A modified Holzapfel-Ogden law for a residually stressed finite strain model of the human left ventricle in diastole

In this work, we introduce a modified Holzapfel-Ogden hyperelastic constitutive model for ventricular myocardium that accounts for residual stresses, and we investigate the effects of residual stresses in diastole using a magnetic resonance imaging–derived model of the human left ventricle (LV). We adopt an invariant-based constitutive modelling approach and treat the left ventricular myocardium as a non-homogeneous, fibre-reinforced, incompressible material. Because in vivo images provide the configuration of the LV in a loaded state even in diastole, an inverse analysis is used to determine the corresponding unloaded reference configuration. The residual stress in this unloaded state is estimated by two different methods. One is based on three-dimensional strain measurements in a local region of the canine LV, and the other uses the opening angle method for a cylindrical tube. We find that including residual stress in the model changes the stress distributions across the myocardium and that whereas both methods yield qualitatively similar changes, there are quantitative differences between the two approaches. Although the effects of residual stresses are relatively small in diastole, the model can be extended to explore the full impact of residual stress on LV mechanical behaviour for the whole cardiac cycle as more experimental data become available. In addition, although not considered here, residual stresses may also play a larger role in models that account for tissue growth and remodelling.     

Effects of using the unloaded configuration in predicting the in vivo diastolic properties of the heart

Computational models are increasingly being used to investigate the mechanical properties of cardiac tissue. While much insight has been gained from these studies, one important limitation associated with computational modeling arises when using in vivo images of the heart to generate the reference state of the model. An unloaded reference configuration is needed to accurately represent the deformation of the heart. However, it is rare for a beating heart to actually reach a zero-pressure state during the cardiac cycle. To overcome this, a computational technique was adapted to determine the unloaded configuration of an in vivo porcine left ventricle (LV). In the current study, in vivo measurements were acquired using magnetic resonance images (MRI) and synchronous pressure catheterization in the LV (N = 5). The overall goal was to quantify the effects of using early–diastolic filling as the reference configuration (common assumption used in modeling) versus using the unloaded reference configuration for predicting the in vivo properties of LV myocardium. This was accomplished by using optimization to minimize the difference between MRI measured and finite element predicted strains and cavity volumes. The results show that when using the unloaded reference configuration, the computational method predicts material properties for LV myocardium that are softer and less anisotropic than when using the early-diastolic filling reference configuration. This indicates that the choice of reference configuration could have a significant impact on capturing the realistic mechanical response of the heart.     

Changes of regional myocardial blood flow during and after acute focal experimental ischaemia.

The regional blood flow through the myocardium of the left ventricle was measured in 11 dogs after ligation of the left anterior descending coronary artery, by means of a local injection of 133Xe depot and precordial detection of its washout 2 hours after ligation. Immediately after ligation the blood flow in the ischaemic area declined considerably but at the same time there was a significant increase of blood flow in the non-ischaemic left ventricular myocardium. The regional flow in the ischaemic and non-ischaemic area increased insignificantly for 2 hrs. These changes were not due to alterations in coronary artery pressure, as the mean arterial pressure declined significantly during the first hour. After temporary ischaemia by ligation of the left anterior descending coronary artery for 2--4 minutes, an intensive reactive hyperaemia developed in the ischaemic region (the blood flow reached 221% of control values on the average) which was the more intensive, the greater the drop of blood flow in the ischaemic area after ligation.     

Catecholamine effects on cardiac remodelling,oxidative stress and fibrosis in experimental heart failure

The aim of the study was to assess the relationships between oxidative stress, cardiac remodelling and fibrosis on an experimental model of heart failure with adrenergic stimulation. Large myocardial infarction (approximately 50% of the left ventricle myocardium) was obtained by ligation of the left coronary artery of normotensive male Wistar rats. Sham animals were submitted to left thoracotomy without coronary ligation. In order to perform cardiac stimulation by catecholamines, mini-osmotic pumps were implanted in animals 10 weeks after surgery to deliver noradrenalin for a 2-week period. At the end of this period, the following investigations were performed: haemodynamics, morphometry, fibrosis quantification, plasma and tissue catecholamine assay and oxidative stress status. Coronary ligation induced dilatation of left ventricle with compensatory hypertrophy of the right ventricle and of the remaining left ventricle myocardium. This remodelling process was associated in non-infarcted myocardium with increased collagen infiltration and increased oxidative stress. Ten weeks after surgery, the chronic administration of noradrenalin for 2 weeks did not increase oxidative stress. Noradrenalin, however, induced inotropic stimulation and myocardial hypertrophy, but to a lesser extent in infarcted rats compared to sham rats. Our results suggest that noradrenalin infusion to levels in excess of those seen post-infarction is associated with fibrosis and oxidative stress. Moreover, noradrenalin in infarcted animals caused additional fibrosis without further increasing oxidative stress. The mechanism of catecholamine-induced fibrosis may thus involve different processes such as ischaemia, increased mechanical stress, cytokines and neurohormones.     

