Quantification of Left Ventricular Twisting Mechanics by Velocity Vector Imaging in an Animal Model of Pericardial Adhesions

Panupong Jiamsripong, Mohsen S. Alharthi, Anna M. Calleja, Eileen M. McMahon, Farouk Mookadam, Bijoy K. Khandheria, Marek Belohlavek

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Diagnosis of constrictive pericarditis remains clinically challenging. Untwisting of the left ventricle (LV) is essential for normal LV diastolic function. Echocardiography is able to measure LV twisting mechanics. We designed an animal model of constrictive pericarditis to determine how pericardial-epicardial adhesions impair LV twisting mechanics. In eight open-chest pigs, the heart was exposed while preserving the pericardium. We simulated early constrictive pericarditis by pericardial constriction and patchy adhesions induced with instant glue and pericardial-epicardial stitches. Using Velocity Vector Imaging™ (VVI), LV magnitudes of twisting and untwisting were measured along with hemodynamic data at baseline and after the experimental intervention. Significant decreases in end-diastolic volume, ejection fraction, stroke volume, and late diastolic filling velocity reflected the effects of the pericardial adhesions. Magnitude of LV untwisting rate decreased from -80 ± 23°/s to -26 ± 10 °/s (p = 0.0009). LV twisting rate dropped from 78 ± 20°/s to 40 ± 8°/s (p = 0.0039) and LV twist magnitude decreased from 9 ± 2° to 5 ± 2 ° (p = 0.0081). Patchy pericardial adhesions are associated with reductions in LV untwisting rate and twisting magnitude, consistent with a negative impact of constrictive pericarditis on systolic and diastolic function. Impairments in LV twisting mechanics may have a diagnostic role in the detection of early stages of constrictive pericarditis. (E-mail: belohlavek.marek@mayo.edu).

Original languageEnglish (US)
Pages (from-to)1963-1972
Number of pages10
JournalUltrasound in Medicine and Biology
Volume35
Issue number12
DOIs
StatePublished - Dec 2009

Fingerprint

animal models
twisting
Mechanics
Heart Ventricles
adhesion
Animal Models
Constrictive Pericarditis
stroke volume
echocardiography
hemodynamics
glues
swine
chest
impairment
ejection
preserving
constrictions
Pericardium
Constriction
Adhesives

Keywords

  • Echocardiography
  • Left ventricular twisting
  • Left ventricular untwisting
  • Pericardial adhesion
  • Pericardial constriction
  • Velocity Vector Imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Biophysics

Cite this

Quantification of Left Ventricular Twisting Mechanics by Velocity Vector Imaging in an Animal Model of Pericardial Adhesions. / Jiamsripong, Panupong; Alharthi, Mohsen S.; Calleja, Anna M.; McMahon, Eileen M.; Mookadam, Farouk; Khandheria, Bijoy K.; Belohlavek, Marek.

In: Ultrasound in Medicine and Biology, Vol. 35, No. 12, 12.2009, p. 1963-1972.

Research output: Contribution to journalArticle

Jiamsripong, Panupong ; Alharthi, Mohsen S. ; Calleja, Anna M. ; McMahon, Eileen M. ; Mookadam, Farouk ; Khandheria, Bijoy K. ; Belohlavek, Marek. / Quantification of Left Ventricular Twisting Mechanics by Velocity Vector Imaging in an Animal Model of Pericardial Adhesions. In: Ultrasound in Medicine and Biology. 2009 ; Vol. 35, No. 12. pp. 1963-1972.
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AB - Diagnosis of constrictive pericarditis remains clinically challenging. Untwisting of the left ventricle (LV) is essential for normal LV diastolic function. Echocardiography is able to measure LV twisting mechanics. We designed an animal model of constrictive pericarditis to determine how pericardial-epicardial adhesions impair LV twisting mechanics. In eight open-chest pigs, the heart was exposed while preserving the pericardium. We simulated early constrictive pericarditis by pericardial constriction and patchy adhesions induced with instant glue and pericardial-epicardial stitches. Using Velocity Vector Imaging™ (VVI), LV magnitudes of twisting and untwisting were measured along with hemodynamic data at baseline and after the experimental intervention. Significant decreases in end-diastolic volume, ejection fraction, stroke volume, and late diastolic filling velocity reflected the effects of the pericardial adhesions. Magnitude of LV untwisting rate decreased from -80 ± 23°/s to -26 ± 10 °/s (p = 0.0009). LV twisting rate dropped from 78 ± 20°/s to 40 ± 8°/s (p = 0.0039) and LV twist magnitude decreased from 9 ± 2° to 5 ± 2 ° (p = 0.0081). Patchy pericardial adhesions are associated with reductions in LV untwisting rate and twisting magnitude, consistent with a negative impact of constrictive pericarditis on systolic and diastolic function. Impairments in LV twisting mechanics may have a diagnostic role in the detection of early stages of constrictive pericarditis. (E-mail: belohlavek.marek@mayo.edu).

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