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PubMed2006

Tumor-necrosis-factor-alpha-gene-deficient mice have improved cardiac function through reduction of intercellular adhesion molecule-1 in myocardial infarction.

BACKGROUND: Tumor necrosis factor (TNF)-alpha is linked to the pathogenesis of cardiovascular diseases, but how it affects myocardial infarction (MI), so the present study examined the effects of TNF-alpha and the involvement of intercellular adhesion molecule (ICAM)-1 on MI. METHODS AND RESULTS: Left coronary arteries of C57BL/6 wild type (WT) and TNF-alpha knockout (KO) mice were ligated and the mice were killed 1, 3, and 7 days later. Fractional shortening on echocardiography of the KO mice was significantly higher than that of the WT mice from day 1 to 7 (p<0.01). The ICAM-1 mRNA in the infarcted area of the KO mice was significantly lower than that of the WT from day 1 (p<0.01) to 7. In immunohistochemistry, the expression of ICAM-1 was weaker in the KO than in the WT mice. The number of neutrophils in the KO mice peaked at day 1, but even this peak level failed to reach the levels in the infarcted (p<0.01) and peri-infarcted areas (p<0.05) in the WT. The number of macrophages in the KO mice peaked at day 7, but this peak level failed to reach the levels in the infarcted (p<0.01) and peri-infarcted areas (p<0.05) in the WT. CONCLUSION: In a permanent occlusion model of MI TNF-alpha decreased cardiac function and ameliorated myocardial remodeling through the induction of ICAM-1.

Animals↗
PubMed1996

Effect of a new beta-blocker, nipradilol, on cardiac function and neurohumoral factors in idiopathic dilated cardiomyopathy.

This study investigated the therapeutic efficacy of a new beta-blocker, nipradilol, a non-selective agent with vasodilating activity, for the treatment of idiopathic dilated cardiomyopathy (DCM). The New York Heart Association functional class improved in the nipradilol group (n = 9, p < 0.01), but not in the control group who received conventional therapy (n = 9). The observation period was 19 +/- 7 months in the nipradilol group, and 20 +/- 9 months in the control group. Before therapy there was no difference in heart rate between the 2 groups (76 +/- 12 vs 79 +/- 15 beats/min). The end-diastolic and end-systolic left ventricular dimensions decreased in the nipradilol group (p < 0.05), but not in the control group. Radionuclide ventriculography revealed that the left ventricular ejection fraction increased in the nipradilol group (27 +/- 8 to 41 +/- 18%, p < 0.05), but not in the control group (27 +/- 11 to 27 +/- 8%). Plasma norepinephrine tended to be lowered, although not significantly, whereas plasma alpha atrial natriuretic peptide significantly decreased after the therapy (p < 0.01) in the treatment group. Lymphocyte beta-adrenoceptors were up-regulated in the nipradilol group (p < 0.05). None of these parameters changed during the observation period in the control group. Thus, nipradilol improved symptoms and cardiac function with a favorable effect on neurohumoral factors in patients with DCM.

Adrenergic beta-Antagonists↗
PubMed1977

Cardiac function in total anomalous pulmonary venous return before and after surgery.

Cardiac performance was evaluated in 12 infants with isolated total anomalous pulmonary venous return. Four had significant pulmonary venous obstruction and severe pulmonary hypertension (group A). Eight had no obvious venous obstruction, and the pulmonary pressures were lower (group B). In all subjects, right ventricular end-diastolic volume was increased (197% of predicted normal) and its ejection fraction was normal. Left ventricular volume was, generally speaking, still in the normal range (87% of predicted normal); however, its ejection fraction was reduced (0.57 vs normal of 0.73) and left ventricular output was low (3.08 L/min/m2 vs normal of 3.98). Left atrial volume was consistently small (53% of predicted normal) with an appendage of normal size. The infants in group A had smaller chamber volumes/m2 BSA than those in group B. Left atrial function was abnormal, characterized by reduced reservoir function and a greater role as "conduit" from right atrium to left ventricle. Left atrial size was not found to be critical in the surgical repair of TAPVR. Cardiac function is restored to normal following surgery.

