p. to rats immediately after burn and repeated 2 h before examination. Using the isolated perfused working heart and biochemistry methods, heart rate (HR), cardiac output (CO), coronary flow (CF), left ventricular pressure (LVP), aortic pressure (AP), +/- dp/dtmax, and content of malondialdehyde (MDA), activity of superoxide dismutase (SOD) in ventricular myocardium homogenate were examined 8 h after burn. RESULTS: After burn, HR, CO, CF, LVP, AP, +dp/dtmax, -dp/dtmax, and SOD activity decreased from 206 bpm, 92 mL min-1 g-1, 26 mL min-1 g-1, 7 kPa, 5.9 kPa, 149 kPa s-1, 73 kPa s-1, 2.9 NU/mg protein to 162 bpm, 72 mL min-1 g-1, 14 mL min-1 g-1, 4 kPa, 2.2 kPa, 77 kPa s-1, 44 kPa s-1, 1.7 NU/mg protein, respectively, and MDA content raised from 0.77 nmol/mg protein to 1.35 nmol/mg protein (P all < 0.05). But in PDS-treated group, above decreased or increased dates restored to 202 bpm, 91 mL min-1 g-1, 25 mL min-1 g-1, 6 kPa, 4.1 kPa, 112 kPa s-1, 62 kPa s-1, 2.8 NU/mg protein, 0.91 nmol/mg protein, respectively (P all < 0.05 vs burn). CONCLUSION: PDS exerts definite protective effects on the cardiac functions after burn injury possibly through its enhancement of SOD activity and the reduction of both the levels of free radicals and lipid peroxides (LPO) of the myocardium.

Animals↗

Determinants of left ventricular filling dynamics: alteration in the Doppler-derived transmitral filling profile with progressive impairment of cardiac function in a dog preparation.

To clarify the factors determining transmitral filling, left ventricular and atrial pressures (LVP and LAP) and Doppler-derived diastolic indices were analysed in six anaesthetized dogs at various right atrial pacing rates during dextran infusion. The relationship of the late to early diastolic peak velocity ratio (A/E ratio) to end-diastolic LVP (LVEDP) showed a quadratic curve concave to the LVEDP axis in five animals (r2 = 0.320-0.588). An elevation in LVEDP up to 25 mmHg accompanied an increase in A/E ratio (ascending limb), and further LVEDP elevation caused its inverse decline (descending limb). Multiple regression analysis indicated that A/E ratio correlated positively with maximal LVP, a-wave LAP and heart rate, and negatively with v-wave LAP in both limbs. The time constant of isovolumic LVP decline, which was prolonged as LVEDP was elevated, was a positive correlate of A/E ratio in the ascending limb, but lost its influence on A/E ratio in the descending limb. An elevation in v-wave LAP must have masked the expected effect of left ventricular relaxation abnormality on A/E ratio in this limb. Thus, the transmitral filling profile did not alter unidirectionally, but returned to that seen before volume loading, with a simultaneous progressive impairment of cardiac function.

Animals↗

Enhancement of cardiac function and suppression of heart failure progression by inhibition of protein phosphatase 1.

Abnormal calcium cycling, characteristic of experimental and human heart failure, is associated with impaired sarcoplasmic reticulum calcium uptake activity. This reflects decreases in the cAMP-pathway signaling and increases in type 1 phosphatase activity. The increased protein phosphatase 1 activity is partially due to dephosphorylation and inactivation of its inhibitor-1, promoting dephosphorylation of phospholamban and inhibition of the sarcoplasmic reticulum calcium-pump. Indeed, cardiac-specific expression of a constitutively active inhibitor-1 results in selective enhancement of phospholamban phosphorylation and augmented cardiac contractility at the cellular and intact animal levels. Furthermore, the beta-adrenergic response is enhanced in the transgenic hearts compared with wild types. On aortic constriction, the hypercontractile cardiac function is maintained, hypertrophy is attenuated and there is no decompensation in the transgenics compared with wild-type controls. Notably, acute adenoviral gene delivery of the active inhibitor-1, completely restores function and partially reverses remodeling, including normalization of the hyperactivated p38, in the setting of pre-existing heart failure. Thus, the inhibitor 1 of the type 1 phosphatase may represent an attractive new therapeutic target.