超声心动图对心肌致密化不全的诊断及临床意义探讨

目的：探讨超声心动图对心肌致密化不全的诊断及临床意义。方法：应用Vivid7、HP5500彩色多普勒超声诊断仪（探头频率为2～4MHz）对32例左室心肌致密化不全患者进行检查,采用二维、M型、彩色及频谱多普勒观察病变心肌及心内膜改变,重点观察心尖段。常规测量各腔室内径、左室壁正常段心肌厚度及动度,评价心室舒张功能、计算左心室射血分数EF及瓣膜反流等基本信息。结果：①受累的心室内膜面可见多发异常粗大的、呈蜂窝状的肌小梁和交错深陷的隐窝形成网状结构。②病变区域心室壁外层的致密心肌明显变薄,为中低回声,较正常心肌薄2~4mm,其心肌厚度〈6mm,而内层心肌疏松增厚为强回声。③病变以近心尖部1/3室壁节段最为明显,很少累及室间隔及基底段室壁。④彩色多普勒可示隐窝间隙之间有低速血流与心腔相通。⑤多数患者以渐进性的心功能不全、呼吸困难、体循环栓塞、心律失常为主要表现,本组患者临床表现为心力衰竭22例,心脏杂音3例,心律失常2例,5例无明显不适症状。结论：超声心动图检查是准确、无创诊断心肌致密化不全的首选方法,能够对房室结构和心功能进行全面评价,有助于明确心力衰竭病因并协助治疗,同时也有助于筛查心肌致密化不全家族,对临床治疗起着很好的指导作用。     

Passive material properties of intact ventricular myocardium determined from a cylindrical model

The equatorial region of the canine left ventricle was modeled as a thick-walled cylinder consisting of an incompressible hyperelastic material with homogeneous exponential properties. The anisotropic properties of the passive myocardium were assumed to be locally transversely isotropic with respect to a fiber axis whose orientation varied linearly across the wall. Simultaneous inflation, extension, and torsion were applied to the cylinder to produce epicardial strains that were measured previously in the potassium-arrested dog heart. Residual stress in the unloaded state was included by considering the stress-free configuration to be a warped cylindrical arc. In the special case of isotropic material properties, torsion and residual stress both significantly reduced the high circumferential stress peaks predicted at the endocardium by previous models. However, a resultant axial force and moment were necessary to cause the observed epicardial deformations. Therefore, the anisotropic material parameters were found that minimized these resultants and allowed the prescribed displacements to occur subject to the known ventricular pressure loads. The global minimum solution of this parameter optimization problem indicated that the stiffness of passive myocardium (defined for a 20 percent equibiaxial extension) would be 2.4 to 6.6 times greater in the fiber direction than in the transverse plane for a broad range of assumed fiber angle distributions and residual stresses. This agrees with the results of biaxial tissue testing. The predicted transmural distributions of fiber stress were relatively flat with slight peaks in the subepicardium, and the fiber strain profiles agreed closely with experimentally observed sarcomere length distributions. The results indicate that torsion, residual stress and material anisotropy associated with the fiber architecture all can act to reduce endocardial stress gradients in the passive left ventricle.     

