Non-invasive CMR-based quantification of myocardial power and efficiency under stress and ischemic conditions in landrace pigs

  • Background: Myocardial efficiency should be maintained stable under light-to-moderate stress conditions, but ischemia puts the myocardium at risk for impaired functionality. Additionally, the measurement of such efficiency typically requires invasive heart catheterization and exposure to ionizing radiation. In this work, we aimed to non-invasively assess myocardial power and the resulting efficiency during pharmacological stress testing and ischemia induction. Methods: In a cohort of n = 10 healthy Landrace pigs, dobutamine stress testing was performed, followed by verapamil-induced ischemia alongside cardiac magnetic resonance (CMR) imaging. External myocardial power, internal myocardial power, and myocardial efficiency were assessed non-invasively using geometrical and functional parameters from CMR volumetric as well as blood flow and pressure measurements. Results: External myocardial power significantly increased under dobutamine stress [2.3 (1.6–3.1) W/m2 vs. 1.3 (1.1–1.6) W/m2, p = 0.005] and significantly decreased under verapamil-induced ischemia [0.8 (0.5–0.9) W/m2, p = 0.005]. Internal myocardial power [baseline: 5.9 (4.6–8.5) W/m2] was not affected by dobutamine [7.5 (6.9–9.0) W/m2, p = 0.241] nor verapamil [5.8 (4.7–8.8) W/m2, p = 0.878]. Myocardial efficiency did not change from baseline to dobutamine [21% (15–27) vs. 31% (20–44), p = 0.059] but decreased significantly during verapamil-induced ischemia [10% (8–13), p = 0.005]. Conclusion: In healthy Landrace pigs, dobutamine stress increased external myocardial power, whereas myocardial efficiency was maintained stable. On the contrary, verapamil-induced ischemia substantially decreased external myocardial power and myocardial efficiency. Non-invasive CMR was able to quantify these efficiency losses and might be useful for future clinical studies evaluating the effects of therapeutic interventions on myocardial energetics.

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Author:Alessandro Faragli, Alessio Alogna, Chong Bin Lee, Miry Zhu, Niky Ghorbani, Francesco Paolo Lo Muzio, Bernhard Schnackenburg, Christian Stehning, Titus Kühne, Heiner Post, Leonid Goubergrits, Eike NagelORCiDGND, Burkert Pieske, Sebastian Kelle, Marcus Kelm
Parent Title (English):Frontiers in Cardiovascular Medicine
Publisher:Frontiers Media
Place of publication:Lausanne
Document Type:Article
Date of Publication (online):2021/07/26
Date of first Publication:2021/07/26
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2021/10/15
Tag:dobutamine stress; landrace pigs; myocardial efficiency; myocardial ischaemia; myocardial power
Issue:art. 689255
Page Number:8
First Page:1
Last Page:8
AF, HP, EN, AA, and SK received funding from DZHK (German Centre for Cardiovascular Research—Grant Number: 81X2100305). MK is a participant in the Charité Digital Clinician Scientist Program funded by DFG, and AA is a participant in the BIH-Charité Clinician Scientist Program funded by the Charité–Universitätsmedizin Berlin and the Berlin Institute of Health. Both programs were initiated and led by Professor Duska Dragun to enable resident physicians to pursue a career in academic medicine. Furthermore, AA was supported by the EU Horizon 2020 FETOPEN-2018-2020 Programme LIONHEARTED, grant agreement no. 828984, as well as by the EU Horizon 2020 NMBP-2016 Programme CUPIDO, grant agreement no. 720834.
Dewey Decimal Classification:5 Naturwissenschaften und Mathematik / 59 Tiere (Zoologie) / 590 Tiere (Zoologie)
6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0