El-Husseiny Hussein M, Mady Eman A, Ma Danfu, Hamabe Lina, Takahashi Ken, Tanaka Ryou
Laboratory of Veterinary Surgery, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu-shi, Japan.
Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Benha University, Toukh, Egypt.
Front Cardiovasc Med. 2022 Aug 16;9:944171. doi: 10.3389/fcvm.2022.944171. eCollection 2022.
Congestive heart failure (CHF), the leading cause of death, is deemed a grave sequel of myocardial infarction (MI). The employment of left ventricular end-diastolic pressure (LVEDP), as a primary indication of CHF, becomes restricted owing to the potential impairment of heart function and caused injury to the aortic valve during its measurement. Echocardiography is the standard technique to detect cardiac dysfunction. However, it exhibits a low capacity to predict the progression of CHF post chronic MI. Being extremely sensitive, noninvasive, and preload-independent, intraventricular pressure gradient (IVPG) was lately introduced to evaluate cardiac function, specifically during cardiomyopathy. Yet, the utility of its use to assess the CHF progression after chronic MI was not investigated. Herein, in the current research, we aimed to study the efficacy of a novel echocardiographic-derived index as IVPG in the assessment of cardiac function in a chronic MI rat model with CHF. Fifty healthy male rats were involved, and MI was surgically induced in 35 of them. Six months post-surgery, all animals were examined using transthoracic conventional and color M-mode echocardiography (CMME) for IVPG. Animals were euthanized the following day after hemodynamics recording. Gross pathological and histological evaluations were performed. J-tree cluster analysis was conducted relying on ten echocardiographic parameters suggestive of CHF. Animals were merged into two main clusters: CHF+ (MI/HF + group, = 22) and CHF- ( = 28) that was joined from Sham ( = 15), and MI/HF- ( = 13) groups. MI/HF+ group showed the most severe echocardiographic, hemodynamic, anatomic, and histologic alterations. There was no significant change in the total IVPG among various groups. However, the basal IVPG was significantly increased in MI/HF+ group compared to the other groups. The remaining IVPG measures were considerably increased in the MI/HF+ group than in the Sham one. The segmental IVPG measures were significantly correlated with the anatomical, histological, echocardiographic, and hemodynamic findings except for the heart rate. Moreover, they were significant predictors of CHF following a long-standing MI. Conclusively, IVPG obtained from CMME is a substantially promising noninvasive tool with a high ability to detect and predict the progression of CHF following chronic MI compared to conventional echocardiography.
充血性心力衰竭（CHF）是主要死因，被认为是心肌梗死（MI）的严重后遗症。由于在测量左心室舒张末期压力（LVEDP）时可能损害心脏功能并损伤主动脉瓣，将其作为CHF的主要指标受到限制。超声心动图是检测心脏功能障碍的标准技术。然而，它预测慢性心肌梗死后CHF进展的能力较低。心室压力梯度（IVPG）极其敏感、无创且与前负荷无关，最近被引入用于评估心脏功能，特别是在心肌病期间。然而，尚未研究其用于评估慢性心肌梗死后CHF进展的效用。在此，在当前研究中，我们旨在研究一种新的超声心动图衍生指标IVPG在评估慢性心肌梗死合并CHF大鼠模型心脏功能中的疗效。纳入50只健康雄性大鼠，其中35只通过手术诱导心肌梗死。术后6个月，所有动物均使用经胸常规和彩色M型超声心动图（CMME）检查IVPG。在记录血流动力学后的第二天对动物实施安乐死。进行大体病理和组织学评估。基于提示CHF的十个超声心动图参数进行J树聚类分析。动物被合并为两个主要类别：CHF +（MI/HF +组，= 22）和CHF -（= 28），CHF -由假手术组（= 15）和MI/HF -（= 13）组组成。MI/HF +组显示出最严重的超声心动图、血流动力学、解剖学和组织学改变。各组之间的总IVPG无显著变化。然而，与其他组相比，MI/HF +组的基础IVPG显著升高。MI/HF +组的其余IVPG测量值比假手术组显著增加。除心率外，节段性IVPG测量值与解剖学、组织学、超声心动图和血流动力学结果显著相关。此外，它们是长期心肌梗死后CHF的重要预测指标。总之，与传统超声心动图相比，从CMME获得的IVPG是一种非常有前景的无创工具，具有很高的检测和预测慢性心肌梗死后CHF进展的能力。