Effect of Adaptation to Graduated Physical Exercises on the Function of the Rat Myocardium

On isolated hearts obtained from control rats and rats subjected to regular physical exercises (forced swimming) during 6 weeks, we studied the contractile activity of the heart, resistance of the myocardium to ischemia/reperfusion-induced injuries, as well as the dependence of the developed and end-diastolic pressures in the aortic ventricle (AV) on the strain of the myocardium (by means of a dosed increase in the volume of a polyethylene reservoir inserted into the ventricle). It was demonstrated that adaptation to regular graduated physical exercises exerts a positive effect on the functional state of the AV myocardium and its contractile function. This was manifested in intensification of the contractile activity of the myocardium, a decrease in its oxygen “job cost,” and an increase in the resistance to injuries induced by ischemia-reperfusion. In addition, regular physical trainings led to an increase in the resistance of the AV myocardium to the strain. In trained rats, the plateau of the Frank–Starling plot was significantly greater than that in control animals, while the rigidity of the AV myocardium was significantly lower. Neirofiziologiya/Neurophysiology, Vol. 41, No. 1, pp. 41–47, January–February, 2009.     

Increase and regression of the protective effect of high altitude acclimatization on the isoprenaline-induced necrotic lesions in the rat myocardium

Cardiac resistance to the cardiotoxic effect of isoprenaline--ISO (single dose of 0.1 mg X kg-1) was studied in rats acclimatized to intermittent high altitude--IHA (barochamber, 8 h a day, 5 days a week, stepwise up to 7000 m). The extent of lesions was evaluated quantitatively by means of the increased accumulation of 203HgCl2. Five weeks' acclimatization was followed by a marked increase in the resistance of the myocardium to the necrogenic effect of ISO; this effect was more expressed in the left ventricle, so that the right to left difference generally observed under normoxic conditions disappeared. The increased resistance of the myocardium to ISO-induced damage persisted long after the animals had been returned to normoxic conditions; even six weeks after the last hypoxic exposure the sensitivity of the myocardium to damage had still not returned to the values of unacclimatized animals.     

Electron microscopy of the medial cortex in the lizard Psammodromus algirus

The medial cortex of Psammodromus presents a three-layer organization. Most of the cell bodies are localized in a compact lamina, the cellular layer. Two plexiform layers, superficial and deep, enclose the cellular layer. The most external portion of the superficial plexiform layer is formed by a limiting glial sheet consisting of tanycytic processes that reach the surface of the cortex. Astrocytes are localized close to the glial sheet. There are two types of axon terminals within the superficial plexiform layer: type S with spheric vesicles and type F with pleomorphic vesicles. Large solitary neurons are present at middle levels of the layer. In the cellular layer there are three neuronal types: large neurons with dispersed chromatin, neurons of medium size with chromatin clumps, and electron-dense neurons. Protoplasmic astrocytes are found superficially in this layer. In the deep plexiform layer numerous neuronal cell bodies are visible, and three types can be distinguished: horizontal fusiform cells, globous neurons with indented nuclei, and electron-dense neurons. Protoplasmic astrocytes are present throughout this layer. Oligodendrocytes are more frequent in the inner third of the layer, often related to fibers of a thick fascicle running in contact with the ependyma, the alveus. The ependyma is formed by a single row of prismatic cells bordering the lateral ventricle.     

Ischaemic preconditioning in the pig assessed by myocardial perfusion imaging and histochemistry

Ischaemic preconditioning (IP) is a strong endogenous infarct reducing stimulus which has not previously been evaluated with myocardial perfusion imaging using 99mTc-MIBI. Factors responsible for cellular MIBI uptake are affected by both IP and acute ischaemia (plasma membrane and mitochondrial membrane potential and oxidative metabolism). IP seems to involve mitochondrial K-ATP channels affecting mitochondrial membrane potential and thereby potentially MIBI uptake. The study evaluated the performance of MPI with MIBI as a tracer to characterise the extent that severely ischaemic compromised myocardium was salvaged by IP. In a closed chest model, an ischaemic preconditioned group (8 pigs) subjected to IP before introducing a 45 min period of catheter based coronary occlusion was compared with a control group (9 pigs). Area at risk'(AAR), infarct size (IS) and IS relative to AAR was determined by MIBI SPECT and by a standard histochemical method. The results demonstrated that infarct size was significantly smaller in the IP group both relative to left ventricle (IS/LV) and to area at risk (IS/AAR). Both AAR/LV and IS/LV, however, were greater when measured by MPI than with histochemistry. There was no difference in the ratio between infarct size and area at risk (IS/AAR). In conclusion, MPI with MIBI is a reliable measurement of infarct reduction by ischaemic preconditioning. Myocardium affected by recent ischaemia is correctly distinguished as viable by MPI in early reperfusion, when compared to a standard histochemical technique.     