Animals↗

Predictive value of microvolt T-wave alternans for sudden cardiac death in patients with preserved cardiac function after acute myocardial infarction: results of a collaborative cohort study.

OBJECTIVES: We conducted a collaborative cohort study to evaluate the predictive power of microvolt T-wave alternans (TWA) in patients with preserved left ventricular ejection fraction (LVEF) after myocardial infarction (MI). BACKGROUND: There is little information available about the prognostic value of risk stratification markers in this population. Although these patients have a relatively good prognosis, identifying high-risk patients is important in clinical practice. METHODS: This study enrolled 1,041 post-MI patients with an LVEF > or =40% (average 55 +/- 10%). Microvolt TWA testing was performed 48 +/- 66 days after acute MI, and 10 other risk variables were also evaluated. The end points were prospectively defined as sudden cardiac death or life-threatening arrhythmic events. RESULTS: During a follow-up of 32 +/- 14 months, 38 patients (3.7%) died of nonarrhythmic causes and were not considered for analysis. Of the 1,003 evaluable patients, 18 (1.8%) reached an end point. Microvolt TWA was positive in 169 patients (17%), negative in 747 (74%), and indeterminate in 87 (9%). A positive microvolt TWA test, nonsustained ventricular tachycardia, and ventricular late potentials were predictors of events, and percutaneous coronary intervention decreased the risk rate. On multivariate analysis, a positive microvolt TWA test was the most significant predictor, with a hazard ratio of 19.7 (p < 0.0001). This marker had the highest sensitivity and negative predictive value for events. CONCLUSIONS: In patients with preserved cardiac function, the incidence of indeterminate results of microvolt TWA is low, and a positive test result is associated with arrhythmic events. Microvolt TWA could be used for risk stratification in this low-risk population.

Aged↗

[Radionuclide ventriculography in evaluation of cardiac function in valvular diseases (second part)].

Patients with valvular heart disease usually require serial, long-term evaluation to determine changes in the severity of their disorder, its effect on ventricular function, and the advisability of corrective surgery. Echocardiography is excellent technique for visualization of the motion of atrioventricular valves, but it is not reliable method for quantifying valvular insufficiency. Equilibrium radionuclide ventriculography is readily available, noninvasive means for quantifying the degree of valvular insufficiency, using left to right ventricular stroke volume ratio. Besides, other parameters important for cardiac function, such as ventricular volumes and ejecton fraction can also be calculated. In this paper the methodology of equilibrium radionuclide ventriculography and its application to the functional and prognostic characterisation of patients with valvular diseases will be discussed.

Gated Blood-Pool Imaging↗

Effects of increasing intracellular reactive iron level on cardiac function and oxidative injury in the isolated rat heart.

Elevation of cell iron content was produced by use of a lipophilic iron ligand, 8-hydroxyquinoline (HQ), capable of transferring catalytically active iron into cells. The Fe(3+)-HQ complex labeled with 59Fe was avidly taken up by isolated perfused hearts contrary to the hydrophilic complex Fe(3+)-citrate. Hearts perfused in aerobic conditions with Krebs-Henseleit buffer were exposed for 15 min to the iron complexes, Fe(3+)-HQ (5 microM/10 microM and 10 microM/20 microM), or Fe(3+)-citrate (10 microM), and then perfused for 30 min with normal buffer. Exposure to the high dose of Fe(3+)-HQ (10 microM/20 microM) resulted in early and irreversible decreases in coronary flow and heart rate (-48% and -33%, respectively), initial increases followed by decreases in left ventricular systolic pressure and +dP/dt, and increase in left ventricular end-diastolic pressure (+80%). The low dose of Fe(3+)-HQ (5 microM/10 microM) mimicked with a lower magnitude the effects of the high dose, whereas Fe(3+)-citrate had no effects on cardiac parameters. Only hearts exposed to the high dose of Fe(3+)-HQ exhibited a significant increase (+60%) in thiobarbituric acid-reactive substance level, an index of lipid peroxidation. The production of hydroxyl radicals was investigated by measuring 2,3-dihydroxybenzoic acid level in the coronary effluent after addition of salicylic acid (1 mM) in the perfusate. An immediate and high increase (x6) was seen during heart exposure to Fe(3+)-HQ (10 microM/20 microM) and to Fe(3+)-citrate (10 microM). Considering Fe(3+)-citrate had no effect on cardiac function and lipid peroxidation it was concluded that this hydroxyl radical formation occurring in the extracellular space was not implicated in Fe(3+)-HQ-induced cardiac dysfunction. These results demonstrate the deleterious effect of increasing intracellular reactive iron level in non-ischemic hearts.

