Multi-detector CT and MRI of microembolized myocardial infarct: monitoring of left ventricular function, perfusion, and myocardial viability in a swine model

Saeed, Maythem; Bajwa, Hisham Z; Do, Loi; Hetts, Steven W.; Wilson, Mark W.

doi:10.1177/0284185115574737

Cited by 7 publications

(6 citation statements)

References 32 publications

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“…Obtaining accurate baseline values is important for the application of new innovative techniques in both experimental and clinical studies [21]. The findings from the present study showed that the left ventricular end-systolic volume (LVESV) was lower, and the left ventricle ejection fraction (LVEF) and stroke volume (SV) were higher compared with the findings previously reported from studies that used early-generation DSCT [22,24]. However, the findings from the present study were similar to those described by Busch et al in 2008 in a study that compared dual-source CT with cardiac magnetic resonance imaging (MRI) [25].…”

Section: Discussionsupporting

confidence: 56%

A Pilot Study of Third-Generation Dual-Source Computed Tomography for the Assessment of Global Dynamic Changes in Left Ventricular Structure and Function in a Porcine Model of Acute Myocardial Infarction

Lyu

Yang

et al. 2019

Med Sci Monit

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BackgroundFirst-generation and second-generation dual-source computed tomography (DSCT) are useful for analyzing left ventricle (LV) structure and function. This pilot study aimed to investigate the feasibility and role of third-generation DSCT for the evaluation of dynamic changes in LV structural and functional characteristics in a Diannan small-ear pig model of acute myocardial infarction (AMI).Material/MethodsThe model of AMI was established by balloon occlusion of the distal third of the left anterior descending (LAD) coronary artery in 14 Diannan small-eared pigs. Third-generation DSCT was performed to observe dynamic changes in LV structure and function before and after AMI was induced, with a follow-up period of 30 days.ResultsThe mean structural measurements at baseline included interventricular septum thickness (8.50±0.90 mm), LV anterior wall thickness (8.40±1.30 mm), LV posterior wall thickness (7.80±1.20 mm), LV end-diastolic dimension (LVEDD) (45.00±4.90 mm), and LV end-systolic dimension (LVESD) (25.90±4.10 mm). The mean functional measurements at baseline included the LV end-diastolic volume (LVEDV) (74.62±13.54 ml), LV end-systolic volume (LVESV) (23.06±7.46 ml), LV ejection fraction (LVEF) (69.29±6.83%), LV mass (86.35±14.02 g), stroke volume (SV) (51.56±9.77 ml), and cardiac output (CO) (4.22±2.14 l/min). Trends of time-dependent changes were observed for LVESV, LVEF, SV, and CO, but not for LVEDV or LV mass.ConclusionsThird-generation DSCT was validated as a tool for assessing dynamic changes in LV global function in a porcine model of AMI.

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Section: Discussionsupporting

confidence: 56%

A Pilot Study of Third-Generation Dual-Source Computed Tomography for the Assessment of Global Dynamic Changes in Left Ventricular Structure and Function in a Porcine Model of Acute Myocardial Infarction

Lyu

Yang

et al. 2019

Med Sci Monit

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“…61 Similar techniques are used in imaging (magnetic resonance imaging or computed tomography) studies to quantify LV function in animal models of HFrEF and compare microemboli with surgical interventions. 57,62,63 These protocols are more time-consuming as well as stressful to the animals, as multiple treatments must be performed in a short amount of time.…”

