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Hibernating myocardium

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https://www.readbyqxmd.com/read/27553362/intramyocardial-gene-therapy-directed-to-hibernating-heart-muscle-using-a-combination-of-electromechanical-mapping-and-positron-emission-tomography
#1
Iiro Hassinen, Antti Kivelä, Antti Hedman, Antti Saraste, Juhani Knuuti, Juha Ek Hartikainen, Seppo Ylä-Herttuala
Cardiac gene transfer for the treatment of ischemic diseases has suffered from low gene transfer efficiency and inability to target treatment genes to the ischemic myocardium. We have developed a combined method based on electromechanical mapping and radiowater PET imaging to target gene therapy to viable but ischemic and hibernating areas of the myocardium. Electromechanical NOGA mapping produces 3D images of myocardium with both an electric activity map and a myocardial contractility map. These have been converted to 17-segment 2D bull's eye maps which were superimposed onto PET radiowater perfusion imaging maps of the myocardium...
August 23, 2016: Human Gene Therapy
https://www.readbyqxmd.com/read/27523610/electroanatomical-properties-of-the-myocardium-predict-response-to-cd34-cell-therapy-in-patients-with-ischemic-and-non-ischemic-heart-failure
#2
Gregor Zemljic, Gregor Poglajen, Matjaz Sever, Marko Cukjati, Sabina Frljak, Vesna Androcec, Peter Cernelc, François Haddad, Bojan Vrtovec
BACKGROUND: We investigated a correlation between electromechanical properties of the myocardium and response to CD34+ cell therapy in patients with chronic heart failure. METHODS AND RESULTS: We enrolled 40 patients with ischemic cardiomyopathy (ICM) and 40 with non-ischemic dilated cardiomyopathy (DCM). All patients were NYHA class III and had LVEF<40%. CD34+ cells were mobilized by G-CSF and collected via apheresis. Electroanatomical mapping was performed to define areas of myocardial scar and hibernation and CD34+ cells were injected transendocardially in the hibernating areas...
August 11, 2016: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/27488429/reverse-mismatch-pattern-in-cardiac-18f-fdg-viability-pet-ct-is-not-associated-with-poor-outcome-of-revascularization-a-retrospective-outcome-study-of-91-patients-with-heart-failure
#3
Allan Kjeldsen Hansen, Michael Gejl, Kirsten Bouchelouche, Lars Poulsen Tolbod, Lars Christian Gormsen
PURPOSE: Revascularization strategies in patients with ischemic heart failure (HF) should be based on evidence of reversible perfusion defects and myocardial viability. Myocardial viability assessment is preferably based on dual isotope PET using perfusion and metabolism tracers. However, in a nonnegligible subset of HF patients, reverse mismatch (RM) pattern (reduced glucose uptake relative to perfusion) of unknown origin is observed. We aimed to investigate determinants of RM and the impact of RM on the subsequent improvement in left ventricular function by revascularization...
October 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27450736/cardioprotection-by-thymosin-beta-4
#4
G T Pipes, J Yang
Treatment with thymosin beta 4 (Tβ4) reduces infarct volume and preserves cardiac function in preclinical models of cardiac ischemic injury. These effects stem in part from decreased infarct size, but additional benefits are likely due to specific antifibrotic and proangiogenic activities. Injected or transgenic Tβ4 increase blood vessel growth in large and small animal models, consistent with Tβ4 converting hibernating myocardium to an actively contractile state following ischemia. Tβ4 and its degradation products have antifibrotic effects in in vitro assays and in animal models of fibrosis not related to cardiac injury...
2016: Vitamins and Hormones
https://www.readbyqxmd.com/read/27283041/identification-of-angiogenesis-rich-viable-myocardium-using-rgd-dimer-based-spect-after-myocardial-infarction
#5
Min Su Lee, Hyun Soo Park, Byung Chul Lee, Jae Ho Jung, Jung Sun Yoo, Sang Eun Kim
Cardiac healing after myocardial ischemia is a complex biological process. Advances in understanding of wound healing response have paved the way for clinical testing of novel molecular imaging to improve clinical outcomes. A key factor for assessing myocardial viability after ischemic injury is the evaluation of angiogenesis accompanying increased expression of integrin αvβ3. Here, we describe the capability of an αvβ3 integrin-targeting SPECT agent, (99m)Tc-IDA-D-[c(RGDfK)]2, for identification of ischemic but viable myocardium, i...
