scholarly journals The Utility of Intraventricular Pressure Gradient for Early Detection of Chemotherapy-Induced Subclinical Cardiac Dysfunction in Dogs

Animals ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 1122
Author(s):  
Katsuhiro Matsuura ◽  
Kenjirou Shiraishi ◽  
Ahmed S. Mandour ◽  
Kotomi Sato ◽  
Kazumi Shimada ◽  
...  
Keyword(s):  
Early Detection ◽  
Cardiac Function ◽  
Pressure Gradient ◽  
Cardiac Dysfunction ◽  
Systolic Pressure ◽  
Treatment Protocol ◽  
Left Ventricular ◽  
Intraventricular Pressure ◽  
Potential Marker ◽  
Intraventricular Pressure Gradient

Early detection of doxorubicin (DXR)-induced cardiomyopathy (DXR-ICM) is crucial to improve cancer patient outcomes and survival. In recent years, the intraventricular pressure gradient (IVPG) has been a breakthrough as a sensitive index to assess cardiac function. This study aimed to evaluate the usefulness of IVPG for the early detection of chemotherapy-related cardiac dysfunction. For this purpose, six dogs underwent conventional, speckle tracking, and color M-mode echocardiography concomitantly with pressure-and-volume analysis by conductance catheter. The cardiac function measurements were assessed before DXR administration (baseline, Pre), at the end of treatment protocol (Post), and at 1.5 years follow-up (Post2). The result showed a significant reduction in the left ventricular end-systolic pressure-volume (Emax: 4.4 ± 0.7, 6.1 ± 1.6 vs. 8.4 ± 0.8 mmHg/mL), total-IVPG (0.59 ± 0.12, 0.62 ± 0.15 vs. 0.86 ± 0.12 mmHg), and mid-IVPG (0.28 ± 0.12, 0.31 ± 0.11 vs. 0.48 ± 0.08 mmHg), respectively in Post2 and Post compared with the baseline (p < 0.05). Mid-to-apical IVPG was also reduced in Post2 compared with the baseline (0.29 ± 0.13 vs. 0.51 ± 0.11). Meanwhile, the fraction shortening, ejection fraction, and longitudinal strain revealed no change between groups. Total and mid-IVPG were significantly correlated with Emax (R = 0.49; p < 0.05, both) but only mid-IVPG was a predictor for Emax (R2 = 0.238, p = 0.040). In conclusion, this study revealed that impairment of contractility was the initial changes observed with DXR-ICM in dogs and only IVPG could noninvasively detect subclinical alterations in cardiac function. Color M-mode echocardiography-derived IVPG could be a potential marker for the early detection of doxorubicin cardiomyopathy.

LEFT INTRAVENTRICULAR PRESSURE GRADIENT UPON CARDIAC STIMULATION IN THORACOTOMIZED HEMORRHAGED RATS

1965 ◽  
Vol 43 (6) ◽  
pp. 893-900
Author(s):  
J. M. Dieudonné
Keyword(s):  
Pressure Gradient ◽  
Blood Volume ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Intraventricular Pressure ◽  
Experimental Conditions ◽  
Predisposing Factor ◽  
Acute Hemorrhage ◽  
Intraventricular Pressure Gradient

Pressures were recorded in thoracotomized rats at the ascending aorta and at various sites of the left ventricle. After induction of an acute hemorrhage, injection of norepinephrine elicited the appearance of a large late-systolic pressure gradient between the left ventricular main chamber and ascending aorta, but not between the outflow tract and ascending aorta. Restoration of the initial blood volume abolished any significant pressure gradient in response to nor-epinephrine.The systematic appearance of an intraventricular pressure gradient in these anatomically normal hearts required the simultaneous presence of two experimental conditions: (a) a reduced blood volume as a predisposing factor; (b) a stimulation of the cardiac force of contraction in the presence of a relatively-lower aortic resistance as a triggering factor.

Intraventricular pressure gradients change during the development of left ventricular hypertrophy: Effect of salvianolic acid B and beta-blocker

Ultrasound ◽  
2021 ◽  
pp. 1742271X2098758
Author(s):  
Danfu Ma ◽  
Ahmed S Mandour ◽  
Tomohiko Yoshida ◽  
Katsuhiro Matsuura ◽  
Kazumi Shimada ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Treatment Group ◽  
Left Ventricular Hypertrophy ◽  
Pressure Gradient ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Salvianolic Acid B ◽  
Intraventricular Pressure ◽  
Salvianolic Acid ◽  
Intraventricular Pressure Gradient

