Document Detail


Alterations in transmural myocardial strain: an early marker of left ventricular dysfunction in mitral regurgitation?
MedLine Citation:
PMID:  18824764     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In asymptomatic patients with severe isolated mitral regurgitation (MR), identifying the onset of early left ventricular (LV) dysfunction can guide the timing of surgical intervention. We hypothesized that changes in LV transmural myocardial strain represent an early marker of LV dysfunction in an ovine chronic MR model.
METHODS AND RESULTS: Sheep were randomized to control (CTRL, n=8) or experimental (EXP, n=12) groups. In EXP, a 3.5- or 4.8-mm hole was created in the posterior mitral leaflet to generate "pure" MR. Transmural beadsets were inserted into the lateral and anterior LV wall to radiographically measure 3-dimensional transmural strains during systole and diastolic filling, at 1 and 12 weeks postoperatively. MR grade was higher in EXP than CTRL at 1 and 12 weeks (3.0 [2-4] versus 0.5 [0-2]; 3.0 [1-4] versus 0.5 [0-1], respectively, both P<0.001). At 12 weeks, LV mass index was greater in EXP than CTRL (201+/-18 versus 173+/-17 g/m(2); P<0.01). LVEDVI increased in EXP from 1 to 12 weeks (P=0.015). Between the 1 and 12 week values, the change in BNP (-4.5+/-4.4 versus -3.0+/-3.6 pmol/L), PRSW (9+/-13 versus 23+/-18 mm Hg), tau (-3+/-11 versus -4+/-7 ms), and systolic strains was similar between EXP and CTRL. The changes in longitudinal diastolic filling strains between 1 and 12 weeks, however, were greater in EXP versus CTRL in the subendocardium (lateral: -0.08+/-0.05 versus 0.02+/-0.14; anterior: -0.10+/-0.05 versus -0.02+/-0.07, both P<0.01).
CONCLUSIONS: Twelve weeks of ovine "pure" MR caused LV remodeling with early changes in LV function detected by alterations in transmural myocardial strain, but not by changes in BNP, PRSW, or tau.
Authors:
Carl J Carlhäll; Tom C Nguyen; Akinobu Itoh; Daniel B Ennis; Wolfgang Bothe; David Liang; Neil B Ingels; D Craig Miller
Related Documents :
633594 - Left ventricular performance in various heart diseases with or without heart failure:--...
12652114 - Effects of long-term monotherapy with metoprolol cr/xl on the progression of left ventr...
23678214 - Is rheumatic mitral valve repair still a feasible alternative?: indications, technique,...
3548294 - Prophylactic anticoagulation for left ventricular thrombi after acute myocardial infarc...
8407004 - Prevalence of coronary heart disease in turkish adults.
2330864 - Parasympathetically modulated antiarrhythmic action of lidocaine in atrial fibrillation.
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  118     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-30     Completed Date:  2008-10-23     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S256-62     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiothoracic Surgery, Falk Cardiovascular Research Center, Stanford University School of Medicine, Stanford, CA 94305-5247, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Animals
Coronary Circulation
Diastole
Heart / physiopathology*
Hemodynamics
Male
Mitral Valve Insufficiency / complications*,  physiopathology*
Natriuretic Peptide, Brain / blood
Sheep
Stress, Mechanical
Stroke Volume
Systole
Time Factors
Ventricular Dysfunction, Left / etiology*,  physiopathology
Ventricular Remodeling*
Grant Support
ID/Acronym/Agency:
HL-29589/HL/NHLBI NIH HHS; HL-67025/HL/NHLBI NIH HHS; K99 HL087614-02/HL/NHLBI NIH HHS; K99-HL087614/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Saddle-shaped mitral valve annuloplasty rings experience lower forces compared with flat rings.
Next Document:  A novel approach for reducing ischemic mitral regurgitation by injection of a polymer to reverse rem...