Document Detail


Mechanisms of heart failure with well preserved ejection fraction in dogs following limited coronary microembolization.
MedLine Citation:
PMID:  15364615     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: It has been suggested that in some settings, heart failure (HF) may occur with normal ejection fraction (EF) as a consequence of undetected systolic dysfunction. However, others have argued that this can only occur in the presence of diastolic dysfunction. We therefore sought to determine the contribution of diastolic dysfunction in an animal model of HF with normal EF. METHODS AND RESULTS: Limited myocardial injury was induced in 21 dogs chronically instrumented to measure hemodynamics and LV properties by daily coronary microembolization ( approximately 115 microm beads) until LV end diastolic pressure (LVEDP) was > or =16 mm Hg. Nine dogs developed HF within 16+/-6 days (LVEDP 12+/-2 vs. 21+/-2 mm Hg, p<0.001) with no significant change in dP/dt(max) (2999+/-97 vs. 2846+/-189 mm Hg/s), mean arterial pressure (103+/-4 vs. 100+/-4 mm Hg), EF (57+/-5% vs. 53+/-4%) or E(es) (end-systolic elastance, 3.1+/-0.9 vs. 2.9+/-0.8 mm Hg/ml) but with an approximately 10 ml increase in V(o) (14+/-12 vs. 25+/-16 ml; p<0.01). The EDPVR and time constant of relaxation (tau, 25+/-3 vs. 28+/-3 ms) did not change significantly. These animals were hemodynamically stable out to 3 1/2 months. Neurohormonal activation occurred (elevations of NE, AngII, BNP) and there was intravascular volume expansion by approximately 16% (p<0.05). CONCLUSIONS: A small amount of myocardial injury can lead to neurohormonal activation with intravascular volume expansion and elevation of LVEDP in the absence of reductions in dP/dt(max) or EF and without diastolic dysfunction. Thus, HF with preserved EF does not a priori equate with diastolic heart failure.
Authors:
Kun-Lun He; Marc Dickstein; Hani N Sabbah; Geng-Hua Yi; Anguo Gu; Mathew Maurer; Chi-Ming Wei; Jie Wang; Daniel Burkhoff
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cardiovascular research     Volume:  64     ISSN:  0008-6363     ISO Abbreviation:  Cardiovasc. Res.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-14     Completed Date:  2004-12-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0077427     Medline TA:  Cardiovasc Res     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  72-83     Citation Subset:  IM    
Affiliation:
Department of Cardio-Nephrology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China. hekunlun2002@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Angiotensin II / blood
Animals
Blood Volume
Dogs
Echocardiography
Heart Failure / blood,  etiology*,  physiopathology
Hemodynamics
Microcirculation
Myocardial Infarction / complications*,  physiopathology
Natriuretic Peptide, Brain / blood
Phosphopyruvate Hydratase / blood
Time Factors
Ventricular Function / physiology*
Chemical
Reg. No./Substance:
11128-99-7/Angiotensin II; 114471-18-0/Natriuretic Peptide, Brain; EC 4.2.1.11/Phosphopyruvate Hydratase
Comments/Corrections
Comment In:
Cardiovasc Res. 2004 Oct 1;64(1):9-11   [PMID:  15364608 ]

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


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