Angiocardiography↗
PubMed1986

Cardiac function in alcohol-associated systemic hypertension.

The pathogenesis of alcohol cardiomyopathy is obscure. Because systemic hypertension is observed in one-third of alcoholics, the relation of this finding to left ventricular (LV) function was analyzed in 66 alcoholics (26 with a blood pressure of 160/95 mm Hg or higher) 4 to 5 days after alcohol withdrawal. Hypertensive alcoholics had a more abnormal ratio of preejection period/LV ejection time (PEP/ET) (0.398 +/- 0.01 vs 0.35 +/- 0.01, p less than 0.02) than normotensive alcoholics (matched normal 0.290 +/- 0.01). Hypertensive alcoholics (transitory hypertension) with blood pressures of 120/80 mm Hg or less at time of study also had more abnormal PEP/LVET than matched normotensive alcoholics (0.415 +/- 0.03 vs 0.331 +/- 0.01, p less than 0.05). In both hypertensive (77 +/- 6 dynes/cm2 X 10(3)) and normotensive alcoholics (67 +/- 4 dynes/cm2 X 10(3) LV stress was elevated (normal 46 +/- 3 dynes/cm2 X 10(3), both p less than 0.02). However, LV mass was not increased (hypertensive 96 +/- 4 g/m2; vs normotensive 100 +/- 4 g/m2; (normal 92 +/- 5 g/m2), resulting in a markedly increased stress to mass ratio (hypertensive 0.8 +/- 0.06; Normal 0.05 +/- 0.05, p less than 0.02). Hypertensive alcoholics also had LV "hyperfunction," with an increased stress/LV end-systolic volume ratio (1.7 +/- 0.1 vs 1.3 +/- 0.1 dynes/cm2 X 10(3)/ml, p less than 0.02). Thus, hypertensive alcoholics, even those with transitory hypertension, have more abnormal cardiac function than normotensive alcoholics. Presence of hypertension with hyperdynamic LV features may be a prelude to heart failure.

Adult↗
PubMed2001

Age- and gender-specific differences in left ventricular cardiac function and volumes determined by gated SPET.

The aim of this study was to determine normative volumetric data and ejection fraction values derived from gated myocardial single-photon emission tomography (SPET) using the commercially available software algorithm QGS (quantitative gated SPET). From a prospective database of 876 consecutive patients who were referred for a 2-day stress-rest technetium-99m tetrofosmin (925 MBq) gated SPET study, 102 patients (43 men, 59 women) with a low (<10%) pre-test likelihood of coronary disease were included (mean age 57.6 years). For stress imaging, a bicycle protocol was used in 79 of the patients and a dipyridamole protocol in 23. Left ventricular ejection fraction (LVEF) and end-diastolic and -systolic volumes (EDV and ESV) were calculated by QGS. EDV and ESV were corrected for body surface area, indicated by EDVi and ESVi. To allow comparison with previous reports using other imaging modalities, men and women were divided into three age groups (<45 years, > or =45 years but <65 years and > or =65 years). Men showed significantly higher EDVi and ESVi values throughout and lower LVEF values when compared with women in the subgroup > or =65 years (P<0.05, ANOVA). Significant negative and positive correlations were found between age and EDVi and ESVi values for both women and men and between LVEF and age in women (Pearson P< or =0.01). LVEF values at bicycle stress were significantly higher than at rest (P=0.000, paired t test), which was the result of a significant decrease in ESV (P=0.003), a phenomenon which did not occur following dipyridamole stress (P=0.409). The data presented suggest that LVEF and EDVi and ESVi as assessed by QGS are strongly gender-specific. Although the physiological significance of these results is uncertain and needs further study, these findings demonstrate that the evaluation of cardiac function and volumes of patients by means of QGS should consider age- and gender-matched normative values.

Adult↗
PubMed1989

Cardiac function in spontaneously diabetic BB rats treated with low and high dose insulin.