2016: Scientific Reports
https://www.readbyqxmd.com/read/27184805/cardiac-strain-in-a-swine-model-of-regional-hibernating-myocardium-effects-of-coq10-on-contractile-reserve-following-bypass-surgery
#6
Laura Hocum Stone, Tammy A Butterick, Cayla Duffy, Corey Swingen, Herbert B Ward, Rosemary F Kelly, Edward O McFalls
There is conflicting clinical evidence whether administration of coenzyme Q10 (CoQ10) improves function following coronary artery bypass graft surgery (CABG). Using a swine model of hibernating myocardium, we tested whether daily CoQ10 would improve contractile function by MRI at 4-week post-CABG. Twelve pigs underwent a thoracotomy and had a constrictor placed on the left anterior descending (LAD). At 12 weeks, they underwent off-pump bypass and received daily dietary supplements of either CoQ10 (10 mg/kg/day) or placebo...
August 2016: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/27147609/taxonomy-of-segmental-myocardial-systolic-dysfunction
#7
Adam K McDiarmid, Pierpaolo Pellicori, John G Cleland, Sven Plein
The terms used to describe different states of myocardial health and disease are poorly defined. Imprecision and inconsistency in nomenclature can lead to difficulty in interpreting and applying trial outcomes to clinical practice. In particular, the terms 'viable' and 'hibernating' are commonly applied interchangeably and incorrectly to myocardium that exhibits chronic contractile dysfunction in patients with ischaemic heart disease. The range of inherent differences amongst imaging modalities used to define myocardial health and disease add further challenges to consistent definitions...
May 4, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27115143/myocardial-viability-and-revascularization-current-understanding-and-future-directions
#8
REVIEW
Pavan Patel, Alexander Ivanov, Kumudha Ramasubbu
The initial observation of functional recovery in dysfunctional myocardium following revascularization led to the introduction of the concept of hibernating myocardium. Since then, the pathophysiologic basis of hibernating myocardium has been well described. Multiple imaging modalities have been utilized to prospectively detect viable myocardium and thus predict its functional recovery following revascularization. It has been hypothesized that viability imaging will be instrumental in the selection of patients with ischemic cardiomyopathy likely to benefit from revascularization...
June 2016: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/27037806/implantation-of-a-novel-allogeneic-mesenchymal-precursor-cell-type-in-patients-with-ischemic-cardiomyopathy-undergoing-coronary-artery-bypass-grafting-an-open-label-phase-iia-trial
#9
Kyriakos Anastasiadis, Polychronis Antonitsis, Stephen Westaby, Ajan Reginald, Sabena Sultan, Argirios Doumas, George Efthimiadis, Martin John Evans
Heart failure is a life-limiting condition affecting over 40 million patients worldwide. Ischemic cardiomyopathy (ICM) is the most common cause. This study investigates in situ cardiac regeneration utilizing precision delivery of a novel mesenchymal precursor cell type (iMP) during coronary artery bypass surgery (CABG) in patients with ischemic cardiomyopathy (LVEF < 40 %). The phase IIa safety study was designed to enroll 11 patients. Preoperative scintigraphy imaging (SPECT) was used to identify hibernating myocardium not suitable for conventional myocardial revascularization for iMP implantation...
June 2016: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/26980317/cardiac-mri-and-ischemic-heart-disease-role-in-diagnosis-and-risk-stratification
#10
REVIEW
Rahul N Sawlani, Jeremy D Collins
Cardiac magnetic resonance imaging (CMRI) has been under development for the past four decades and has more recently become an essential tool in the evaluation of ischemic heart disease (IHD). It is the reference standard for quantification of both right and left ventricular volume and function and, after landmark work published in the New England Journal of Medicine in 2000, has proven effective in identifying hibernating myocardium, or hypokinetic myocardium that will recover after revascularization. More recent literature continues to support both delayed enhancement imaging and CMRI stress perfusion as essential tools in evaluating IHD...
