| Alterations in transmural myocardial strain: an early marker of left ventricular dysfunction in mitral regurgitation? | |
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MedLine Citation:
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PMID: 18824764 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Carl J Carlhäll; Tom C Nguyen; Akinobu Itoh; Daniel B Ennis; Wolfgang Bothe; David Liang; Neil B Ingels; D Craig Miller |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 118 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2008 Sep |
Date Detail:
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Created Date: 2008-09-30 Completed Date: 2008-10-23 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: S256-62 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiothoracic Surgery, Falk Cardiovascular Research Center, Stanford University School of Medicine, Stanford, CA 94305-5247, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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:
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114471-18-0/Natriuretic Peptide, Brain |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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