Cardiac abnormalities observed in animals with drug-induced diabetes may be due to the direct cardiotoxic effect of the drugs or factors not related to the diabetic state. The purpose of this investigation was to examine cardiac sarcoplasmic reticular (SR) calcium transport and heart function in the BB rat, a strain in which diabetes occurs spontaneously and clearly resembles insulin-dependent diabetes in humans. Complete insulin withdrawal for 2 or 4 days from BB diabetic rats leads to a spectrum of metabolic derangements including a loss of body weight, hyperglycemia, and elevated triglyceride levels confirming the insulin dependence of this model. The present study involved treating BB diabetic rats with a low (hyperglycemic) and high (normoglycemic) insulin dose for 12 weeks after the detection of glycosuria. The hearts from these animals were then isolated, and SR Ca2+ transport and heart function (using isolated perfused working hearts) were examined and compared with BB nondiabetic littermates or Wistar controls. Strain-related differences were found in ATP-dependent SR Ca2+ transport between the Wistar and BB rats. There were, however, no significant diabetes-related differences in SR Ca2+ transport between the low dose insulin treated diabetic group (LD) and the high dose insulin treated diabetic group (HD) or the nondiabetic littermates. Plasma lipid concentrations of the LD and HD BB rats and nondiabetic littermates were also generally higher than those of control Wistar rats indicating strain-related but not diabetes-related differences. In addition, there were no differences in cardiac function between the LD and BB nondiabetic littermates or Wistar controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

Endogenous endothelin-1 participates in the maintenance of cardiac function in rats with congestive heart failure. Marked increase in endothelin-1 production in the failing heart.

BACKGROUND: Although it was demonstrated that circulating endothelin-1 (ET-1) levels are elevated in congestive heart failure (CHF), the production and roles of ET-1 in the failing heart are not known. We investigated the production of ET-1 in the heart and the density of myocardial ET receptors in rats with CHF. We also investigated the effects of intravenously infused BQ-123, an endothelin(A) (ETA) receptor antagonist, on both heart and myocardial contractility in rats with CHF. METHODS AND RESULTS: We used the left coronary artery-ligated rat model of CHF (CHF rats). Three weeks after surgery, the rats developed CHF. Plasma ET-1 concentration was significantly higher in the CHF rats than in the sham-operated rats (P<.01). In the left ventricle, the expression prepro-ET-1 mRNA was markedly higher in the CHF rats than in the sham-operated rats. The peptide level of ET-1 in the left ventricle was also significantly higher in the CHF rats than in the sham-operated rats (500+/-41 versus 102+/-10 pg/g tissue, P<.01). Myocardial ET receptors were significantly higher in the CHF rats than in the sham-operated rats (243+/-20 versus 155+/-17 fmol/mg protein, P<.05). In the CHF rats, intravenous BQ-123 infusion (0.1 mg x kg(-1) x min(-1) for 120 minutes) significantly decreased both heart rate (P<.01) and LV+dP x dt(max) (P<.05) but not mean blood pressure. BQ-123 infusion did not affect these hemodynamic parameters in the sham-operated rats. CONCLUSIONS: In the present study, we demonstrated that the production of ET-1 in the heart is markedly increased and that the density of myocardial ET receptors is significantly elevated in the CHF rats. Intravenous BQ-123 infusion significantly reduced both heart rate and LV+dP/dt(max) in the CHF rats but not in the sham-operated rats. Therefore, the ET receptor-mediated signal transduction system in the heart appears to be markedly stimulated in the CHF rats, and endogenous ET-1 may be involved in the maintenance of the cardiac function in these rats.

Animals↗
PubMed1991

Assessment of cardiac function using radionuclide techniques--theory, technical considerations and clinical application.

