Immunohistochemical evaluation of apoptosis and ICAM-1, VCAM-1 and P-selectin expression in ischemic and idiopathic dilated cardiomyopathy

Apoptosis and cell adhesion molecules are implicated in many cardiovascular diseases such as: coronary artery diseases [CAD], atherosclerosis, heart failure and cardiomyopathy. In this study, we compared between twenty human myocardial samples of idiopathic dilated cardiomyopathy [IDCM] ineluding males and females] and a similar number of ischemie cardiomyopathy [ISCM]. Samples were cut frozen and examined after staining with imm uno-peroxidase technique to detect intercellular adhesion molecule [ICAM-1], Vascular cell adhesion molecule [VCAM-1] and P-Selectin and the TUNEL technique to detect apoptosis. Tissues samples were taken at the Department of Pathology and Laboratory Medicine, Emory University [Atlanta - GA. USA]. Stained sections were analyzed by computerized image analysis. Sections of IDCM showed greater nuclear and cellular diameters of their myocytes than ISCM. Cytoplasmic spaces were more frequent in ISCM. Apoptosis and VCAM-1 expression were sagnificantly higher in ISCM than in IDCM [P < 0.001]. ICAM-1 expression was also higher in ISCM but statistically insignificant [p values = 2.66]. On the other hand, the expression of p-selectin was higher in IDCM [P value = 0.01]. The results signify a higher role of apoptosis. VCAM- I and ICAM-1 in ISCM. It also showed that P-selectin have a higher role in IDCM. We hope that these data can be utilized in the diagnosis and treatment in both diseases

Comparative study between low dose dobutamine echocardiography and low dose dobutamine gated single photon emission computed tomography [gSPECT] in detection of myocardial viability

The identification of severely dysfunctional but viable myocardium is of particular importance for the selection of patients with depressed left ventricular function who will benefit from coronary revascularization. Assessment of inotropic reserve with dobutamine has recently been used for this purpose. Comparing the accuracy of low-dose dobutamine [LDD] gated myocardial SPECT [gSPECT] with the accuracy of low dose dobutamine echocardiography [DSE] and resting perfusion single photon emission computed tomogra phytomography [SPECT] for the identification of viable myocardium in patients with previous myocardial infarction. Resting and low-dose dobutamine [7.5 micro g/kg/min] gated 99mTc-tetrofosmin gSPECT [TI and T2 respectively] and echocardiography [at rest and during low dose dobutamine] [R and DSE] and resting post-revascularization echocardiography [PRecho] [3 months later] were prospectively studied in 33 patients with previous myocardial infarction and severely depressed regional [function. Revascularization had been done either by CABG or PTCA for all patients. Nitroglycarine had been administered 15 min for all patients before 99m Tc-tetroforminT2. Wall motion assessment was done using 4 point score with 1 normal and 4 dyskinetic and viable tissue was diagnosed by presence of contractile response [CD] during LDD infusion in hoth echocardiography and gated SPECT using 17 segment model. Viability was defined in perfusion study by a relative Uptake 50% of tile maximum uptake. Viability in "SPECT depended upon both end-diastolic [ED] image [perfusion] and End-systolic [ES] [Contractility] images. Out of the 561 myocardial segments resting echo [R] revealed 367 segments with normal wall motion [NWM], 109 hypokinetic with CD in 83, 52 akinetic with CD in 24, 33 dyskinetic with CD in 3. Post-revascularization echo revealed 476 segments with NWM, 26 hypo, 29 ak., and 30 dyskinetic. Concerning gSPECT, out of the 194 segments with abnormal wall motion. T1 and T2 revealed 16 and 23 with normal uptake, 11 and 18 with complete reversibility, 60 and 96 with partial reversibility with overall detection of viability in 44.8%: and 70.% respectively. Degree of matching between DSE and T1 and T2 was found to be 70.6% and 80.9% respectively. Compared to PR echo., degree of matching was 69.6%, 92.3% and 85.6% for TI, T2 and DSE respectively. Pharmacological enhancement for detecting viability either by gSPECT or echocardiography. Combined Perfusion and functional assessment compensates for lower sensitivity of [99m]Tc-tetrofosmin

Non invasive evaluation of left ventricular filling pressure by doppler echocardiography

This study was carried out on 45 patients to evaluate the accuracy of different echo-Doppler parameters for the assessment of LV diastolic function. The patients were divided according to end diastolic pressure [EDP] into two groups. Comparing patients with normal and elevated EDP revealed that the deceleration time of E wave, velocity time integrity [VTI] of E-wave, acceleration slope of A wave, deceleration slope of A wave LA diameter and FS were significant variables. When taking FS into consideration, the echo-Doppler parameters were significantly valuable in the differentiation between patients with normal and elevated EDP