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Decreased atrioventricular plane displacement after acute myocardial infarction yields a concomitant decrease in stroke volume

Berg, J. LU orcid ; Jablonowski, R. LU ; Nordlund, D. LU ; Kopic, S. LU ; Bidhult, S. LU ; Xanthis, C. G. LU ; Saeed, M. ; Solem, K. ; Arheden, H. LU and Carlsson, M. LU (2020) In Journal of Applied Physiology 128(2). p.252-263
Abstract

Acute myocardial infarction (AMI) can progress to heart failure, which has a poor prognosis. Normally, 60% of stroke volume (SV) is attributed to the longitudinal ventricular shortening and lengthening evident in the atrioventricular plane displacement (AVPD) during the cardiac cycle, but there is no information on how the relationship changes between SV and AVPD before and after AMI. Therefore, the aim of this study was to determine how SV depends on AVPD before and after AMI in two swine models. Serial cardiac magnetic resonance imaging was carried out before and 1-2 h after AMI in a microembolization model (n = 12) and an ischemia-reperfusion model (n = 14). A subset of pigs (n = 7) were additionally imaged at 24 h and at 7 days.... (More)

Acute myocardial infarction (AMI) can progress to heart failure, which has a poor prognosis. Normally, 60% of stroke volume (SV) is attributed to the longitudinal ventricular shortening and lengthening evident in the atrioventricular plane displacement (AVPD) during the cardiac cycle, but there is no information on how the relationship changes between SV and AVPD before and after AMI. Therefore, the aim of this study was to determine how SV depends on AVPD before and after AMI in two swine models. Serial cardiac magnetic resonance imaging was carried out before and 1-2 h after AMI in a microembolization model (n = 12) and an ischemia-reperfusion model (n = 14). A subset of pigs (n = 7) were additionally imaged at 24 h and at 7 days. Cine and late gadolinium enhancement images were analyzed for cardiac function, AVPD measurements and infarct size estimation, respectively. AVPD decreased (P < 0.05) in all myocardial regions after AMI, with a concomitant SV decrease (P < 0.001). The ischemia-reperfusion model affected SV to a higher degree and had a larger AVPD decrease than the microembolization model (-29 ± 14% vs. -15 ± 18%; P < 0.05). Wall thickening decreased in infarcted areas (P < 0.001), and A-wave AVPD remained unchanged (P = 0.93) whereas E-wave AVPD decreased (P < 0.001) after AMI. We conclude that AVPD is coupled to SV independent of infarct type but likely to a greater degree in ischemia-reperfusion infarcts compared with microembolization infarcts. AMI reduces diastolic early filling AVPD but not AVPD from atrial contraction. These findings shed light on the physiological significance of atrioventricular plane motion when assessing acute and subacute myocardial infarction.NEW & NOTEWORTHY The link between cardiac longitudinal motion, measured as atrioventricular plane displacement (AVPD), and stroke volume (SV) is investigated in swine after acute myocardial infarction (AMI). This cardiac magnetic resonance study demonstrates a close coupling between AVPD and SV before and after AMI in an experimental setting and demonstrates that this connection is present in ischemia-reperfusion and microembolization infarcts, acutely and during the first week. Furthermore, AVPD is equally and persistently depressed in infarcted and remote myocardium after AMI.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
AMI, animal model, AVPD, cardiac failure, ischemia-reperfusion
in
Journal of Applied Physiology
volume
128
issue
2
pages
12 pages
publisher
American Physiological Society
external identifiers
  • pmid:31854250
  • scopus:85079078323
ISSN
1522-1601
DOI
10.1152/japplphysiol.00480.2019
language
English
LU publication?
yes
id
db11e2f5-d6c4-404d-b2d5-4f0a0c2f1201
date added to LUP
2021-01-12 23:35:19
date last changed
2022-08-04 03:40:32
@article{db11e2f5-d6c4-404d-b2d5-4f0a0c2f1201,
  abstract     = {{<p>Acute myocardial infarction (AMI) can progress to heart failure, which has a poor prognosis. Normally, 60% of stroke volume (SV) is attributed to the longitudinal ventricular shortening and lengthening evident in the atrioventricular plane displacement (AVPD) during the cardiac cycle, but there is no information on how the relationship changes between SV and AVPD before and after AMI. Therefore, the aim of this study was to determine how SV depends on AVPD before and after AMI in two swine models. Serial cardiac magnetic resonance imaging was carried out before and 1-2 h after AMI in a microembolization model (n = 12) and an ischemia-reperfusion model (n = 14). A subset of pigs (n = 7) were additionally imaged at 24 h and at 7 days. Cine and late gadolinium enhancement images were analyzed for cardiac function, AVPD measurements and infarct size estimation, respectively. AVPD decreased (P &lt; 0.05) in all myocardial regions after AMI, with a concomitant SV decrease (P &lt; 0.001). The ischemia-reperfusion model affected SV to a higher degree and had a larger AVPD decrease than the microembolization model (-29 ± 14% vs. -15 ± 18%; P &lt; 0.05). Wall thickening decreased in infarcted areas (P &lt; 0.001), and A-wave AVPD remained unchanged (P = 0.93) whereas E-wave AVPD decreased (P &lt; 0.001) after AMI. We conclude that AVPD is coupled to SV independent of infarct type but likely to a greater degree in ischemia-reperfusion infarcts compared with microembolization infarcts. AMI reduces diastolic early filling AVPD but not AVPD from atrial contraction. These findings shed light on the physiological significance of atrioventricular plane motion when assessing acute and subacute myocardial infarction.NEW &amp; NOTEWORTHY The link between cardiac longitudinal motion, measured as atrioventricular plane displacement (AVPD), and stroke volume (SV) is investigated in swine after acute myocardial infarction (AMI). This cardiac magnetic resonance study demonstrates a close coupling between AVPD and SV before and after AMI in an experimental setting and demonstrates that this connection is present in ischemia-reperfusion and microembolization infarcts, acutely and during the first week. Furthermore, AVPD is equally and persistently depressed in infarcted and remote myocardium after AMI.</p>}},
  author       = {{Berg, J. and Jablonowski, R. and Nordlund, D. and Kopic, S. and Bidhult, S. and Xanthis, C. G. and Saeed, M. and Solem, K. and Arheden, H. and Carlsson, M.}},
  issn         = {{1522-1601}},
  keywords     = {{AMI; animal model; AVPD; cardiac failure; ischemia-reperfusion}},
  language     = {{eng}},
  month        = {{02}},
  number       = {{2}},
  pages        = {{252--263}},
  publisher    = {{American Physiological Society}},
  series       = {{Journal of Applied Physiology}},
  title        = {{Decreased atrioventricular plane displacement after acute myocardial infarction yields a concomitant decrease in stroke volume}},
  url          = {{http://dx.doi.org/10.1152/japplphysiol.00480.2019}},
  doi          = {{10.1152/japplphysiol.00480.2019}},
  volume       = {{128}},
  year         = {{2020}},
}