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A new diagnostic feasibility for cardiomyopathy utilizing acoustic microscopy

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DOI: 10.4236/wjcd.2013.31006    2,635 Downloads   4,604 Views   Citations

ABSTRACT

Aims: Dilated cardiomyopathy often shows left ventricular systolic dysfunction, although histologically it always exhibits non-specific abnormality. We hypothesized that myocyte sound speed might be altered due to incomplete protein accumulation in cells. Methods and Results: Ninety eight biopsied samples were obtained from 49 patients comprising 43 with clinical dilated cardiomyopathy and 6 with hypertrophic cardiomyopathy. Sound speed was evaluated in deparaffinized 10 μm thick sections using an acoustic microscope (frequency range: 50 - 105 MHz). Conventional histology revealed 7 cases of persistent myocarditis derived from clinical dilated cardio- myopathy samples. Histology of the remaining dilated cardiomyopathy patients indicated non-specific abnormality. All hypertrophic cardiomyopathy cases exhibited myocardial disarray. Ten normal autopsied hearts were compared as controls. The sound speed of controls was 1627 ± 30m/sec. The sound speed in dilated cardiomyopathy samples (1700 ±51m/sec) was 1.045-fold faster compared to controls. The sound speed in hypertrophic cardiomyopathy samples (1734 ±51m/sec, 1.066-fold compared to controls) was faster than that of the myocarditis group (1672 ±30m/sec, 1.028-fold) (P = 0.0218). Furtheremore, desmin expression was evaluated as extent of emergence (grading 0 - 4). The desmin expression score in hypertrophic cardiomyopathy samples (2.7 ± 0.8) was significantly higher than in other groups (dilated 2.0 ± 1.4, myocarditis 1.6 ± 1.5 vs., controls 0, P ≤ 0.0001, 0.0001, 0.0129, respectively). Conclusion: Cardio-myopathy enhanced the sound speed, which correlated with the elasticity of myocytes, following the impaired compliance of left ventricle, despite the absence of histological changes. The elevation of sound speed of myocytes may be linked to cytoskeletal changes. Myocyte sound speed may be a new diagnostic tool for diagnosis of idiopathic cardiomyopathy independently of conventional histological diagnosis.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Nakamura, Y. , Kusano, K. , Nakamura, K. , Kobayashi, K. , Hozumi, N. , Saijo, Y. and Ohe, T. (2013) A new diagnostic feasibility for cardiomyopathy utilizing acoustic microscopy. World Journal of Cardiovascular Diseases, 3, 22-30. doi: 10.4236/wjcd.2013.31006.

