Journal of the American Society of Echocardiography
Pre-Clinical InvestigationLeft Ventricular Longitudinal Strain as a Marker for Point of No Return in Hypertensive Heart Failure Treatment
Section snippets
Experimental Animals
Animal experiments were carried out humanely after obtaining approval for this study from the Institutional Animal Experiments Committee of the University of Tsukuba. Experimental protocols were in accordance with the Regulation for Animal Experiments in our university.
In this study, 32 male Dahl salt-sensitive (DSS) rats ages 6-23 weeks, a well-validated animal model of HFpEF due to hypertension (DIS/Eis; Eisai, Tokyo, Japan), were used. Rats were divided into six experimental groups (Figure 1
Results
Initial measurements were obtained from all 32 rats, and histologic measurements were performed in 28 rats. Four rats in the high-salt group died spontaneously. Among these, two rats in the control group died at 20 and 22 weeks and two rats in the ACE-I treated group died at 12 (early group) and 16 weeks (CS group).
Discussion
To the best of our knowledge, this is the first study to investigate the effect of myocardial strain to identify the optimal timing of ACE-I treatment initiation for preventing heart failure. This study demonstrated that if ACE-I administration was initiated just after the LS impairment, heart failure, which was characterized by an increase in lung weight, LV weight, and amount of subendocardial fibrosis, can be prevented. Although the CS group showed intermediate improvement in subendocardial
Conclusion
Myocardial strains by echocardiography may be able to guide the therapeutic timing in HFpEF. The PNR of HFpEF treatment may exist between just after LS impairment and before CS impairment.
Acknowledgments
We thank Emi Shiomitsu, BSc (Department of Medical Science, Faculty of Medicine, University of Tsukuba), for assistance with pathologic specimen measurements.
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T.I. and Y.S. received grants from the Japan Society for the Promotion of Science, Grant-in-Aid for Scientific Research (16K09416).
Conflicts of Interest: None.