Usefulness of Mitral Annulus Velocity for the Early Detection of Left Ventricular Dysfunction in a Rat Model of Diabetic Cardiomyopathy
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: Diabetic cardiomyopathy (DMCMP) is characterized by myocardial dysfunction regardless of coronary artery disease in diabetic patients. The features of LV dysfunction in rat model of type 1 DM induced by streptozocin, are variable and controversial. Thus, we tested the usefulness of tissue Doppler imaging in the early detection of ventricular dysfunction in a rat model of DMCMP. Methods: Diabetes was induced by intra-peritoneal injection of streptozocin (70 mg/kg) in 8 weeks of Sprague-Dawley rat. Diagnosis of diabetes was defined as venous glucose level over 350 mg/dL 48 hrs after streptozocin injection. Echocardiography was done at baseline and 10 weeks after diabetes induction both in diabetes group (n=15) and normal control (n=10). After echocardiography at 10 weeks, invasive hemodynamic measurement using miniaturized conductance catheter was done in both groups. Results: Ten weeks after diabetes induction, heart and lung mass indexes of diabetes were larger than those of normal control (3.2±0.3 vs. 2.4±0.2 mg/g, p＜0.001, 5.5±1.1 vs. 3.6±0.6 mg/g, p＜0.001, respectively). In echocardiographic data, s’ (2.4±0.4 vs. 3.1±0.5 cm/s, p＜0.001), e’ velocity of mitral annulus (2.9±0.6 vs. 3.8±1.1 cm/s, p＜0.001), and E/e’ ratio (27.1±5.6 vs. 19.7±2.6, p＜0.001) were impaired in diabetes group. In hemodynamic measurement, there were no differences in ejection fraction, peak dP/dt between the diabetic group and normal control. However, load independent indexes of contractility, the slope of the end-systolic pressure volume relation (0.18±0.07 vs. 0.62±0.18 mmHg/μL, p ＜0.001) and preload recruitable stroke work (51.8±22.0 vs. 90.9±22.5 mmHg, p＜0.001) were impaired in diabetic group compared to normal control. Conclusion: In a rat model of diabetic cardiomyopathy, tissue Doppler imaging of mitral annulus can be a good modality for early detection of myocardial dysfunction.
Abstract
Background: Diabetic cardiomyopathy (DMCMP) is characterized by myocardial dysfunction regardless of coronary artery disease in diabetic patients. The features of LV dysfunction in rat model of type 1 DM induced by streptozocin, are variable and controversial. Thus, we tested the usefulness of tissue Doppler imaging in the early detection of ventricular dysfunction in a rat model of DMCMP. Methods: Diabetes was induced by intra-peritoneal injection of streptozocin (70 mg/kg) in 8 weeks of Sprague-Dawley rat. Diagnosis of diabetes was defined as venous glucose level over 350 mg/dL 48 hrs after streptozocin injection. Echocardiography was done at baseline and 10 weeks after diabetes induction both in diabetes group (n=15) and normal control (n=10). After echocardiography at 10 weeks, invasive hemodynamic measurement using miniaturized conductance catheter was done in both groups. Results: Ten weeks after diabetes induction, heart and lung mass indexes of diabetes were larger than those of normal control (3.2±0.3 vs. 2.4±0.2 mg/g, p＜0.001, 5.5±1.1 vs. 3.6±0.6 mg/g, p＜0.001, respectively). In echocardiographic data, s’ (2.4±0.4 vs. 3.1±0.5 cm/s, p＜0.001), e’ velocity of mitral annulus (2.9±0.6 vs. 3.8±1.1 cm/s, p＜0.001), and E/e’ ratio (27.1±5.6 vs. 19.7±2.6, p＜0.001) were impaired in diabetes group. In hemodynamic measurement, there were no differences in ejection fraction, peak dP/dt between the diabetic group and normal control. However, load independent indexes of contractility, the slope of the end-systolic pressure volume relation (0.18±0.07 vs. 0.62±0.18 mmHg/μL, p ＜0.001) and preload recruitable stroke work (51.8±22.0 vs. 90.9±22.5 mmHg, p＜0.001) were impaired in diabetic group compared to normal control. Conclusion: In a rat model of diabetic cardiomyopathy, tissue Doppler imaging of mitral annulus can be a good modality for early detection of myocardial dysfunction.