References

[1] Hershberger, R.E. and Siegfried, J.D. (2011) Update 2011: Clinical and genetic issues in familial dilated cardiomyopathy. Journal of the American College of Cardiology, 57, 1641-1649. doi:10.1016/j.jacc.2011.01.015
[2] Watkins, H., Ashrafian, H. and Redwood, C. (2011) Inherited cardiomyopathies. The New England Journal of Medicine, 364, 1643-1656. doi:10.1056/NEJMra0902923
[3] Marston, S.B. (2011) How do mutations in contractile proteins cause the primary familial cardiomyopathies? Journal of Cardiovascular Translational Research, 4, 245-255. doi:10.1007/s12265-011-9266-2
[4] Theis, J.L., Bos, J.M., Theis, J.D., et al. (2009) Expression patterns of cardiac myofillament proteins-genomic and protein analysis of surgical myectomy tissue from patients with obstructive hypertrophic cardiomyopathy. Circulation: Heart Failure, 2, 325-333. doi:10.1161/CIRCHEARTFAILURE.108.789735
[5] Maron, B.J., Towbin, J.A., Thiene, G., et al. (2006) Contemporary definitins and classification of the cardiomyo-pathies: An American Heart Association scientific statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation, 113, 1807-1816. doi:10.1161/CIRCULATIONAHA.106.174287
[6] Elliot, P., Andersson, B., Arbustini, E., et al. (2008) Classification of the cardiomyopathies: A position statement from the European society of cardiology working group on myocardial and pericardial diseases. European Heart Journal, 29, 270-276. doi:10.1093/eurheartj/ehm342
[7] Cooper, L.T., Baughman, K.L., Feldman, A.M., et al. (2007) The role of endomyocardial biopsy in the management of cardiovascular disease: A scientific statement from the American heart association, the American college of cardiology, and the European society of cardiology. Circulation, 116, 2216-2233. doi:10.1161/CIRCULATIONAHA.107.186093
[8] Hauck, A.J., Kearney, D.L. and Edwards, W.D. (1989) Evaluation of postmortem endomyocardial biopsy specimens from 38 patients with lymphocytic myocarditis: Im- plications for role of sampling error. Mayo Clinic Pro- ceedings, 64, 1235-1245. doi:10.1016/S0025-6196(12)61286-5
[9] Chow, L.H., Radio, S.J., Sears, T.D., et al. (1989) Insen-sitivity of right ventricular endomyocardial biopsy in the diagnosis of myocarditis. Journal of the American College of Cardiology, 14, 915-920. doi:10.1016/0735-1097(89)90465-8
[10] Chow, L.C., Dittrich, H.C. and Shabetai, R. (1988) Endomyocardial biopsy in patients with unexplained congestive heart failure. Annals of Internal Medicine, 109, 535-539.
[11] Sokolov, S. (1949) The ultrasonic microscope. Doklandy Akademii Nauk SSSR, 64, 333-335.
[12] Lemons, R.A. and Quate, C.F. (1975) Acoustic microscopy: Biomedical applications. Science, 188, 905-911.
[13] Saijo, Y., Sasaki, H., Sato, M., et al. (2000) Visualization of human umbilical vein endothelial cells by acoustic microscopy. Ultrasonics, 38, 396-399. doi:10.1016/S0041-624X(99)00200-0
[14] Saijo, Y., Jorgensen, C.S. and Falk, E. (2001) Ultrasonic tissue characterization of collagen in lipid-rich plaques in apo Edeficient mice. Atherosclerosis, 158, 289-295. doi:10.1016/S0021-9150(01)00435-X
[15] Okawai, H., Kobayashi, K. and Nitta, S. (2001) An ap- proach to acoustic properties of biological tissues using acoustic micrographs of attenuation constant and sound speed. Journal of Ultrasound in Medicine, 20, 891-907.
[16] Hozumi, N., Yamashita, R., Lee, C.K., et al. (2004) Time-frequency analysis for pulse driven ultrasounic microscopy for biologicaltissue characterization. Ultrasonics, 42, 717-722. doi:10.1016/j.ultras.2003.11.005
[17] Hagiwara, Y., Saijo, Y., Chimoto, E., et al. (2006) Increased elasticity of capsule after immobilization in a rat knee experimental model assessed by scanning acoustic microscopy. Upsala Journal of Medical Sciences, 111, 303-313. doi:10.3109/2000-1967-054
[18] Towbin, J.A., Lowe, A.M., Colan, S.D., et al. (2006) Incidence, causes, and outcomes of dilated cardiomyopathy in children. JAMA, 296, 1867-1876. doi:10.1001/jama.296.15.1867
