Investigation of coronary vessels in microscopic dimensions by two- and three-dimensional NMR microscopic imaging in the isolated rat heart. Visualization of vasoactive effects of endothelin 1

The low oxygen-carrying capacity of Krebs buffer causes a doubling in ventricular wall thickness in the isolated heart

The buffer-perfused Langendorff heart is significantly vasodilated compared with the in vivo heart. In this study, we employed ultrasound to determine if this vasodilation translated into changes in left ventricular wall thickness (LVWT), and if this effect persisted when these hearts were switched to the "working" mode. To investigate the effects of perfusion pressure, vascular tone, and oxygen availability on cardiac dimensions, we perfused hearts (from male Wistar rats) in the Langendorff mode at 80, 60, and 40 cm H2O pressure, and infused further groups of hearts with either the vasoconstrictor endothelin-1 (ET-1) or the blood substitute FC-43. Buffer perfusion induced a doubling in diastolic LVWT compared with the same hearts in vivo (5.4 ± 0.2 mm vs. 2.6 ± 0.2 mm, p < 0.05) that was not reversed by switching hearts to "working" mode. Perfusion pressures of 60 and 40 cm H2O resulted in an increase in diastolic LVWT. ET-1 infusion caused a dose-dependent decrease in diastolic LVWT (6.6 ± 0.4 to 4.8 ± 0.4 mm at a concentration of 10–9 mol/L, p < 0.05), with a concurrent decrease in coronary flow. FC-43 decreased diastolic LVWT from 6.7 ± 0.5 to 3.8 ± 0.7 mm (p < 0.05), with coronary flow falling from 16.1 ± 0.4 to 8.1 ± 0.4 mL/min (p < 0.05). We conclude that the increased diastolic LVWT observed in buffer-perfused hearts is due to vasodilation induced by the low oxygen-carrying capacity of buffer compared with blood in vivo, and that the inotropic effect of ET-1 in the Langendorff heart may be the result of a reversal of this wall thickening. The implications of these findings are discussed.Key words: ultrasound, endothelin, ventricular wall thickness, vasodilation.

Microvascular adaptation to coronary stenosis in the rat heart in vivo: a serial magnetic resonance imaging study

Changes in the microcirculation may compensate for the reduction of perfusion supplied by the stenotic vessel. The objective of this study was to determine functional adaptive processes in the microcirculation by magnetic resonance imaging (MRI) during coronary stenosis in the rat heart. Left coronary artery (LAD) narrowing (cross-sectional area 49.8 +/- 3.5%; n = 14) or sham operation (n = 10) was induced in rats. Myocardial perfusion and relative intracapillary blood volume (RBV) at rest and during vasodilatation 1 and 2 weeks after surgery were quantified using MRI. Coronary stenosis in vivo was verified by 3D MR angiography. Foci of fibrosis were found in the poststenotic myocardium. In this area, perfusion at rest was significantly reduced (1.79 +/- 0.11 ml/g/min, p < 0.001) despite a maintained perfusion reserve during adenosine (3.12 +/- 0.20 ml/g/min compared to the remote myocardium (3.07 +/- 0.12 and 5.24 +/- 0.24 ml/g/min, respectively) and the sham operated group (3.22 +/- 0.07 and 5.28 +/- 0.24 ml/g/min, respectively). Poststenotic RBV at rest (12.63 +/- 0.42 %) and during vasodilatation (22.42 +/- 0.81 %) were not significantly different (p > 0.05) from RBV of the remote myocardium (12.92 +/- 0.33 and 23.32 +/- 0.52 %, respectively). Coronary stenosis in the rat leads to foci of tissue injury with impaired perfusion at rest despite a partially maintained perfusion reserve distal to the stenosis. RBV remains constant in order to maintain blood supply. These functional changes reflect adaptive processes that may compensate for ischemic tissue loss.