The recent expansion of interventional cardiovascular techniques has stimulated the development of non-invasive cardiac studies, to evaluate the outcome of the interventional therapy. Radionuclide ventriculographic technique provides to quantify global left ventricular systolic/diastolic performance, and evaluate the regional left ventricular wall motion during rest or exercise. This concept was extended from the "bedside" to the ambulatory environment with the description of a battery powered device, the radionuclide ventricular function monitor. To assess the performance of cardiac function using radionuclide ventriculography to that using the ambulatory ventricular function monitor, the systolic and diastolic function were measured at rest in a series of healthy volunteers (n = 10) and in patients with cardiovascular disease (n = 23). Seventeen patients had coronary artery disease (CAD) with prior myocardial infarction, three patients had coronary artery disease, and three patients had dilated cardiomyopathy. The 23 patients manifested a wide variation in LV systolic function. The relationship between the multiple gated acquisition (MUGA)-ejection fraction and the ambulatory ventricular function monitor-ejection fraction correlated well (r = 0.90). As a complement to the radionuclide perfusion studies, cardiac blood pool imaging and radionuclide ventricular function monitoring allow for through non-invasive description of cardiac physiology and function in patients with various cardiac disorders.

Adult↗
PubMed2004

Abnormal cardiac function in children after renal transplantation.

BACKGROUND: Cardiac hypertrophy frequently is found in children with a renal transplant. In adults with a transplant, left ventricular (LV) mass (LVM) is associated with cardiac dysfunction. However, in children with a transplant, the relationship between LVM and LV function has not been evaluated. METHODS: Twenty-nine children who underwent transplantation and 33 controls had echocardiographic evaluations during rest and peak exercise. LV contractility was determined based on the relation between heart rate-corrected velocity of circumferential fiber shortening and end-systolic wall stress. Contractile reserve was assessed by the difference between contractility at rest and peak exercise. Early diastole was assessed using indices of LV relaxation derived from transmitral and tissue Doppler and reported as maximal early (E wave) and late (A wave) wave ratio (E-A ratio) and septal mitral annular velocities (Em). Late diastole was determined using an index of LV compliance (E-Em ratio). RESULTS: Compared with controls, children with a transplant had a significantly greater LVM index (P < 0.001) and high prevalence of LV hypertrophy (LVH; 55%). Transplant recipients had increased LV contractility (P < 0.001). Contractile reserve was similar to that of controls. Patients with a transplant had a lower E-A ratio and Em (P < 0.01 for both variables) and higher E-Em ratio (P < 0.001) than controls. In children with a transplant, LVM index was a significant independent predictor for both abnormal LV relaxation (Em; P = 0.03) and abnormal LV compliance (E-Em ratio; P = 0.02). CONCLUSION: Results show impaired cardiac structure and diastolic function in pediatric renal allograft recipients. This suggests that LVH may be a risk factor for diastolic dysfunction in these children.

Adolescent↗
PubMed1993

Studies on the autonomic nervous function in Tsukuba emotional rats--with special reference to their cardiac function.

Autonomic nervous function in Tsukuba high (THE) and low (TLE) emotional rats as well as Wistar rats (control) was studied by means of electrocardiographical examination in addition to the runway test. In the runway test, locomotive activity differed significantly among the three strains, the greatest activity in TLE and the smallest in THE. Electrocardiogram (ECG) and locomotive activity were successively recorded for 24 hr using a small size of telemeter system. Though the locomotive activity showed a clear nocturnal rhythm, no significant difference was observed among the three strains. The mean value of R-R intervals in THE tended to be smaller than those in other two strains; showing a significant difference between THE and TLE. The mean value of standard deviation (SD) of R-R intervals in TLE tended to be larger than those in other two strains; showing a significant difference between TLE and Wistar in the light and dark periods, and also between TLE and THE in the light period. As regards coefficients of variation of R-R intervals (CV), there was no significant difference among the three strains. Autonomic nervous tone in THE and TLE was evaluated by means of autonomic blockades using atropine and/or propranolol. The sympathetic nervous tone represented 21.6% in THE and 16.8% in TLE, while the parasympathetic nervous tone -9.0% and -12.3% in THE and TLE, respectively. There was a significant difference in the net autonomic nervous tone between THE (10.7%) and TLE (-6.6%).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

Perfluorocarbon supplementation and postischemic cardiac function.