참고문헌 (22)
- Marwick TH, "Diabetic heart disease", Heart, 92, pp.296~300 (2006)
- Rubler S, "New type of cardiomyopathy associated with diabetic glomerulosclerosis", Am J Cardiol, 30, pp.595~602 (1972)
- Boudina S, "Diabetic cardiomyopathy revisited", Circulation, 115, pp.3213~3223 (2007)
- Zarich SW, "Diabetic cardiomyopathy", Am Heart J, 118, pp.1000~1012 (1989)
- Cai L, "Oxidative stress and diabetic cardiomyopathy: a brief review", Cardiovasc Toxicol, 1, pp.181~193 (2001)
- Fiordaliso F, "Myocyte death in streptozotocin-induced diabetes in rats in angiotensin II- dependent", Lab Invest, 80, pp.513~527 (2000)
- Tschöpe C, "Prevention of cardiac fibrosis and left ventricular dysfunction in diabetic cardiomyopathy in rats by transgenic expression of the human tissue kallikrein gene", FASEB J, 18, pp.828~835 (2004)
- Tschöpe C, "Improvement of defective sarcoplasmic reticulum Ca2+ transport in diabetic heart of transgenic rats expressing the human kallikrein-1 gene", FASEB J, 18, pp.1967~1969 (2004)
- Westermann D, "Contributions of inflammation and cardiac matrix metalloproteinase activity to cardiac failure in diabetic cardiomyopathy: the role of angiotensin type 1 receptor antagonism", Diabetes, 56, pp.641~646 (2007)
- Boyer JK, "Prevalence of ventricular diastolic dysfunction in asymptomatic, normotensive patients with diabetes mellitus", Am J Cardiol, 93, pp.870~875 (2004)
- Fang ZY, "Echocardiographic detection of early diabetic myocardial disease", J Am Coll Cardiol, 41, pp.611~617 (2003)
- Candido R, "A breaker of advanced glycation end products attenuates diabetes-induced myocardial structural changes", Circ Res, 92, pp.785~792 (2003)
- Tschöpe C, "Myocardial expression of rat bradykinin receptors and two tissue kallikrein genes in experimental diabetes", Immunopharmacology, 44, pp.35~42 (1999)
- Georgakopoulos D, "In vivo murine left ventricular pressure-volume relations by miniaturized conductance micromanometry", Am J Physiol, 274, pp.H1416~1422 (1998)
- Pacher P, "Measurement of cardiac function using pressure-volume conductance catheter technique in mice and rats", Nat Protoc, 3, pp.1422~1434 (2008)
- Van Linthout S, "Anti-inflammatory effects of atorvastatin improve left ventricular function in experimental diabetic cardiomyopathy", Diabetologia, 50, pp.1977~1986 (2007)
- Westermann D, "Cardioprotective and anti-inflammatory effects of interleukin converting enzyme inhibition in experimental diabetic cardiomyopathy", Diabetes, 56, pp.1834~1841 (2007)
- Yoon YS, "Progressive attenuation of myocardial vascular endothelial growth factor expression is a seminal event in diabetic cardiomyopathy: restoration of microvascular homeostasis and recovery of cardiac function in diabetic cardiomyopathy after replenishment of local vascular endothelial growth factor", Circulation, 111, pp.2073~2085 (2005)
- Sherif F. Nagueh, "Tissue Doppler Imaging for the Assessment of Left Ventricular Diastolic Function", Journal of Cardiovascular Ultrasound, 16(3), pp.76~79 (2008), 한국심초음파학회
- Ommen SR, "Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: A comparative simultaneous Doppler-catheterization study", Circulation, 102, pp.1788~1794 (2000)
- Prunier F, "Doppler echocardiographic estimation of left ventricular end-diastolic pressure after MI in rats", Am J Physiol Heart Circ Physiol, 283, pp.H346~352 (2002)
- 김용진, "조직도플러영상", Journal of Cardiovascular Ultrasound, 11(2), pp.63~69 (2003), 한국심초음파학회