Effect of streptozotocin-induced diabetes on left ventricular function in adult rats: an in vivo Pinhole Gated SPECT study

<p>Abstract</p> <p>Background</p> <p>Recent studies have suggested that diabetes mellitus (DM) may cause left ventricular (LV) dysfunction directly resulting in increased susceptibility to heart failure. Using pinhole collimators and advances in data processing, gated SPECT was recently adapted to image the rat heart. The present study was aimed to assess this new imaging technique for quantifying LV function and remodeling from the Streptozotocin (STZ) rat model compared to controls.</p> <p>Methods</p> <p>Twenty one rats were randomly assigned to control or diabetic group. Six months after the induction of diabetes by STZ, Pinhole 99 m Tc-sestamibi gated SPECT was performed for determining rat LV volumes and function. Post-mortem histopathologic analysis was performed to evaluate the determinant of LV remodeling in this model.</p> <p>Results</p> <p>After six months, the normalized to body weight LV End-systolic volume was significantly different in diabetic rats compared to controls (0.46 ± 0.02 vs 0.33 ± 0.03 μL/g; p = 0.01). The normalized LV End-diastolic volume was also different in both groups (1.51 ± 0.03 vs 0.88 ± 0.05 μL/g; p = 0.001) and the normalized stroke volume was significantly higher in STZ-rats (1.05 ± 0.02 vs 0.54 ± 0.06 μL/g; p = 0.001). The muscular fibers were thinner at histology in the diabetic rats (0.44 ± 0.07 vs 0.32 ± 0.06 AU; p = 0.01).</p> <p>Conclusion</p> <p>Pinhole 99 m Tc-sestamibi gated SPECT can successfully be applied for the evaluation of cardiac function and remodeling in STZ-induced diabetic rats. In this model, LV volumes were significantly changed compared to a control population, leading to a LV dysfunction. These findings were consistent with the histopathological abnormalities. Finally, these data further suggest the presence of diabetes cardiomyopathy.</p

Effect of streptozotocin-induced diabetes on myocardial blood flow reserve assessed by myocardial contrast echocardiography in rats

The role of structural and functional abnormalities of small vessels in diabetes cardiomyopathy remains unclear. Myocardial contrast echocardiography allows the quantification of myocardial blood flow at rest and during dipyridamole infusion. The aim of the study was to determine the myocardial blood flow reserve in normal rats compared with Streptozotocin-induced diabetic rats using contrast echocardiography

Loss and retrieval of a coronary angioplasty stent balloon

A case is presented in which a breakage of the coronary stent delivery catheter occurred as retrieval of the stent balloon was attempted after stent implantation. The broken distal balloon shaft with its stuck balloon was retrieved by controlled pulling on the guiding catheter in which a new balloon was inflated, thus trapping the distal shaft. The case underscores the importance of adequate lesion assessment and preparation

How to measure quality of care in patients presenting with STEMI? A single-centre experience

Objective: The evaluation of the quality of care delivered to patients with acute coronary syndromes is becoming increasingly important. Due to novel regulations permitting the installation of new catheterization laboratories in Belgium, the Flemish government initiated a project to measure quality of care in patients with an ST-elevated myocardial infarction (STEMI) by measuring four quality indicators: prescription of ACE inhibitor, beta blocker or aspirin on discharge and unadjusted mortality. However, we are not convinced that these four indicators will provide sufficient information on the quality of care in our hospitals. Hence, we performed a retrospective analysis on a larger set of parameters and evaluated their applicability as indicators of quality of care. Methods: We measured 38 indicators in 153 patients (69 transferred and 84 on-site) with a STEMI who presented at, or were transferred to the UZ Brussels in 2013 and received percutaneous coronary intervention (PCI). Results: The unadjusted overall mortality was 7.2% (n=11/153). Important differences in unadjusted mortality were observed between the on-site and transferred patients (10.7%, n=9 vs 2.9%, n=2, P=0.112), which were attributed to the initial condition at presentation and a larger proportion of cardiogenic shocks in the on-site group. Discharge medication highly corresponded with the ESC guidelines. Conclusion: We demonstrate that the proposed quality indicators do not provide sufficient information to compare hospitals and that it is of utmost importance to weigh the mortality according to risk profile

Comparison of transthoracic echocardiography with second harmonic imaging with transesophageal echocardiography in the detection of right to left shunts.

We compared the use of transthoracic echocardiography with second harmonic imaging after a peripheral intravenous injection of an agitated saline solution with transesophageal echocardiography (TEE) in the detection of right to left shunts at the cardiac and pulmonary level. Second harmonic mode transthoracic echocardiography and TEE are equally sensitive in detecting right to left shunts in patients undergoing a daily routine TEE