Animals↗

[A meta-analysis of the effects of exercise programs on glucose and lipid metabolism and cardiac function in patients with type II diabetes mellitus].

PURPOSE: This study was a systematic review and meta-analysis of the effects of exercise programs in patients with type II diabetes mellitus. METHOD: Two investigators systematically searched and reviewed English articles from PUBMED from 1988 to 2004, selecting randomized controlled trials on structured exercise programs for DM patients. Out of 87 studies identified, a meta analysis was done for eleven studies which satisfied inclusion criteria and focused on glycemic indices, lipid indices, and cardiac function indices. RESULTS: The means and standard deviations were compared for experimental groups that received exercise-only or exercise and diet programs and control groups that received no intervention or only diet education. The groups were considered homogeneous as the p value of the Q score in each variable group was over 0.05. The experimental groups demonstrated a moderate positive effect on HbA1c and VO2max (d=0.55 & 0.5), and a small positive effect on fasting blood glucose and cholesterol (d=0.38 & 0.27) compared to the control groups. HDL and LDL cholesterol levels, however, showed a very low positive effect (d=0.11 & 0.12) in the experimental groups. Aerobic exercise was more beneficial than resistance exercise on HbA1c (d=0.59 vs 0.28) in the groups. CONCLUSIONS: Regular exercise has a positive effect on HbA1c, fasting blood glucose, total cholesterol, HDL cholesterol, LDL cholesterol, and VO2max in Type 2 diabetic patients.

Blood Glucose↗

Cardiac function and central circulation in lysine-vasopressin treatment of experimental burns.

Anesthetized piglets were subjected to a standardized full thickness skin burn, covering one third of the body surface area, and given fluid treatment. One group was also submitted to early excision of the burned area 5 h after the burn and another group was excised and given lysine-vasopressin by continuous infusion. In both the excised groups there was earlier circulatory restitution compared with the conservatively treated animals. After 24 h, cardiac function was best in the pigs treated with vasopressin and excision. The mechanisms by which vasopressin treatment and excision might have favourable circulatory effects in burn treatment are discussed.

Animals↗

Quantitative analysis of myocardial inflammation by flow cytometry in murine autoimmune myocarditis: correlation with cardiac function.

Inflammation has been increasingly recognized as an important pathological component of heart failure. Existing methods of assessing myocardial infiltrate are labor-intensive and provide data that are difficult to quantify and not representative of the whole heart. As a result, little effort has been made to systematically assess the components of myocardial inflammation. We established an alternative method of quantitative assessment of myocardial inflammation by flow cytometry after enzymatic digestion of hearts to characterize the infiltrate and study the association between inflammation and cardiac function in murine experimental autoimmune myocarditis. The severity of acute myocarditis uniquely correlated with the proportion of neutrophils, but not T cells, B cells, or macrophages. Both acute and chronic phases were characterized by the presence of CD44high (activated) T cells in the heart, whereas T cells trafficking through normal hearts exhibited CD44low phenotype. During the chronic phase, the proportion of CD4+ T cells was associated with increased left-ventricular volumes and deterioration of systolic function, the hallmarks of dilated cardiomyopathy. We conclude that flow cytometry on uniformly digested mouse hearts provides sensitive and reproducible assessment of myocardial infiltrate and can be used to dissect out the specific role of individual immune components from the overall inflammatory response in the heart.

