Regional myocardial blood flow reserve impairment and metabolic changes suggesting myocardial ischemia in patients with idiopathic dilated cardiomyopathy

Heuvel, Ad F. M. van den; Veldhuisen, Dirk J. van; Wall, Ernst E. van der; Blanksma, PK; Siebelink, Hans‐Marc J.; Vaalburg, W; Gilst, Wiek H. van; Crijns, Harry J.G.M.

doi:10.1016/s0735-1097(99)00499-4

Cited by 221 publications

(152 citation statements)

References 26 publications

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“…In patients with DCM and heart failure, a reduced blood flow through the myocardium (8,17) and disturbances in function of the endothelium of small vessels were noted. These changes resulted in decreased susceptibility of the vessels to dilate during stress (7,8,15,19).…”

Section: Discussionmentioning

confidence: 99%

Pathomorphological Changes of the Myocardium in Canine Dilated Cardiomyopathy (DCM)

Janus

Nowak

Madej

2015

Bulletin of the Veterinary Institute in Pulawy

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The study was conducted on ventricular and atrial wall preparations from 11 dogs with clinically diagnosed dilated cardiomyopathy. After fixation, the specimens were stained with haematoxylin and eosin and Masson-Goldner trichrome technique. Parenchymal changes (fibrosis and fatty infiltration), vascular changes (congestion and coronary vessel wall hypertrophy), degenerative changes (loss of striation, changes in cardiomycyte and nuclei structure), and presence of inflammatory infiltrates (mononuclear and polynuclear) were estimated. Complex histological changes in both ventricular and atrial muscles were shown. It was not determined whether the processes occurring in the myocardium have a primary character, or are a consequence of developing heart failure. Such issues will be put under further and more detailed examination.

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Section: Discussionmentioning

confidence: 99%

Pathomorphological Changes of the Myocardium in Canine Dilated Cardiomyopathy (DCM)

Janus

Nowak

Madej

2015

Bulletin of the Veterinary Institute in Pulawy

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“…3 Such encasing foci of fibrosis may functionally segregate the viable cardiac myocytes from the coronary circulation, leading to regional perfusion imbalance typical of the progression phase toward myocardial insufficiency. 33 It should be noted that coronary reserve, as measured by double fluorescent microsphere methodology, is reportedly normal in the KKS mutants studied by Meneton's group. 9 Although assessment of maximal dilatation capacity provides functional estimation of coronary circulation, the method does not match histology in dissecting the structural profile of myocardial microvasculature.…”

Section: Cardiac Parameters In Wild-type and B2r Knockout Micementioning

confidence: 95%

Cardiac Hypertrophy and Microvascular Deficit in Kinin B2 Receptor Knockout Mice

et al. 2003

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Abstract-Experimental and clinical evidence suggests kinin involvement in adaptive myocardial growth. Kinins are growth-inhibitory to cardiomyocytes. Knockout of kinin B2 receptor (B2R) signaling causes dilated and failing cardiomyopathy in 129/J mice, and a 9-bp deletion polymorphism of human B2R is associated with reduced receptor expression and exaggerated left ventricular growth response to physical stress. We reasoned that genetic background and aging may significantly influence the impact of B2R mutation on cardiac phenotype. The theory was challenged in C57BL/6 mice, a strain that naturally differs from the 129/J strain, carrying 1 instead of 2 renin genes. C57BL/6 B2R knockouts (B2R-KO) showed higher blood pressure and heart rate levels (PϽ0.05) compared with wild-type controls (WT) at all ages examined. At 12 months, left ventricular contractility and diastolic function were mildly altered (PϽ0.05) and histological and morphological analyses revealed ventricular hypertrophy and cardiomyocyte enlargement in B2R-KO (PϽ0.01). Reparative fibrosis was enhanced by 208% and capillary density reduced by 38% (PϽ0.01).Functional and structural alterations induced by B2R deletion in C57BL/6 mice were less severe than those reported previously in the 129/J strain. We conclude that interaction of B2R signaling with other genetic determinants influences aging-related changes in myocardial structure and function. These findings may help us understand the role of kinins in the development of cardiac failure.

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“…There is increasing evidence that decreased myocardial perfusion also may play an important role in heart failure patients without epicardial coronary artery disease. In patients with DCM, coronary flow reserve is often impaired both globally and regionally because of impaired vasculogenesis and angiogenesis 20, 21. In our previous clinical studies in DCM, CD34 + cell therapy was associated with a significant improvement in myocardial perfusion as assessed by SPECT 5, 22.…”

Section: Discussionmentioning

confidence: 96%

CD34+ Cell Transplantation Improves Right Ventricular Function in Patients with Nonischemic Dilated Cardiomyopathy

Frljak

Jaklič

Zemljic

et al. 2018

Stem Cells Translational Medicine

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We investigated the effects of CD34+ cell therapy on right ventricular (RV) function in patients with nonischemic dilated cardiomyopathy (DCM). We enrolled 60 patients with DCM who were randomized to CD34+ cell therapy (Stem Cells (SC) Group n = 30), or no cell therapy (Controls, n = 30). The SC Group received granulocyte‐colony stimulating factor, and CD34+ cells were collected by apheresis and injected transendocardially. Patients were followed for 6 months. At baseline, the groups did not differ in age, gender, left ventricular ejection fraction, N‐terminal probrain natriuretic peptide, or parameters of RV function. At 6 months, we found a significant improvement in RV function in the SC Group (tricuspid annular plane systolic excursion [TAPSE]: +0.44 ± 0.64 cm, p = .001; peak systolic tissue Doppler velocity of tricuspid annulus [St]: +1.5 ± 2.1 cm/s; p = .001; percent of fractional area change [FAC]: +8.6% ± 5%, p = .01), but not in Controls (TAPSE: −0.07 ± 0.32 cm, p = .40; St: −0.1 ± 1.2 cm/s; p = .44; FAC: −1.2% ± 3.2%, p = .50). On repeat electroanatomical mapping, we found an improvement in interventricular septum viability in 19 of 30 patients from the SC Group; this correlated with the improvements in RV function (13/19 in the improved septum group versus 3/11 in the remaining cohort, p = .029). These results suggest that patients with DCM, changes in RV function correlate with changes of viability of interventricular septum. CD34+ cell therapy appears to be associated with improved right ventricular function in this patient cohort. (Clinical Trial Registration Information: www.clinicaltrials.gov; NCT02248532). Stem Cells Translational Medicine 2018;7:168–172

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Regional myocardial blood flow reserve impairment and metabolic changes suggesting myocardial ischemia in patients with idiopathic dilated cardiomyopathy

Cited by 221 publications

References 26 publications

Pathomorphological Changes of the Myocardium in Canine Dilated Cardiomyopathy (DCM)

Pathomorphological Changes of the Myocardium in Canine Dilated Cardiomyopathy (DCM)

Cardiac Hypertrophy and Microvascular Deficit in Kinin B2 Receptor Knockout Mice

CD34+ Cell Transplantation Improves Right Ventricular Function in Patients with Nonischemic Dilated Cardiomyopathy

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