Introduction Intraventricular pressure gradient is regarded as a non-invasive indicator of diastolic function. Salvianolic acid B (Sal-B), a traditional Asian medicine, revealed its usefulness in myocardial infarction models; however, the hemodynamic effect of salvianolic acid B is still unknown. The present study aimed to investigate the intraventricular pressure gradient changes during the development of left ventricular hypertrophy with or without salvianolic acid B and a beta-blocker. Methods In total, 48 rats were divided into four groups; Sham, Non-treatment, salvianolic acid B, and Carvedilol. Aortic coarctation-induced left ventricular hypertrophy was done in three groups and the treatment was started from the third to the sixth week. Blood pressure, conventional echocardiography, and color M-mode echocardiography for measurement of intraventricular pressure gradient were carried out for six consecutive weeks. Results At 4.5 weeks, the LV mass was elevated in the coarctation groups but the blood pressure was significantly lower in salvianolic acid B and Carvedilol groups ( P < 0.05). In the Non-treatment group, the total intraventricular pressure gradient was increased at 4.5 and 6 weeks (2.60 and 2.65, respectively). Meanwhile, the basal intraventricular pressure gradient was elevated at 3 and 6 weeks (1.67 and 1.75) compared with the Sham group. Salvianolic acid B and Carvedilol significantly reduced the basal intraventricular pressure gradient at six weeks compared with the Non-treatment group (1.52 and 1.51 vs 1.75, respectively). Conclusions Salvianolic acid B and Carvedilol promote cardiac function by decreasing the elevated basal intraventricular pressure gradient. The current preclinical results revealed the efficacy of salvianolic acid B as a potential therapy for left ventricular hypertrophy because of the non-blood pressure lowering effect.

Transient Left Ventricular Apical Ballooning Without Coronary Stenoses Syndrome: Importance of the Intraventricular Pressure Gradient

2004 ◽  
Vol 57 (1) ◽  
pp. 85-88
Author(s):  
Roberto Barriales Villa ◽  
Raquel Bilbao Quesada ◽  
Enrique Iglesias Río ◽  
Nicolás Bayón Meleiro ◽  
Ramón Mantilla González ◽  
...  
Keyword(s):  
Pressure Gradient ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Intraventricular Pressure ◽  
Coronary Stenoses ◽  
Intraventricular Pressure Gradient

scholarly journals Left intraventricular pressure gradient in hypertrophic cardiomyopathy patients receiving implantable cardioverter-defibrillators for primary prevention

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kyoichiro Yazaki ◽  
Atsushi Suzuki ◽  
Tsuyoshi Shiga ◽  
Yuichiro Minami ◽  
Kotaro Arai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ventricular Tachycardia ◽  
Hypertrophic Cardiomyopathy ◽  
Primary Prevention ◽  
Pressure Gradient ◽  
Potential Risk ◽  
Left Ventricular ◽  
Intraventricular Pressure ◽  
Conventional Risk Factors ◽  
Intraventricular Pressure Gradient

Abstract Background Conventional risk factors for sudden cardiac death (SCD) justify primary prevention through implantable cardioverter-defibrillator (ICD) implantation in hypertrophic cardiomyopathy (HCM) patients. However, the positive predictive values for these conventional SCD risk factors are low. Left ventricular outflow tract obstruction (LVOTO) and midventricular obstruction (MVO) are potential risk modifiers for SCD. The aims of this study were to evaluate whether an elevated intraventricular pressure gradient (IVPG), including LVOTO or MVO, is a potential risk modifier for SCD and ventricular arrhythmias requiring ICD interventions in addition to the conventional risk factors among HCM patients receiving ICDs for primary prevention. Methods We retrospectively studied 60 HCM patients who received ICDs for primary prevention. An elevated IVPG was defined as a peak instantaneous gradient ≥ 30 mmHg at rest, as detected by continuous-wave Doppler echocardiography. The main outcome was a composite of SCD and appropriate ICD interventions, which were defined as an antitachycardia pacing or shock therapy for ventricular tachycardia or fibrillation. The Cox proportional hazards model was used to assess the relationships between risk factors and the occurrence of SCD and appropriate ICD interventions. Results Thirty patients met the criteria of elevated IVPG (50%). During the median follow-up period of 66 months, 2 patients experienced SCD, and 10 patients received appropriate ICD interventions. Kaplan–Meier curves showed that the incidence of the main outcome was higher in patients with an IVPG ≥ 30 mmHg than in those without an IVPG ≥ 30 mmHg (log-rank P = 0.03). There were no differences in the main outcome between patients with LVOTO and patients with MVO. The combination of nonsustained ventricular tachycardia (NSVT) and IVPG ≥ 30 mmHg was found to significantly increase the risk of the main outcome (HR 6.31, 95% CI 1.36–29.25, P = 0.02). Five patients experienced ICD implant-related complications. Conclusions Our findings showed that a baseline IVPG ≥ 30 mmHg was associated with an increased risk of experiencing SCD or appropriate ICD interventions among HCM patients who received ICDs for primary prevention. Combined with NSVT, which is a conventional risk factor, a baseline IVPG ≥ 30 mmHg may be a potential modifier of SCD risk in HCM patients.

