3-D MRI assessment of regional left ventricular  systolic wall stress in patients with reperfused MI

Delépine, Stéphane; Furber, Alain; Beygui, Farzin; Prunier, Fabrice; Balzer, Philippe; Jeune, J. J. Le; Geslin, Philippe

doi:10.1152/ajpheart.00106.2002

Cited by 29 publications

(18 citation statements)

References 29 publications

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“…12 During the analysis of the LV parameters, operators were blinded to the patient group. We also calculated end-systolic wall stress using the Grossman formula, as follows 13 :…”

Section: Discussionmentioning

confidence: 99%

Early Hypertension Is Associated With Reduced Regional Cardiac Function, Insulin Resistance, Epicardial, and Visceral Fat

et al. 2008

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Abstract-Mild-to-moderate hypertension is often associated with insulin resistance and visceral adiposity. Whether these metabolic abnormalities have an independent impact on regional cardiac function is not known. The goal of this study was to investigate the effects of increased blood pressure, insulin resistance, and ectopic fat accumulation on the changes in peak systolic circumferential strain. Thirty-five male subjects (age: 47Ϯ1 years; body mass index: 28.4Ϯ0.6 kg . m Ϫ2 ; meanϮSEM) included 13 with normal blood pressure (BP: 113Ϯ5/67Ϯ2 mm Hg), 13 with prehypertension (BP: 130Ϯ1/76Ϯ2 mm Hg), and 9 newly diagnosed with essential hypertension (BP: 150Ϯ2/94Ϯ2 mm Hg) who underwent cardiac magnetic resonance tissue tagging (MRI) and MRI quantitation of abdominal visceral and epicardial fat. Glucose tolerance, on oral glucose tolerance test, and insulin resistance were assessed along with the serum lipid profile. All of the subjects had normal glucose tolerance, left-and right-ventricular volumes, and ejection fraction. Across the BP groups, left ventricular mass tended to increase, and circumferential shortening was progressively reduced at basal, midheart, and apical segments (on average, from Ϫ17.0Ϯ0.5% in normal blood pressure to Ϫ15.2Ϯ0.7% in prehypertension to Ϫ13.6Ϯ0.8% in those newly diagnosed with essential hypertension; Pϭ0.004). Reduced circumferential strain was significantly associated with raised BP independent of age (rϭ0.41; Pϭ0.01) and with epicardial and visceral fat, serum triglycerides, and insulin resistance independent of age and BP. In conclusion, regional left ventricular function is already reduced at the early stages of hypertension despite the normal global cardiac function. Insulin resistance, dyslipidemia, and ectopic fat accumulation are associated with reduced regional systolic function. T he mechanisms of cardiovascular damage in hypertension are still partially unclear; in particular, it is not known what role the metabolic changes frequently associated with high blood pressure (ie, insulin resistance, dyslipidemia, glucose intolerance, and ectopic fat accumulation) may play. Mild increases in blood pressure are recognized as a risk factor for myocardial infarction and coronary artery disease. 1 For this reason, in 2003, the Joint National Committee on High Blood Pressure identified "prehypertension" as a new category of blood pressure in adults 2 : prehypertensive (pre-HT) individuals carry a higher risk (Յ3-fold) of developing hypertension and cardiovascular disease in comparison with normotensive (NT) subjects. 3 We have shown recently that ectopic fat accumulation in visceral and epicardial areas is a characteristic feature of essential hypertension 4 ; the consequences, however, for cardiac morphology and function have not been investigated. We have assessed cardiac function using MRI and tagging. [5][6][7] MRI provides a "1-shop" method for assessing not only cardiac morphology and function but also epicardial and visceral fat mass during the same session. MRI tagging, whi...

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“…12 During the analysis of the LV parameters, operators were blinded to the patient group. We also calculated end-systolic wall stress using the Grossman formula, as follows 13 :…”

Section: Discussionmentioning

confidence: 99%

Early Hypertension Is Associated With Reduced Regional Cardiac Function, Insulin Resistance, Epicardial, and Visceral Fat

et al. 2008

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“…This wall stress acts as a compressive force on the coronary arteries and vasculature, increasing the resistance to flow. Using the current standard of care, even after reperfusion is established, wall stress remains high and impaired microvascular flow persists [ 98 ]. This exacerbates ischemia, leading to further cell damage and cell death.…”

Section: Acute Cardiac Unloading and I-r Injurymentioning

confidence: 99%

Beyond Reperfusion: Acute Ventricular Unloading and Cardioprotection During Myocardial Infarction

Curran

Burkhoff

Kloner

2019

J. of Cardiovasc. Trans. Res.

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Heart failure is a major cause of morbidity and mortality around the world, and myocardial infarction is its leading cause. Myocardial infarction destroys viable myocardium, and this dead tissue is replaced by a non-contractile scar that results in impaired cardiac function and a significantly increased likelihood of the patient developing heart failure. Limiting infarct scar size has been the target of pre-clinical and clinical investigations for decades. However, beyond reperfusion, few therapies have translated into the clinic that limit its formation. New approaches are needed. This review will focus on new clinical and pre-clinical data demonstrating that acute ventricular unloading prior to reperfusion by means of percutaneous left ventricular support devices reduces ischemia-reperfusion injury and limits infarct scar size. Emphasis will be given to summarizing our current mechanistic understanding of this new therapeutic approach to treating myocardial infarction.

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“…1 Three dimensional wall thickening (3DW T ) is defined by end-systolic wall thickness (EST ) and end-diastolic wall thickness (EDT ) 15 :…”

Section: Wall Thickeningmentioning

confidence: 99%

Functional analysis of cardiac MR images using SPHARM modeling

et al. 2005

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Visualization and quantification of cardiac function can provide direct and reliable indicators of cardiac health. The heart's operation occurs in three dimensions, and is dependent on three dimensional forces and ventricular geometry, making the observation of its shape important. Many approaches have been presented to extract cardiac shape and do functional analysis from a variety of imaging modalities. We apply a spherical harmonics (SPHARM) model to cardiac function analysis using magnetic resonance (MR) images. Our three dimensional SPHARM approach increases measurement accuracy over two dimensional approaches and also simplifies the management and indexing of clinical data by providing access to many important functional measures directly from the SPHARM representation.

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3-D MRI assessment of regional left ventricular systolic wall stress in patients with reperfused MI

Cited by 29 publications

References 29 publications

Early Hypertension Is Associated With Reduced Regional Cardiac Function, Insulin Resistance, Epicardial, and Visceral Fat

Early Hypertension Is Associated With Reduced Regional Cardiac Function, Insulin Resistance, Epicardial, and Visceral Fat

Beyond Reperfusion: Acute Ventricular Unloading and Cardioprotection During Myocardial Infarction

Functional analysis of cardiac MR images using SPHARM modeling

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