Animals↗

[Experimental observation on the relation between pericardium meridian and cardiac function].

The theory of Traditional Chinese Medicine (TCM) holds that "internally, meridians connect with the visceral organs, and externally, with the joints, limbs and other superficial tissues of the body". The results of the investigations on the meridian phenomena, including propagated sensation along meridians (PSM) and others, also showed that certain lines or tracks, coincident with the course of classical meridians, really existed over the body surface. In order to probe into the relation between the pericardium meridian, acting as a organic whole, and the cardiac function, 100 cases of patients suffering from coronary heart disease, with or without PSM, were observed on the one and the same subject before and after acupuncture for comparison. Four acupoints, namely Neiguan (PC6), Ximen (PC4), Quze (PC3), Tianquan (PC2) and two other non-acupoint spots on the Pericerdium Meridian of the same person were acupunctured in different days respectively. At the same time, the spots locating on the both sides of above 4 acupoints, with a distance of 1.5-2.0 cm from them former, and Guangming (GB37) of Gall-Bladder Meridian were taken as controls. Electrocardiogram, cardiophonogram and rheocardiogram were recorded simultaneously. Taking PEP, LVET, P/L, HI, SV, CO, ST segment and T wave of ECG as indexes for analysis, the effect of acupuncture of acupoints on Pericardium Meridian and controls were compared. The results of 737 times of observation demonstrated that the 8 indexes of 4 acupoints and other two non-acupoint spots on the Pericardium Meridian all changed conspicuously after acupuncture. However, the changes of above indexes of the controls, including 8 spots beside Pericardium Meridian, were slight.(ABSTRACT TRUNCATED AT 250 WORDS)

Acupuncture Points↗

Cardiac function and Fourier phase data from simulated Wolff-Parkinson-White syndrome in a baboon model.

The diagnostic value of Fourier phase analysis and planar scintigraphy in Wolff-Parkinson-White (WPW) syndrome has been suspect. This study investigates phase analytical data from planar radionuclide ventriculography of six baboons with simulated WPW syndrome by means of implanted electrodes. An electrode in the atrium controlled the heart rate and a subsequent stimulation was delivered by electrodes placed at different sites on the ventricles, delayed to cause the characteristic delta wave of the WPW syndrome. Sensitivity for accurately-localizing variously-situated first points of activation (FPAs) from the Fourier phase images was found highest for premature right ventricular (RV) activation, and for atrioventricular (AV) delays around 125 msec. Other sites were subject to artifacts. Changes in cardiac function, phase delay, and histogram parameters were not statistically meaningful.

Animals↗

Fibroblast growth factor-1 improves cardiac functional recovery and enhances cell survival after ischemia and reperfusion: a fibroblast growth factor receptor, protein kinase C, and tyrosine kinase-dependent mechanism.

OBJECTIVES: We sought to investigate the role of fibroblast growth factor (FGF)-1 during acute myocardial ischemia and reperfusion. BACKGROUND: The FGFs display cardioprotective effects during ischemia and reperfusion. METHODS: We investigated FGF-1-induced cardioprotection during ischemia and reperfusion and the intracellular signaling pathways responsible for these effects in an ex vivo murine setup of myocardial ischemia and reperfusion. RESULTS: Cardiac-specific human FGF-1 overexpression was associated with enhanced post-ischemic hemodynamic recovery and decreased lactate dehydrogenase release during reperfusion. Inhibition of the FGF receptor, protein kinase C (PKC), and tyrosine kinase (TK) resulted in blockade of FGF-1-induced protective effects on cardiac functional recovery and cell death. CONCLUSIONS: The overexpression of FGF-1 induces cardioprotection through a pathway that involves the FGF receptor, PKC, and TK.

Animals↗

Non invasive assessment of cardiac function in patients with bronchial asthma (BA) or chronic obstructive pulmonary disease (COPD).