Use of strain rate imaging for early detection of epirubicin-induced cardiotoxicity in patients with breast cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12531-e12531
Author(s):  
Vasiliki Michalaki ◽  
George Koutroulis ◽  
Ioannis Kontis ◽  
Nikolaos Dafnios ◽  
Dina Tiniakos ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Cardiac Function ◽  
Strain Rate ◽  
Cardiac Dysfunction ◽  
Longitudinal Strain ◽  
Radial Strain ◽  
Left Ventricular ◽  
Strain Rate Imaging ◽  
Lv Dysfunction

e12531 Background: Although epirubicin has improved outcome in breast cancer (BC) patients, its application is limited by its cardiotoxicity . Assessment of left ventricular (LV) ejection fraction (EF) is performed to demonstrate cardiac dysfunction. Changes in cardiac function induced by this therapy, however, are difficult to quantitate by conventional echocacardiography. Tissue Doppler myocardial imaging (TDI) derived wall motion velocity, and strain rate (SR) have been shown to sensitively quantify abnormalities in cardiac function. The aim of this study was to determine if sensitive indices of LV dysfunction, would be useful for addressing the early detection of cardiotoxic side effects of epirubicin. Methods: BC patients (N = 45 median age 60.2years) without cardiovascular risk factors were prospectively included. All patients received epirubicin. Twenty patients received further trastuzumab. Conventional and TDI echocardiography were obtained at baseline , every 2cycles of treatment and 3 months after chemotherapy. Segmental peak systolic longitudinal and radial velocity, SR and strain, were measured. Results: at baseline, median LV-EF was > 55 %. There was no overall change in LV dimensions, EF and peak systolic velocity. In contrast, a significant reduction in longitudinal and radial SR and strain was found after 3 cycles (longitudinal strain -10.2% +/- 1.3 % vs baseline 22 +/- 4.1 %, P = .001; radial strain 26.1% +/-4,2% vs baseline 47.3% +/- 9.2 %, P < .001). Changes in radial strain appeared earlier and were more pronounced than longitudinal strain. Conclusions: In this study we confirm the clinical use of TDI parameters for early detection of epirubicin mediated cardiac dysfunction. TDI detected subtle changes of LV function after 3 cycles of therapy. Use of Strain Rate Imaging detects subclinical LV dysfunction and can predict further changes in EF ,therefore can be used to monitor epirubicin-induced cardiotoxicity.

Effects of free fatty acids and dichloroacetate on isolated working diabetic rat heart

1991 ◽  
Vol 261 (4) ◽  
pp. H1053-H1059 ◽  
Author(s):  
T. A. Nicholl ◽  
G. D. Lopaschuk ◽  
J. H. McNeill
Keyword(s):  
Fatty Acids ◽  
Heart Rate ◽  
Cardiac Function ◽  
Free Fatty Acids ◽  
Cardiac Dysfunction ◽  
Glucose Oxidation ◽  
Heart Function ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Diabetic Heart

It is well established that cardiac dysfunction independent of atherosclerosis develops in both humans and animals with diabetes mellitus. The etiology is complex, involving many different processes, one of which may be increased fatty acid utilization and/or a concomitant decrease in glucose utilization by the diabetic heart. We compared control and 6-wk streptozotocin (STZ)-induced diabetic isolated working rat hearts and were able to demonstrate cardiac dysfunction in the diabetic as assessed by depressed heart rate (HR), heart rate peak systolic pressure product (HR.PSP), left ventricular developed pressure (LVDP), and rate of pressure rise (+dP/dt). Paralleling depressed cardiac function in the diabetic were hyperglycemia, hyperlipidemia, and decreased body weight gain compared with age-matched controls. The addition of free fatty acids, in the form of 1.2 mM palmitate, to the isolated working heart perfusate had no effect on either control or diabetic heart function, with the exception of a depressive effect on +dP/dt of diabetic hearts. But diabetic hearts perfused with palmitate-containing perfusate plus the glucose oxidation stimulator dichloroacetate (DCA) showed a marked improvement in function. HR and HR.PSP in spontaneously beating hearts, as well as LVDP and +dP/dt in paced hearts were all restored to control heart values in diabetic hearts perfused in the presence of DCA. Creatine phosphate and ATP levels were similar under all perfusion conditions, thus eliminating energy stores as the limiting factor in heart function. Results indicate that DCA will acutely reverse diabetic cardiac function depression. Therefore glucose oxidation depression in the diabetic heart may be a significant factor contributing to cardiac dysfunction.

Diastolic intraventricular pressure gradient in symmetric left ventricular hypertrophy

1995 ◽  
Vol 130 (1) ◽  
pp. 178-180
Author(s):  
Daniel Krauss ◽  
Richard H. Marcus ◽  
Lynn Weinert ◽  
Claudia Korcarz ◽  
Roberto M. Lang
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Pressure Gradient ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Intraventricular Pressure ◽  
Intraventricular Pressure Gradient
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