Myocardial contractility in the stress echo lab: from pathophysiological toy to clinical tool

详细信息    查看全文

• 作者：Tonino Bombardini (1)
  Monica Zoppè (1)
  Quirino Ciampi (2)
  Lauro Cortigiani (3)
  Eustachio Agricola (4)
  Stefano Salvadori (1)
  Tiziana Loni (1)
  Lorenza Pratali (1)
  Eugenio Picano (1)
  
• 关键词：Force ; frequency relation ; Pressure ; volume relation ; Stress echo ; Contractility ; Heart failure ; Wearable contractility sensor ; Molecular animation ; Bioblender
• 刊名：Cardiovascular Ultrasound
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：11
• 期：1
• 全文大小：710 KB
• 参考文献：1. Bombardini T: Myocardial contractility in the echo lab: molecular, cellular and pathophysiological basis. / Cardiovasc Ultrasound 2005, 3:27. Review CrossRef
  2. Mulieri LA, Hasenfuss G, Leavitt B, Allen PD, Alpert NR: Altered myocardial force-frequency relation in human heart failure. / Circulation 1992, 85:1743-750. CrossRef
  3. Piot C, Lemaire S, Albat B, Seguin J, Nargeot J, Richard S: High frequency-induced upregulation of human cardiac calcium currents. / Circulation 1996, 93:120-28. CrossRef
  4. Suga H, Sagawa K, Shoukas AA: Load independence of the instantaneous pressure/volume ratio of the canine left ventricle and effects of epinephrine and heart rate on the ratio. / Circ Res 1973, 32:314-22. CrossRef
  5. Ginzton LE, Laks MM, Brizendine M, Conant R, Mena I: Noninvasive measurement of the rest and exercise peak systolic pressure/end-systolic volume ratio: a sensitive two-dimensional echocardiographic indicator of left ventricular function. / J Am Coll Cardiol 1984, 4:509-16. CrossRef
  6. Bombardini T, Correia MJ, Cicerone C, Agricola E, Ripoli A, Picano E: Force-frequency relationship in the echocardiography laboratory: a noninvasive assessment of Bowditch treppe? / J Am Soc Echocardiogr 2003, 16:646-55. CrossRef
  7. Grosu A, Bombardini T, Senni M, Duino V, Gori M, Picano E: End-systolic pressure/volume relationship during dobutamine stress echo: a prognostically useful non-invasive index of left ventricular contractility. / Eur Heart J 2005, 26:2404-412. CrossRef
  8. Bombardini T, Agrusta M, Natsvlishvili N, Solimene F, Pap R, Coltorti F, Varga A, Mottola G, Picano E: Noninvasive assessment of left ventricular contractility by pacemaker stress echocardiography. / Eur J Heart Fail 2005, 7:173-81. CrossRef
  9. Bombardini T, Nevola E, Giorgetti A, Landi P, Picano E, Neglia D: Prognostic value of left-ventricular and peripheral vascular performance in patients with dilated cardiomyopathy. / J Nucl Cardiol 2008, 15:353-62. CrossRef
  10. Chemla D, Antony I, Lecarpentier Y, Nitenberg A: Contribution of systemic vascular resistance and total arterial compliance to effective arterial elastance in humans. / Am J Physiol Heart Circ Physiol 2003, 285:H614-H620.
  11. Bombardini T, Gherardi S, Marraccini P, Schlueter MC, Sicari R, Picano E: The incremental diagnostic value of coronary flow reserve and left ventricular elastance during high-dose dipyridamole stress echocardiography in patients with normal wall motion at rest. / Int J Cardiol 2013, 168:1683-. CrossRef
  12. Opie LH: Mechanisms of cardiac contraction and relaxation. In / Heart Disease Volume Chap 19. 7th edition. Edited by: Braunwald E, Zipes DP, Libby P, Bonow RO. Philadelphia: WB Saunders Company; 2005:457-89.
  13. Inagaki M, Yokota M, Izawa H, Ishiki R, Nagata K, Iwase M, Yamada Y, Koide M, Sobue T: Impaired force-frequency relations in patients with hypertensive left ventricular hypertrophy. / Circulation 1999, 14:1822-830. CrossRef
  14. Sicari R, Nihoyannopoulos P, Evangelista A, Kasprzak J, Lancellotti P, Poldermans D, Voigt JU, Zamorano JL, European Association of Echocardiography: Stress Echocardiography Expert Consensus Statement–Executive Summary: European Association of Echocardiography (EAE) (a registered branch of the ESC). / Eur Heart J 2009, 30:278-89. CrossRef
  15. Bombardini T, Galderisi M, Agricola E, Coppola V, Mottola G, Picano E: Negative stress echo: further prognostic stratification with assessment of pressure-volume relation. / Int J Cardiol 2008, 126:258-67. CrossRef