Early alterations in myocardia and vessels of the diabetic rat heart: an FTIR microspectroscopic study

Diabetes mellitus is associated with a high incidence and poor prognosis of cardiovascular disease. The aim of the present study was to examine the effect of relatively short-term (5 weeks) Type I diabetes on the left ventricle, the right ventricle and the vessel (vein) on the left ventricle of the myocardium at molecular level by FTIR (Fourier-transform infrared) microspectroscopy. The rats were categorized into two groups: control group (for the left ventricle myocardium, n=8; for the right ventricle myocardium, n=9; for the vein, n=9) and streptozotocin-induced diabetic group (for the left ventricle myocardium, n=7; for the right ventricle myocardium, n=9; for the vein, n=8). Two adjacent cross-sections of 9 microm thickness were taken from the ventricles of the hearts in two groups of rats by using a cryotome. The first sections were used for FTIR microspectroscopy measurements. The second serial sections were stained by haematoxylin/eosin for comparative purposes. Diabetes caused an increase in the content of lipids, an alteration in protein profile with a decrease in alpha-helix and an increase in beta-sheet structure as well as an increase in glycogen and glycolipid contents in both ventricles and the vein. Additionally, the collagen content was found to be increased in the vein of the diabetic group. The present study demonstrated that diabetes-induced alterations in the rat heart can be detected by correlating the IR spectral changes with biochemical profiles in detail. The present study for the first time demonstrated the diabetes-induced alterations at molecular level in both ventricle myocardia and the veins in relatively short-term diabetes.     

The age-related characteristics of the contractile function and of the calcium-transport system of the rat myocardium under conditions of restricted coronary perfusion

In experiments on isolated rat heart, it has been shown that in old animals the sensitivity to restriction of the coronary perfusion increases whereas the resistance of the heart to this restriction decreases. It was established that incomplete reversible ischaemia causes significant changes in different steps of Ca2(+)-transporting system of the myocardium which are more evident in older animals and which presumably account for the increased sensitivity of cardiac muscle to ischaemia.     

Effect on breathing of abruptly loading and unloading the canine left heart

Cardiopulmonary bypass and pulmonary vein ligation were used to isolate left hearts of anesthetized open-chest dogs. After external gas exchange, blood was returned at constant flow (approximately 120 ml.min-1.kg-1) directly to the aorta or indirectly through the left heart ("left heart loading"). Loading caused breathing frequency (f) to increase approximately 5 breaths/min (approximately 20%), whereas systemic arterial pressure (Psa) fell approximately 15%. Because Psa was pulsatile during loading, we demonstrated separately the effect of pulsatile pressure and found it to lower mean Psa without changing f. Cooling cervical vagi to 7 degrees C eliminated the f response to loading and slightly decreased the Psa response. Loading was compared with graded distension of the fibrillating ventricle and beating atrium, which also increased f. As measured by an abdominal pneumograph, depth of breathing decreased significantly (approximately 4%) during left heart loading but did not change significantly on distension of the fibrillating heart. I conclude that left heart loading may induce tachypnea and a slightly reduced tidal volume by a vagal reflex most likely originating from the left heart.     

A finite volume method solution for the bidomain equations and their application to modelling cardiac ischaemia

This paper presents an implementation of the finite volume method with the aim of studying subendocardial ischaemia during the ST segment. In this implementation, based on hexahedral finite volumes, each quadrilateral sub-face is split into two triangles to improve the accuracy of the numerical integration in complex geometries and when fibre rotation is included. The numerical method is validated against previously published solutions obtained from slab and cylindrical models of the left ventricle with subendocardial ischaemia and no fibre rotation. Epicardial potential distributions are then obtained for a half-ellipsoid model of the left ventricle. In this case it is shown that for isotropic cardiac tissue the degree of subendocardial ischaemia does not affect the epicardial potential distribution, which is consistent with previous findings from analytical studies in simpler geometries. The paper also considers the behaviour of various preconditioners for solving numerically the resulting system of algebraic equations resulting from the implementation of the finite volume method. It is observed that each geometry considered has its own optimal preconditioner.     