[19] Baughman, K.L. (2006) Diagnosis of myocarditis: Death of Dallas criteria. Circulation, 113, 593-595. doi:10.1161/CIRCULATIONAHA.105.589663
[20] Prochorec-Sobieszek, M., Bilinska, Z.T., Grzybowski, J., et al. (2006) Assessment of the inflammatory process by endomyocardial biopsy in patinets with dilated cardiomyopathy based on pathological and immunohistochemical methods. Kardiologia Polska, 64, 479-487.
[21] Laforsch, C., Ngwa, W., Grill, W., et al. (2004) An acoustic microscopy technique reveals hidden morphological defenses in Daphnia. PNAS, 101, 15911-15914. doi:10.1073/pnas.0404860101
[22] Leone, O., Veinot, J.P., Angelini, A., et al. (2012) 2011 consensus statement on endomyocardial biopsy from the association for European cardivascular pathology and the society for cardiovascular pathology. Cardiovascular Pathology, 21, 245-274. doi:10.1016/j.carpath.2011.10.001
[23] Fujimoto, S., Mizuno, R., Nakagawa, Y., et al. (1999) Ultrasonic tissue characterization in patients with dilated cardiomyopathy: Comparison with findings from right ventricular endomyocardial biopsy. International Journal of Cardiac Imaging, 15, 391-396. doi:10.1023/A:1006272919061
[24] Di Bello, V., Giorgi, D., Viacava, P., et al. (2004) Severe aortic stenosis and myocardial function: Diagnostic and prognostic usefulness of ultrasonic integrated backscatter analysis. Circulation, 110, 849-855. doi:10.1161/01.CIR.0000138930.12773.41
[25] Mor Avi, V., Lang, R.M., Badano, L.P., et al. (2011) Current and evolving echocardigraphic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese society of echocardiography. Journal of the American Society of Echocardiography, 24, 277-313. doi:10.1016/j.echo.2011.01.015
[26] Suwa, M., Ito, T., Kobashi, A., et al. (2000) Myocardial integrated ultrasonic backscatter in patients with dilated cardiomyopathy: Prediction of response to beta-blocker therapy. American Heart Journal, 139, 905-912. doi:10.1016/S0002-8703(00)90024-3
[27] Lin, Y.H., Lee, H.H., Liu, K.L., et al. (2011) Reversal of myocardial fibrosis in patients with unilateral hyperal-dosteronism receiving adrenalectomy. Surgery, 150, 526- 533. doi:10.1016/j.surg.2011.02.006
[28] Mizuta, Y., Kai, H., Mizoguchi, M., et al. (2008) Long-term treatment with Valsartan improved cyclic variation of the myocardial integral backscatter signal and diastolic dysfunction in hypertensive patients: The echocardio- graphic assessment. Hypertension Research, 31, 1835-1842. doi:10.1291/hypres.31.1835
[29] Fijalkowski, M., Koprowski, A., Galaska, R., et al. (2010) Improvement of ultrasonic myocardial properties after aortic valve replacement for pure severe aortic stenosis: The predictive value of ultrasonic tissue characterization for left ventricle reverse remodeling. Journal of the American Society of Echocardiography, 23, 1060-1066. doi:10.1016/j.echo.2010.07.018
[30] Naito, J., Masuyama, T., Mano, T., et al. (1996) Ultra- sonic myocardial tissue characterization in patients with dilated cardiomyopathy: Value in noninvasive assessment of myocardial fibrosis. American Heart Journal, 131, 115-121. doi:10.1016/S0002-8703(96)90059-9
[31] Weiss, E.C., Lemor, R.M., Pilarczyk, G., et al. (2007) Imaginf of focal contacts of chicken heart muscle cells by high-frequency acoustic microscopy. Ultrasound in Medicine and Biology, 33, 1320-1326. doi:10.1016/j.ultrasmedbio.2007.01.016
[32] Hagiwara, Y., Saijo, Y., Ando, A., et al. (2009) Ultrasonic intensity microscopy for imaging of living cells. Ultrasonics, 49, 386-388. doi:10.1016/j.ultras.2008.10.013
[33] Winterroth, F., Lee, J., Kuo, S., et al. (2011) Acoustic microscopy analyses to determine good vs. failed tissue engineered oral mucosa under normal or thermally stress- sed culture conditions. Annals of Biomedical Engineering, 39, 44-52. doi:10.1007/s10439-010-0176-2

  
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