  16. Bombardini T, Gemignani V, Bianchini E, Venneri L, Petersen C, Pasanisi E, Pratali L, Pianelli M, Faita F, Giannoni M, Picano E: Cardiac reflections and natural vibrations: force-frequency relation recording system in the stress echo lab. / Cardiovasc Ultrasound 2007, 5:42. CrossRef
  17. Bombardini T, Gherardi S, Arpesella G, Maccherini M, Serra W, Magnani G, Del Bene R, Picano E: Favorable short term outcome of transplanted hearts selected from marginal donors by pharmacological stress echocardiography. / J Am Soc Echocardiogr 2011, 24:353-62. CrossRef
  18. Agricola E, Bombardini T, Oppizzi M, Margonato A, Pisani M, Melisurgo G, Picano E: Usefulness of latent left ventricular dysfunction assessed by Bowditch Treppe to predict stress-induced pulmonary hypertension in minimally symptomatic severe mitral regurgitation secondary to mitral valve prolapse. / Am J Cardiol 2005, 95:414-17. CrossRef
  19. Cortigiani L, Bombardini T, Corbisiero A, Mazzoni A, Bovenzi F, Picano E: The additive prognostic value of end-systolic pressure-volume relation in patients with diabetes mellitus having negative dobutamine stress echocardiography by wall motion criteria. / Heart 2009, 95:1429-435. CrossRef
  20. Otasevic P, Popovic ZB, Vasiljevic JD, Pratali L, Vlahovic-Stipac A, Boskovic SD, Tasic N, Neskovic AN: Head-to-head comparison of indices of left ventricular contractile reserve assessed by high-dose dobutamine stress echocardiography in idiopathic dilated cardiomyopathy: five-year follow up. / Heart 2006, 92:1253-258. CrossRef
  21. Otasevi? P, Popovi? ZB, Vasiljevi? JD, Vidakovi? R, Pratali L, Vlahovi? A, Neskovi? AN: Relation of myocardial histomorphometric features and left ventricular contractile reserve assessed by high-dose dobutamine stress echocardiography in patients with idiopathic dilated cardiomyopathy. / Eur J Heart Fail 2005, 7:49-6. CrossRef
  22. Ciampi Q, Pratali L, Bombardini T, Della Porta M, Petruzziello B, Villari B, Picano E, Sicari R: Pressure-volume relationship during dobutamine stress echocardiography predicts exercise tolerance in patients with congestive heart failure. / J Am Soc Echocardiogr 2010, 23:71-8. CrossRef
  23. Agricola E, Meris A, Oppizzi M, Bombardini T, Pisani M, Fragasso G, Margonato A: Rest and stress echocardiographic predictors of prognosis in patients with left ventricular dysfunction and functional mitral regurgitation. / Int J Cardiol 2008, 124:247-49. CrossRef
  24. Ciampi Q, Pratali L, Citro R, Villari B, Picano E, Sicari R: Clinical and prognostic role of pressure-volume relationship in the identification of responders to cardiac resynchronization therapy. / Am Heart J 2010, 160:906-14. CrossRef
  25. Bombardini T, Costantino MF, Sicari R, Ciampi Q, Pratali L, Picano E: End-systolic elastance and ventricular-arterial coupling reserve predict cardiac events in patients with negative stress echocardiography. / Biomed Res Int 2013, 2013:235194. 10.1155/2013/235194. Epub 2013 Aug 19
  26. Leone O, Gherardi S, Targa L, Pasanisi E, Mikus P, Tanganelli P, Maccherini M, Arpesella G, Picano E, Bombardini T: Stress echocardiography as a gatekeeper to donation in aged marginal donor hearts: anatomic and pathologic correlations of abnormal stress echocardiography results. / J Heart Lung Transplant 2009, 28:1141-149. CrossRef
  27. Bombardini T, Gemignani V, Bianchini E, Pasanisi E, Pratali L, Pianelli M, Faita F, Giannoni M, Arpesella G, Sicari R, Picano E: Post-exercise contractility, diastolic function, and pressure: operator-independent sensor-based intelligent monitoring for heart failure telemedicine. / Cardiovasc Ultrasound 2009, 17:21. CrossRef
  28. Jellis CL, Jenkins C, Leano R, Martin JH, Marwick TH: Reduced end-systolic pressure-volume ratio response to exercise: a marker of subclinical myocardial disease in type 2 diabetes. / Circ Cardiovasc Imaging 2010, 3:443-49. CrossRef
  29. Bombardini T, Gherardi S, Leone O, Sicari R, Picano E: Transplant of stunned donor hearts rescued by pharmacological stress echocardiography: a “proof of concept-report. / Cardiovasc Ultrasound 2013, 11:27. CrossRef
  30. Galderisi M, de Simone G, Innelli P, Turco A, Turco S, Capaldo B, Riccardi G, de Divitiis O: Impaired inotropic response in type 2 diabetes mellitus: a strain rate imaging study. / Am J Hypertens 2007 May,20(5):548-5. CrossRef
  