May 2016: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/26419678/ivabradine-reduces-myocardial-stunning-in-patients-with-exercise-inducible-ischaemia
#11
F Maranta, L Tondi, E Agricola, A Margonato, O Rimoldi, Paolo G Camici
Ivabradine is an effective treatment for angina in patients with stable coronary artery disease (CAD) and for heart failure. Experiments in a canine model have shown that ivabradine reduces both acute left ventricular (LV) dysfunction and post-ischaemic stunning. Aim of this study was to investigate the effect of ivabradine on LV dysfunction and stunning in patients with CAD and exercise-inducible ischaemia. Fifteen patients with ejection fraction >40 % and heart rate >70 bpm were enrolled. After pharmacologic washout, echocardiography was performed at rest, at peak treadmill exercise and during recovery until return to baseline...
November 2015: Basic Research in Cardiology
https://www.readbyqxmd.com/read/26296299/one-year-outcome-of-the-sevoflurane-in-acute-myocardial-infarction-randomized-trial
#12
RANDOMIZED CONTROLLED TRIAL
Shahar Lavi, Mistre Alemayehu, David McCarty, James Warrington, Ronit Lavi
BACKGROUND: Sevoflurane is an inhalation anesthetic that has cardioprotective effects. There is limited information regarding its use outside of the operating room and its potential protective effect for patients presenting with myocardial infarction. METHODS: In the Sevoflurane In Acute Myocardial Infarction trial, patients with a first acute ST-elevation myocardial infarction (STEMI) who were treated by primary percutaneous coronary intervention were randomized to inhalation of sevoflurane or oxygen (control)...
December 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26271689/comparative-efficacy-of-intracoronary-allogeneic-mesenchymal-stem-cells-and-cardiosphere-derived-cells-in-swine-with-hibernating-myocardium
#13
COMPARATIVE STUDY
Brian R Weil, Gen Suzuki, Merced M Leiker, James A Fallavollita, John M Canty
RATIONALE: Allogeneic bone marrow-derived mesenchymal stem cells (MSCs) and cardiosphere-derived cells (CDCs) have each entered clinical trials, but a direct comparison of these cell types has not been performed in a large animal model of hibernating myocardium. OBJECTIVE: Using completely blinded methodology, we compared the efficacy of global intracoronary allogeneic MSCs (icMSCs, ≈35×10(6)) and CDCs (icCDCs, ≈35×10(6)) versus vehicle in cyclosporine-immunosuppressed swine with a chronic left anterior descending coronary artery stenosis (n=26)...
September 11, 2015: Circulation Research
https://www.readbyqxmd.com/read/26221599/cardiomyocyte-remodeling-in-atrial-fibrillation-and-hibernating-myocardium-shared-pathophysiologic-traits-identify-novel-treatment-strategies
#14
REVIEW
Brian R Weil, Cevher Ozcan
Atrial fibrillation (AF) is the most common arrhythmia and is associated with a high risk of morbidity and mortality. However, there are limited treatment strategies for prevention of disease onset and progression. Development of novel therapies for primary and secondary prevention of AF is critical and requires improved understanding of the cellular and molecular mechanisms underlying the AF disease process. Translational and clinical studies conducted over the past twenty years have revealed that atrial remodeling in AF shares several important pathophysiologic traits with the remodeling processes exhibited by hibernating myocardium that develop in response to chronic ischemia...
2015: BioMed Research International
https://www.readbyqxmd.com/read/26155706/-modern-strategy-for-the-treatment-of-patients-with-hibernating-myocardium
#15
A V Patrikeev, V Ya Rudman, D A Maksimkin, A V Mambetov, V Kallianpur, Shugushev Z Kh
The paper reports results of endovascular treatment of 66 patients with post-infarction cardiosclerosis. It was shown that normalization of coronary circulation in patients with viable hibernating myocardium in the zone of the affected artery not only eliminates the signs of chronic ischemia and slows down post-infarction heart remodeling but also restores the lost functions of hibernating myocardium which has beneficial influence on prognosis of the disease. Functioning of hibernating myocardium depends on the timely restoration of coronary circulation...