BACKGROUND: During induced ischemia for cardiac surgery inefficient anaerobic energy mechanisms predominate. Sustaining aerobic metabolism with perfluorocarbon-supplemented blood cardioplegia theoretically could lead to improved postischemic recovery. Therefore we studied functional recovery after myocardial ischemia, comparing perflubron (C8F17Br) supplemented blood cardioplegia to standard blood cardioplegia. METHODS: Nineteen dogs underwent 15 minutes of 37 degrees C global ischemia on cardiopulmonary bypass, followed by 90 minutes of cardioplegic arrest by use of blood cardioplegia with or without perflubron and then 30 minutes of 37 degrees C reperfusion. During ischemia myocardial oxygen tension, temperature, and pH were measured. Postischemic left ventricular recovery was assessed by means of preload recruitable stroke work, exponential end-diastolic stress-strain regression, and preservation of adenosine triphosphate and energy charge. RESULTS: The addition of perflubron, a new shorter half-life, lecithin-emulsified perfluorocarbon, provided superior myocardial protection when compared with standard blood cardioplegia. This benefit was evidenced by significantly increased recovery of preload recruitable stroke work slope (71% +/- 8% versus 42% +/- 9%), decreased myocardial edema, and enhanced end ischemic myocardial oxygen and pH levels. CONCLUSIONS: The reliable oxygen delivery system and endothelial-preserving properties of the perfluorocarbons may prove to be an invaluable asset in addition to standard blood cardioplegia in the preservation of postischemic ventricular function. These data support the further investigation of perfluorocarbon-enriched blood cardioplegia.

Animals↗
PubMed1985

Ultrasonic assessment of cardiac function in the intact human fetus.

Echocardiography may provide information concerning the structural development of the fetal human heart. The information available from such studies, when interpreted in light of existing knowledge of developmental cardiac physiology, may give insight concerning in utero cardiac pump function. The quantitation of cardiac structural growth in utero has been used to provide growth curves for the chambers of the fetal heart. Disparity in the ratio of right ventricular/left ventricular size (normally 1.0 to 1.2) may suggest acute ventricular failure and dilation. Electromechanical analysis using M-mode techniques may be used to analyze and monitor the treatment of fetal cardiac arrhythmias and provide systolic time interval analysis. Doppler waveform analysis provides information concerning directional flow and vascular impedance and Doppler flowmetry has promise for the measurement of fetal aortic and umbilical venous blood flows. Such studies have increased our understanding of fetal circulatory function and have practical implications for the establishment of fetal cardiac diagnosis and treatment programs.

Arrhythmias, Cardiac↗
PubMed1989

Average daily blood pressure, not office blood pressure, determines cardiac function in patients with hypertension.

To determine the presence of cardiac disease in hypertensive patients with disparities between physician and out-of-office blood pressures, we prospectively studied three groups of age-matched patients identified by both casual (office) and ambulatory blood pressures: (1) office blood pressure greater than 140/90 mm Hg and awake ambulatory blood pressure of 130/80 mm Hg or less ("office" hypertensives); (2) office blood pressure less than 135/85 mm Hg and awake ambulatory blood pressure of 130/80 mm Hg or less (normotensives); and (3) office blood pressure greater than 140/90 mm Hg and awake ambulatory blood pressure of 140/90 mm Hg or greater ("daytime" hypertensives). In the patients with office hypertension, both the left atrial index and left ventricular mass index were significantly less than in patients with daytime hypertension and not statistically different from those of the normotensive subjects. Left ventricular filling rate at rest and ejection fraction at peak exercise were significantly greater in the office hypertensive group than in the daytime hypertensive group but were no different from those of the normotensive subjects. These findings demonstrate that patients with blood pressure elevation only in the physician's office have cardiac size and function similar to those of normotensive individuals. Thus, the average daily blood pressure best predicts cardiac end-organ damage.

Adult↗
PubMed2002

Adrenomedullin improves cardiac function and prevents renal damage in streptozotocin-induced diabetic rats.