• 作者单位：Tonino Bombardini (1)
  Monica Zoppè (1)
  Quirino Ciampi (2)
  Lauro Cortigiani (3)
  Eustachio Agricola (4)
  Stefano Salvadori (1)
  Tiziana Loni (1)
  Lorenza Pratali (1)
  Eugenio Picano (1)
  
  1. CNR, Institute of Clinical Physiology, Area della Ricerca, Pisa, 56124, Italy
  2. Division of Cardiology, Fatebenefratelli Hospital, V.le Principe di Napoli 14, Benevento, 82100, Italy
  3. Division of Cardiology, Campo di Marte Hospital, Via dell’Ospedale, 238, Lucca, 55100, Italy
  4. Division of Non-Invasive Cardiology, San Raffaele University Hospital, Via Olgettina 58, Milan, 20100, Italy
  
• ISSN：1476-7120

文摘

Up-regulation of Ca2+ entry through Ca2+ channels by high rates of beating is involved in the frequency-dependent regulation of contractility: this process is crucial in adaptation to exercise and stress and is universally known as force-frequency relation (FFR). Disturbances in calcium handling play a central role in the disturbed contractile function in myocardial failure. Measurements of twitch tension in isolated left-ventricular strips from explanted cardiomyopathic hearts compared with non-failing hearts show flat or biphasic FFR, while it is up-sloping in normal hearts. Starting in 2003 we introduced the FFR measurement in the stress echo lab using the end-systolic pressure (ESP)/End-systolic volume index (ESVi) ratio (the Suga index) at increasing heart rates. We studied a total of 2,031 patients reported in peer-reviewed journals: 483 during exercise, 34 with pacing, 850 with dobutamine and 664 during dipyridamole stress echo. We demonstrated the feasibility of FFR in the stress echo lab, the clinical usefulness of FFR for diagnosing latent contractile dysfunction in apparently normal hearts, and residual contractile reserve in dilated idiopathic and ischemic cardiomyopathy. In 400 patients with left ventricular dysfunction (ejection fraction 30?±-%) with negative stress echocardiography results, event-free survival was higher (p-lt;-.001) in patients with ΔESPVR (the difference between peak and rest end-systolic pressure-volume ratio, ESPVR)?≥-.4?mmHg/mL/m2. The prognostic stratification of patients was better with FFR, beyond the standard LV ejection fraction evaluation, also in the particular settings of severe mitral regurgitation or diabetics without stress-induced ischemia. In the particular setting of selection of heart transplant donors, the stress echo FFR was able to correctly select 34 marginal donor hearts efficiently transplanted in emergency recipients. Starting in 2007, we introduced an operator-independent cutaneous sensor to monitor the FFR: the force is quantified as the sensed pre-ejection myocardial vibration amplitude. We demonstrated that the sensor-derived force changes at increasing heart rates are highly related with both max dP/dt in animal models, and with the stress echo FFR in 220 humans, opening a new window for pervasive cardiac heart failure monitoring in telemedicine systems.