Section: Animal Models Of Hfrefmentioning

confidence: 99%

Large and Small Animal Models of Heart Failure With Reduced Ejection Fraction

Pilz

Chang

Kiss

et al. 2022

Circulation Research

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Heart failure (HF) describes a heterogenous complex spectrum of pathological conditions that results in structural and functional remodeling leading to subsequent impairment of cardiac function, including either systolic dysfunction, diastolic dysfunction, or both. Several factors chronically lead to HF, including cardiac volume and pressure overload that may result from hypertension, valvular lesions, acute, or chronic ischemic injuries. Major forms of HF include hypertrophic, dilated, and restrictive cardiomyopathy. The severity of cardiomyopathy can be impacted by other comorbidities such as diabetes or obesity and external stress factors. Age is another major contributor, and the number of patients with HF is rising worldwide in part due to an increase in the aged population. HF can occur with reduced ejection fraction (HF with reduced ejection fraction), that is, the overall cardiac function is compromised, and typically the left ventricular ejection fraction is lower than 40%. In some cases of HF, the ejection fraction is preserved (HF with preserved ejection fraction). Animal models play a critical role in facilitating the understanding of molecular mechanisms of how hearts fail. This review aims to summarize and describe the strengths, limitations, and outcomes of both small and large animal models of HF with reduced ejection fraction that are currently used in basic and translational research. The driving defect is a failure of the heart to adequately supply the tissues with blood due to impaired filling or pumping. An accurate model of HF with reduced ejection fraction would encompass the symptoms (fatigue, dyspnea, exercise intolerance, and edema) along with the pathology (collagen fibrosis, ventricular hypertrophy) and ultimately exhibit a decrease in cardiac output. Although countless experimental studies have been published, no model completely recapitulates the full human disease. Therefore, it is critical to evaluate the strength and weakness of each animal model to allow better selection of what animal models to use to address the scientific question proposed.

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“…(20 %). This difference in the rate of infarct resorption can be affected by: (1) infarct size [7,27] and (2) the presence of MVO inhibits/delays infarct resorption [7,27,28]. The limitation of DE is poor sensitivity in defining peri infarcted zone [29] and small patchy microinfarct [25].…”

Section: Myocardial Viabilitymentioning

confidence: 99%

MRI monitoring of function, perfusion and viability in microembolized moderately ischemic myocardium

Wilson

Krug

et al. 2015

Int J Cardiovasc Imaging

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Assessment of microembolization after coronary interventions is clinically challenging, thus we longitudinally investigated microemboli effects on moderately ischemic myocardium using MRI and histopathology. Twenty-four pigs (8/group) were divided into: group I (no intervention), group II (45 min LAD occlusion) and group III (45 min LAD occlusion with microembolization). Cine, perfusion and delayed contrast enhanced MRI (DE-MRI), using 1.5T MRI, were used for assessment at 3 days and 5 weeks. Triphenyltetrazolium-chloride (TTC) and Masson-trichrome were used as gold standard references for macro and microscopic quantification of myocardial infarction (MI). Cine MRI showed differential increase in end systolic volume (1.3 ± 0.08 ml/kg group II and 1.6 ± 0.1 ml/kg group III) and decrease in ejection fraction (45 ± 2 and 36 ± 2%, respectively) compared with controls at 3 days (2.1 ± 0.1 ml ESV and 50 ± 1% EF, P < 0.05). At 5 weeks group III, but not II, showed persistent perfusion deficits, wall thinning in the LAD territory and compensatory hypertrophy in remote myocardium. DE-MRI MI at 3 days was significantly smaller in group II (3.3 ± 2.2 g) than III (9.8 ± 0.6 g), at 5 weeks, MI were smaller by 60% (1.3 ± 0.9 g) and 22% (7.7 ± 0.5 g), respectively. TTC MI was similar to DE-MRI in group II (1.6 ± 1.0 g) and III (9.2 ± 1.6 g), but not microscopy (2.8 ± 0.4 and 10.5 ± 1.5 g, respectively). The effects of moderate ischemia with and without microembolization on myocardium could be differentiated using multiple MRI sequences. MRI demonstrated that microemboli in moderately ischemic myocardium, but not solely ischemia, prolonged ventricular dysfunction, created perfusion deficits, poor infarct resorption and enhanced compensatory hypertrophy, while moderate ischemia alone caused minor LV changes.

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Multi-detector CT and MRI of microembolized myocardial infarct: monitoring of left ventricular function, perfusion, and myocardial viability in a swine model

Abstract: MDCT can longitudinally quantify regional perfusion deficits, LV dysfunction, and resorption of microembolized MI. MDCT or MRI can be used alternatively after coronary interventions in cases of contraindications for one modality or the other.

Cited by 7 publications

References 32 publications

A Pilot Study of Third-Generation Dual-Source Computed Tomography for the Assessment of Global Dynamic Changes in Left Ventricular Structure and Function in a Porcine Model of Acute Myocardial Infarction

A Pilot Study of Third-Generation Dual-Source Computed Tomography for the Assessment of Global Dynamic Changes in Left Ventricular Structure and Function in a Porcine Model of Acute Myocardial Infarction

Large and Small Animal Models of Heart Failure With Reduced Ejection Fraction

MRI monitoring of function, perfusion and viability in microembolized moderately ischemic myocardium

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