Prevention of disorders in the contractile function of the nonischemic portion of the heart during infarction by preliminary adaptation to brief stress exposures

Preliminary adaptation to short-term exposures to immobilization stress prevents to a large extent the depression of contractile function and the lowering of the right atrium myocardium resistance to hypoxia and excess Ca2+ in experimental infarction of the left ventricle. This fact agrees with the concept that disturbance occurring in the nonischemic heart during infarction is caused by stress-induced damage.     

Phase singularities and filaments: simplifying complexity in computational models of ventricular fibrillation

In the whole heart, millions of cardiac cells are involved in ventricular fibrillation (VF). Experimental studies indicate that VF is sustained by re-entrant activity, and that each re-entrant wave rotates around a filament of phase singularity. Filaments act as organising centres, and offer a way to simplify and quantify the complex spatio-temporal behaviour observed in VF. Where a filament touches the surface of fibrillating myocardium re-entrant activity can be observed, however the behaviour of filaments within bulk ventricular myocardium is difficult to observe directly using present experimental techniques. Large scale computational simulations of VF in three-dimensional (3D) tissue offer a tool to investigate the properties and behaviour of filaments, and the aim of this paper is to review recent advances in this area as well as to compare recent computational studies of fibrillation in whole ventricle geometries.     

Immunohistochemical study of atrial natriuretic polypeptides in the embryonic,fetal and neonatal rat heart

Summary An immunohistochemical study of atrial natriuretic polypeptides was carried out on embryonic, fetal and neonatal rat hearts, using an antiserum raised against -human atrial natriuretic polypeptide (-hANP). Weakly immunoreactive cells were seen in both atrial and ventricular walls at 11 days post coitum (pc). After this stage, the immunoreactive cells became more intensely stained in both atrial and ventricular walls. The immunoreactivity during the prenatal period was stronger in the superficial cell layer beneath the endocardium, than in the deep cell layer of the atrial wall. The cells in the trabecular meshwork also had an apparent, but weak, immunoreactivity, which showed a greater intensity in the left ventricle than in the right one. It is suggested that these immunoreactive cells in the ventricle may differentiate, in situ, into the cells of the impulse-conducting system during the further development of the heart.This research was supported in part by Grants-in-Aid for Scientific research to C. ura from the Ministry of Education of Japan (Nos. 5957009, 59570010)     

Effect of increased left atrial pressure on breathing frequency in anesthetized dog

Distension or loading of the isolated canine left heart caused reflex tachypnea in prior studies. The object of the present effort was to explore the possibility that this depended primarily on atrial distension. Cardiopulmonary bypass perfusion and ligation of pulmonary veins were used to isolate the left-heart chambers of anesthetized dogs. Simultaneous distension of the beating left atrium and fibrillating ventricle stimulated breathing frequency (f), whereas isolated ventricular distension did not. At other times, intervals of atrial fibrillation were imposed under two different conditions: 1) while the right heart and lungs were bypassed and systemic perfusion was provided by the left ventricle using blood returned to the left atrium by pump and 2) while the ventricles fibrillated and systemic perfusion was supplied directly by the pump. Atrial fibrillation increased left atrial pressure and stimulated f in condition 1. In condition 2, f increased only if fibrillation was associated with a rise in left atrial pressure. Vagal cooling blocked the effect of fibrillation. I conclude that left atrial distension may initiate reflex tachypnea.     

Energetics of ventricular contraction as traced in the pressure-volume diagram

The pressure-volume (P-V) relationship of the canine left ventricle can reasonably be simulated by a time-varying elastance model. In this model the total mechanical energy generated by a contraction can be determined theoretically from the change in the elastance. Applying this theory to the actual left ventricle, we have found that the area in the P-V diagram circumscribed by the end-systolic P-V relation line, the end-diastolic P-V relation curve, and the systolic segment of the P-V trajectory is equivalent to the total mechanical energy generated by ventricular contraction. We call this area the systolic P-V area (PVA). We have studied experimentally the correlation between the PVA and myocardial oxygen consumption (VO2) in the canine left ventricle. VO2 was linearly correlated with PVA regardless of the contraction mode and loading conditions in a given left ventricle. The VO2-PVA relation parallel shifted upward with positive inotropic agents. This shift comprised a significant increase in VO2 component for the unloaded contraction. We therefore consider that further analyses of the VO2-PVA relationship will greatly promote our understanding of cardiac energetics.