Adrenomedullin (AM) is a potent vasodilating peptide and is involved in cardiovascular and renal disease. In the present study, we investigated the role of AM in cardiac and renal function in streptozotocin (STZ)-induced diabetic rats. A single tail-vein injection of adenoviral vectors harboring the human AM gene (Ad.CMV-AM) was administered to the rats 1-wk post-STZ treatment (65 mg/kg iv). Immunoreactive human AM was detected in the plasma and urine of STZ-diabetic rats treated with Ad.CMV-AM. Morphological and chemical examination showed that AM gene delivery significantly reduced glycogen accumulation within the hearts of STZ-diabetic rats. AM gene delivery improved cardiac function compared with STZ-diabetic rats injected with control virus, as observed by decreased left ventricular end-diastolic pressure, increased cardiac output, cardiac index, and heart rate. AM gene transfer significantly increased left ventricular long axis (11.69 +/- 0.46 vs. 10.31 +/- 0.70 mm, n = 10, P < 0.05) and rate of pressure rise and fall (+6,090.1 +/- 597.3 vs. +4,648.5 +/- 807.1 mmHg/s), (-4,902.6 +/- 644.2 vs. -3,915.5 +/- 805.8 mmHg/s, n = 11, P < 0.05). AM also significantly attenuated renal glycogen accumulation and tubular damage in STZ-diabetic rats as well as increased urinary cAMP and cGMP levels, along with increased cardiac cAMP and Akt phosphorylation. We also observed that delivery of the AM gene caused an increase in body weight along with phospho-Akt and membrane-bound GLUT4 levels in skeletal muscle. These results suggest that AM plays a protective role in hyperglycemia-induced glycogen accumulation and cardiac and renal dysfunction via Akt signal transduction pathways.

Adenoviridae↗
PubMed2006

Preserved cardiac function after chronic spinal cord injury.

OBJECTIVE: To assess the effect of chronic deconditioning on cardiac dimensions and function in subjects with high-level spinal cord injury (SCI), who represent a human in-vivo model of extreme inactivity. DESIGN: Cross-sectional study. SETTING: University medical center. PARTICIPANTS: Seven men with tetraplegia and 7 able-bodied controls. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Echocardiographic measurements of resting cardiac dimensions, systolic function, and global and long-axis diastolic function. RESULTS: Left ventricular mass index was significantly lower in the subjects with SCI than in the controls (90.8+/-26 g/m(2) vs 122+/-28.9 g/m(2); P=.05). In addition, dimensions of left ventricle, left atrium, and vena cava inferior were all significantly reduced in the subjects with SCI compared with controls (P<.05). There were no differences between the groups for any of the parameters reflecting systolic and global and long-axis diastolic function. CONCLUSIONS: Tetraplegia is associated with a reduction in cardiac mass and dimensions. Resting diastolic and systolic function is not altered with continued exposure to inactivity, however, which suggests a remodeling of the heart as a physiologic adaptive process.

Adult↗
PubMed2005

Intrapericardial IGF-I improves cardiac function in an ovine model of chronic heart failure.

BACKGROUND: Following myocardial infarction, progressive deterioration of left ventricular function often follows, leading eventually to overt heart failure. In the myocardium, there is increased expression of insulin-like growth factor I (IGF-I) mRNA, protein and receptor levels, particularly in the peri-infarct zone, suggesting that IGF-I has a role to play in post-infarct cardiac structure and function. In this study, we examine the effects of exogenous IGF-I on cardiac function. METHODS: Intrapericardial IGF-I (15 microg/kg/d, n=3) or vehicle (sterile saline, n=3) was administered to sheep in chronic heart failure and the results of intrapericardial delivery compared with those of subcutaneous delivery. Left ventricular ejection fraction (EF) was measured to assess cardiac performance. Concentrations of plasma IGF-I were quantified by radioimmunoassay. RESULTS: Intrapericardial delivery of IGF-I resulted in a rapid and sustained increase (P<0.001) in EF, which remained elevated 14 days after cessation of treatment. Subcutaneous IGF-I treatment did not affect EF. Both subcutaneous and intrapericardial IGF-I administration increased concentrations of plasma IGF-I, although concentrations declined prior to the cessation of treatment. CONCLUSIONS: We conclude that the higher concentration of IGF-I in the myocardium, which results from intrapericardial delivery significantly increases EF in chronic heart failure but that subcutaneous delivery of IGF-I does not.

Administration, Cutaneous↗