BACKGROUND: Most respiratory diseases involve the heart and can lead to acute or chronic pulmonary heart in the most serious cases. The common pathogenetic element is pulmonary arterial hypertension which es secondary to the resistance of the pulmonary circulation together with hypertrophy and/or dilatation of the right ventricle, caused mainly by chronic hypoxia. METHODS AND RESULTS: In order to verify the effects induced on pulmonary circulation and right heart by BA or COPD the cardiac function was assessed by mono and bidimensional Doppler echocardiography in 10 patients with BA (group A), 10 with COPD (group B) and 10 healthy control subjects (group C). At the M-mode echocardiography examination no significant difference was observed among the three study groups. By Doppler pw the peak velocity of early tricuspidal flow (VmaxE) was significantly higher in the group A when compared to the group B (p = 0.03). No subject had pulmonary hypertension. The pulmonary acceleration time (PAT) using pw Doppler technique was similar in groups A and B but it was significantly different when compared to group C (p = 0.006:A vs C; p = 0.03:B vs C). CONCLUSIONS: Our results suggest in patients either with BA or COPD, an early involvement of the right heart even if they had a clinical stable condition and no pulmonary hypertension.

Adult↗

Preservation of cardiac function and energy reserve by the angiotensin-converting enzyme inhibitor quinapril during postmyocardial infarction remodeling in the rat.

PURPOSE: Angiotensin-converting enzyme (ACE) inhibitors show beneficial long-term hemodynamic effects in chronically infarcted hearts. The purpose of this study was to test whether prevention of the deterioration of mechanical function by ACE inhibitors is related to beneficial effects on high-energy phosphate metabolism that is deranged in heart failure. METHODS: Twelve-week old rats were randomly assigned to ligation of the left coronary artery [mycardial infarction (MI)] or sham operation (Sham) and to the ACE inhibitor quinapril (+Q) (6 mg/kg/day per gavage) or placebo treatment. Eight weeks later, cardiac function was measured in the isolated heart by a left ventricular balloon (pressure-volume curves), and energy metabolism of residual intact myocardium was analyzed in terms of total and isoenzyme creatine kinase activity (spectrophotometry), steady-state levels [adenosine triptosphate (ATP), phosphocreatine], and turnover rates (creatine kinase reaction velocity) of high-energy phosphates [31P nuclear magnetic resonance (NMR)] and total creatine content [high-performance liquid chromatography (HPLC)]. RESULTS: Quinapril prevented post-MI hypertrophy and partially prevented left ventricular contractile dysfunction [maximum left ventricular developed pressure 166+/-6, 83+/-16 (p < 0.05 MI vs. Sham), 139+/-13 mm Hg (p < 0.05 quinapril treated vs. untreated) in Sham, MI and MI+Q hearts]. Residual intact failing myocardium showed a 17% decrease of MM-CK and a 16% decrease of mito-CK activity. Total creatine was reduced by 23%, phosphocreatine by 26% and CK reaction velocity by 30%. Parallel to improved function, treatment with quinapril largely prevented the impairment of energy metabolism occuring post-MI. CONCLUSIONS: quinapril treatment results in an improvement of high-energy phosphate metabolism, of energy reserve via the creatine kinase reaction, and of contractile performance post-MI.

Adenosine Triphosphate↗

Annexin VI regulation of cardiac function.

Annexins are a family of membrane binding proteins that are characterized by a hypervariable amino terminus followed by a series of highly conserved Ca2+-phospholipid binding domains. Annexins function by binding to anionic phospholipid surfaces in a Ca2+-dependent manner. They self-associate to form trimers which further assemble into sheets that cover the membrane surface and alter properties such as fluidity and permeability. This submembranous skeleton alters integral protein functions such as ion transport properties and shields the surface from phospholipid binding proteins such as phospholipases and protein kinase C. Transgenic mouse hearts overexpressing wild type annexin VI (AnxVI673), a dominant-negative truncated annexin VI (residues 1-129, Anx129) and an annexin VI-null mouse (AnxVI-/-) have implicated the protein as a regulator of intracellular Ca2+ homeostasis which affects cardiac function.

Animals↗