2015: Klinicheskaia Meditsina
https://www.readbyqxmd.com/read/26035516/cardiac-applications-of-pet
#16
REVIEW
Ismet Sarikaya
Routine use of cardiac positron emission tomography (PET) applications has been increasing but has not replaced cardiac single-photon emission computerized tomography (SPECT) studies yet. The majority of cardiac PET tracers, with the exception of fluorine-18 fluorodeoxyglucose (18F-FDG), are not widely available, as they require either an onsite cyclotron or a costly generator for their production. 18F-FDG PET imaging has high sensitivity for the detection of hibernating/viable myocardium and has replaced Tl-201 SPECT imaging in centers equipped with a PET/CT camera...
October 2015: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/25946989/the-recovery-of-hibernating-hearts-lies-on-a-spectrum-from-bears-in-nature-to-patients-with-coronary-artery-disease
#17
REVIEW
Robert W Colbert, Christopher T Holley, Laura Hocum Stone, Melanie Crampton, Selcuk Adabag, Santiago Garcia, Paul A Iaizzo, Herbert B Ward, Rosemary F Kelly, Edward O McFalls
Clinicians often use the term "hibernating myocardium" in reference to patients with ischemic heart disease and decreased function within viable myocardial regions. Because the term is a descriptor of nature's process of torpor, we provide a comparison of the adaptations observed in both conditions. In nature, hearts from hibernating animals undergo a shift in substrate preference in favor of fatty acids, while preserving glucose uptake and glycogen. Expression of electron transport chain proteins in mitochondria is decreased while antioxidant proteins including uncoupling protein-2 are increased...
June 2015: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/25936179/-hypothermia-induced-alteration-of-refractoriness-in-the-ventricular-myocardium-of-ground-souirrel-citellus-undulatus
#18
V S Kuz'min, A A Abramov, Iu V Egorov, L V Rozenshtraukh
Bioelectrical activity and refractoriness in ventricular myocardium of the hibernator--ground squirrel Citellus undulatus were investigated during hypothermia. Experiments were performed with use of isolated, perfused preparations of papillary muscle from right ventricular. Preparations were obtained from hibernating (HS), summer active (SAS) squirrels and from rats. Bioelectrical activity was registered using the standard microelectrode technique at 37-17 degrees C. Action potentials duration (APD), refractoriness duration (RD) and the velocity of the action potential wave front (dV/dt) were estimated...
December 2014: Rossiĭskii Fiziologicheskiĭ Zhurnal Imeni I.M. Sechenova
https://www.readbyqxmd.com/read/25909546/-immediate-and-remote-results-of-endovascular-treatment-of-patients-with-postinfarction-cardiosclerosis
#19
RANDOMIZED CONTROLLED TRIAL
A V Patrikeev, V Ia Rudman, D A Maksimkin, V Iu Baranovich, A G Faĭbushevich, G I Veretnik, A V Mambetov, Z Kh Shugushev
Two approaches in treatment of 131 patients with postinfarction cardiosclerosis are compared in the work. Tactics of "total" myocardial revascularization means restoration of coronary blood flow in all arteries with hemodynamically significant lesion while "selective" revascularization provides restoration of coronary blood flow only in those arteries which have a viable myocardium in their pool. It was concluded that restoration of coronary blood flow in patients after myocardial infarction permits to prevent postinfarction heart remodeling, development of heart failure thereby affecting on the prognosis...
2015: Khirurgiia
https://www.readbyqxmd.com/read/25848764/myocardial-feature-tracking-reduces-observer-dependence-in-low-dose-dobutamine-stress-cardiovascular-magnetic-resonance
#20
Andreas Schuster, Matthias Paul, Nuno Bettencourt, Shazia T Hussain, Geraint Morton, Shelby Kutty, Boris Bigalke, Amedeo Chiribiri, Divaka Perera, Eike Nagel, Philipp Beerbaum
OBJECTIVES: To determine whether quantitative wall motion assessment by CMR myocardial feature tracking (CMR-FT) would reduce the impact of observer experience as compared to visual analysis in patients with ischemic cardiomyopathy (ICM). METHODS: 15 consecutive patients with ICM referred for assessment of hibernating myocardium were studied at 3 Tesla using SSFP cine images at rest and during low dose dobutamine stress (5 and 10 μg/kg/min of dobutamine). Conventional visual, qualitative analysis was performed independently and blinded by an experienced and an inexperienced reader, followed by post-processing of the same images by CMR-FT to quantify subendocardial and subepicardial circumferential (Eccendo and Eccepi) and radial (Err) strain...
2015: PloS One
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