Comparison of Usefulness of Echocardiographic Doppler Variables to Left Ventricular End-Diastolic Pressure in Predicting Future Heart Failure Events

Liang, Hsin Yueh; Cauduro, Sanderson; Pellikka, Patricia A.; Bailey, Kent R.; Grossardt, Brandon R.; Yang, Eric H.; Rihal, Chet; Seward, James B.; Miller, Fletcher A.; Abraham, Theodore P.

doi:10.1016/j.amjcard.2005.09.136

Cited by 78 publications

(59 citation statements)

References 23 publications

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“…Although PKI-166 did not lower heart weight, indicating that it did not prevent LV hypertrophy, the drug completely normalized the 5/6Nx-induced increase in LVEDP. An increase in LVEDP is an early sign of LV diastolic dysfunction (Zile et al, 2001), and has been shown to be an independent predictor of future clinical heart failure events (Liang et al, 2006) and mortality (Judge et al, 1991;Bella et al, 2002). These results indicate that PKI-166 displays therapeutic potential to lower LVEDP, possibly limiting the cardiac risk in CKD.…”

Section: Chronic Egfr Inhibition Prevents Hypertensionmentioning

confidence: 76%

Epidermal Growth Factor Receptor Inhibitor PKI-166 Governs Cardiovascular Protection without Beneficial Effects on the Kidney in Hypertensive 5/6 Nephrectomized Rats

Ulu

Mulder

Vavrinec

et al. 2013

J Pharmacol Exp Ther

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Transactivation of epidermal growth factor receptor (EGFR) signaling by G protein-coupled receptors has been implicated in several cardiovascular (CV) conditions, including hypertension, heart failure, and cardiac and vascular hypertrophy. However, the therapeutic potential of EGFR inhibition in these conditions is currently unknown. The main objective of the present study was to investigate cardiac, vascular, and renal effects of EGFR inhibition by 4- in the hypertensive chronic kidney disease model. Rats underwent 5/6 nephrectomy (5/ 6Nx) and were treated with PKI-166, lisinopril or vehicle from week 6 after disease induction until week 12. Sham animals received either PKI-166 or vehicle. Treatment with PKI-166 did not affect the development of the characteristic renal features in 5/6Nx, including proteinuria, diminished creatinine clearance, and increased glomerulosclerosis, whereas these were attenuated by lisinopril. Despite absence of effects on progressive renal damage, PKI-166 attenuated the progression of hypertension and maintained cardiac function (left ventricle end-diastolic pressure) to a similar extent as lisinopril. Also, PKI-166 attenuated the increase in phosphorylated EGFR in the heart as induced by 5/6Nx. Moreover, PKI-166 and lisinopril restored the impaired contraction of isolated thoracic aortic rings to phenylephrine and angiotensin II and impaired myogenic constriction of small mesenteric arteries in 5/6Nx rats. Blockade of the EGFR displays a CV benefit independent of limiting the progression of renal injury. Our findings extend the evidence on EGFR signaling as a target in CV disorders.

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Section: Chronic Egfr Inhibition Prevents Hypertensionmentioning

confidence: 76%

Epidermal Growth Factor Receptor Inhibitor PKI-166 Governs Cardiovascular Protection without Beneficial Effects on the Kidney in Hypertensive 5/6 Nephrectomized Rats

Ulu

Mulder

Vavrinec

et al. 2013

J Pharmacol Exp Ther

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“…All in all, E/E’ predicts HF events in a manner incremental to clinical factors and ejection fraction 109 . It is important however to note that there are circumstances that spurious results could occur.…”

Section: E/e' and T E‐e'mentioning

confidence: 95%

Echocardiographic evaluation of diastolic heart failure

Thomas

2010

Australas J Ultrason Med

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“…75,82 The ratio predicts heart failure events in a manner incremental to clinical factors and ejection fraction. 83 The high temporal resolution of strain imaging allows interrogation of short-lived diastolic mechanical events. Patients with global diastolic dysfunction have higher numbers of segments with an altered early to late diastolic strain-rate ratio, and the number of altered segments increases with worsening global diastolic function.…”

Section: Diastolic Functionmentioning

confidence: 99%

Role of Tissue Doppler and Strain Echocardiography in Current Clinical Practice

2007

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V isual or semiautomated tracking of the endocardial border provide estimates of cardiac volume, which are used to derive ejection fraction, a quantitative indicator of ventricular function. However, the heart is a complex mechanical organ that undergoes cyclic changes in multiple dimensions that ultimately effect a change in chamber volume that results in ejection of blood. Regardless of imaging technique, ejection fraction is unable to provide information on the underlying myocardial mechanical activity. Also, ejection fraction reflects the sum contribution of several regions and does not provide information on regional function. Regional function assessed visually is subjective and prone to error. 1 Quantification of regional myocardial activity (deformation) was feasible only in experimental studies by use of markers attached directly to the myocardium, a technique not practicable in the clinical realm. 2 Myocardial tagging with cardiac magnetic resonance (CMR) introduced the opportunity to noninvasively track regional myocardial mechanics. 3,4 Modifications to the filter settings on pulsed Doppler to image low-velocity, high-intensity myocardial signal rather than the high-velocity, low-intensity signal from blood flow allows similar assessment by ultrasound. This technique is commonly referred to as tissue Doppler imaging (TDI) or Doppler myocardial imaging. 5 Tissue Doppler ImagingThe TDI method depicts myocardial motion (measured as tissue velocity) at specific locations in the heart. Tissue velocity indicates the rate at which a particular point in the myocardium moves toward or away from the transducer.Integration of velocity over time yields displacement or the absolute distance moved by that point (Figure 1A and 1B).Tissue Doppler-derived velocity can be obtained via pulsed Doppler (by placing a sample volume at a particular location), M-mode Doppler, or 2-dimensional color Doppler ( Figure 1C and 1D). 5 Color Doppler acquires tissue velocity information from the entire sector, and thus, multiple sites can be interrogated simultaneously. Individual segments are analyzed ex post facto. Although all of these methods yield the same mechanical information, differences in the peak values exist. Pulsed Doppler measures peak velocity, which is Ϸ20% to 30% higher than the mean velocity measured by color Doppler. This difference should be considered when one estimates left ventricular filling pressure using the E/eЈ ratio. 6 Frame rates are highest with the M mode, lower with pulsed Doppler, and lowest with color Doppler TDI.Tissue Doppler has been validated extensively and examined in a variety of cardiac pathologies. 7,8 Although initial work reported tissue velocity from the septal or posterior wall in the parasternal projections, recent work almost exclusively interrogates tissue velocities in the longitudinal direction (apical projections). In the longitudinal direction, myocardial motion is such that the apex is generally immobile, whereas the base moves toward the apex in systole and away from the apex...

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Comparison of Usefulness of Echocardiographic Doppler Variables to Left Ventricular End-Diastolic Pressure in Predicting Future Heart Failure Events

Cited by 78 publications

References 23 publications

Epidermal Growth Factor Receptor Inhibitor PKI-166 Governs Cardiovascular Protection without Beneficial Effects on the Kidney in Hypertensive 5/6 Nephrectomized Rats

Epidermal Growth Factor Receptor Inhibitor PKI-166 Governs Cardiovascular Protection without Beneficial Effects on the Kidney in Hypertensive 5/6 Nephrectomized Rats

Echocardiographic evaluation of diastolic heart failure

Role of Tissue Doppler and Strain Echocardiography in Current Clinical Practice

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