Combined high-speed NMR imaging of perfusion and microscopic coronary conductance vessels in the isolated rat heart

Noninvasive characterization of microcirculation at the level of both coronary conductance and resistance vessels is of major importance for the understanding of microvascular adaptive processes in the heart. The objective of this study was to determine simultaneously myocardial perfusion and microvessel diameters in the myocardium by magnetic resonance (MR) imaging within the same heart. A MR imaging method is presented which combines high-resolution perfusion measurement (140 x 140 microm2) by spin labeling with flow-weighted MR microscopy of coronary microvessels (phi > 140 microm). We determined changes in myocardial perfusion and vessel diameters of isolated beating rat hearts (n = 10) at rest and during administration of nitroglycerin (0.5 mg/min). Alterations in perfusion were validated by microsphere measurements. Under the influence of nitroglycerin an increase in perfusion (+2.51 +/- 0.4 ml x min(-1) x g(-1), mean +/- SEM) and vessel diameters (+14.22 +/- 1.92%) could be observed. Endocardial perfusion revealed a modest enhanced susceptibility to nitroglycerin in comparison to epicardial perfusion. Analysis of vessels according to their diameters showed no significant differences. MR imaging allows the noninvasive and simultaneous determination of conducting arteries and smaller resistance vessels in one and the same beating rat heart. Due to an excellent spatial resolution of these methods, transmural characterization of both parameters at rest and during vasodilation is feasible.

The endothelium: dysfunction and beyond

Since its anatomic discovery in the 19th century, the endothelium was considered to fulfill no other purpose than that of a physical barrier between blood and tissue, until Furchgott and colleagues defined endothelium-dependent vasoreactivity in the late 1970s. Henceforth, a functional paradigm defined the balance between endothelium-derived relaxing factors and endothelium-derived contracting factors as the hallmark of endothelial cell integrity. As a consequence, any reflection of a deviation from this state was defined as endothelial dysfunction, most notably the impairment of vasorelaxation in response to pharmacologic stimuli such as acetylcholine or nonpharmacologic stimuli such as shear stress and cold pressor. Within the coronary artery tree these alterations have been recognized before the development of obstructive coronary artery disease, affecting the microcirculation before the epicardial conduit vessel. Furthermore, recent clinical trials outlined the prognostic significance of these changes, whereby impairment of increase in coronary blood flow in response to endothelium-dependent stimuli seemed to be of utmost importance. Thus it is intriguing to speculate on the evolving role of myocardial perfusion imaging in combination with pharmacologic and nonpharmacologic stimuli for the noninvasive assessment of coronary endothelial dysfunction in patients at risk for future adverse events. At a minimum, this review aims to put endothelial dysfunction into an imaging perspective beyond the scope of the conventional approach.

Scanning electron microscopic studies of the vascular smooth muscle cells and pericytes in the rat heart

The cytoarchitecture of smooth muscle cells and pericytes in the rat cardiac vessels was studied by scanning electron microscopy after the removal of connective tissue matrices using a modified KOH-collagenase digestion method. The initial stem of the coronary arteries had groups of smooth muscle cells which ran in various directions on the outermost layer of the media. Although smooth muscle cells in coronary arteries of more than 100 microm in the outer diameter were arranged in a rough circle around the vessel axis, oblique and/or longitudinal muscle bundles were often present in the medio-adventitial border of the vessels. The presence of irregularly oriented muscular bundles is probably connected with resistance against the stretching force induced by the beating of the heart. As the vessel size decreased toward the periphery, almost all of the smooth muscle cells became spindle-shaped with several tiny processes and ran circularly or helicaly to the vessel axis. In the precapillary arterioles (6-12 microm), smooth muscle cells acquired various cytoplasmic processes which helicaly surrounded endothelial cells. Unmyelinated nerves were often associated with arterioles. Blood capillaries were morphologically divided into three segments: arterial capillaries which had pericytes with wide and circularly oriented processes, true capillaries whose pericytes extended long and thin primary processes bilaterally along the vessel axis, and venous capillaries surrounded irregularly and loosely by wide pericytic processes. The stellate pericytes in the postcapillary venules (10-30 microm) gradually changed into flat tape-like smooth muscle cells, which ran circularly in the collecting venules and veins (30-200 microm). The large collecting veins were finally overwhelmed by superficial thin layer of the myocardium, their own smooth muscle cells being very sparse. This suggests that large veins have poor ability to contract by themselves but are influenced by the surrounding myocardial cells.

The effect of perfusion on T1 after slice-selective spin inversion in the isolated cardioplegic rat heart: measurement of a lower bound of intracapillary-extravascular water proton exchange rate

Many NMR measurements of cardiac microcirculation (perfusion, intramyocardial blood volume) depend on some kind of assumption of intracapillary-extravascular water exchange rate, e.g., fast exchange. The magnitude of this water exchange rate, however, is still unknown. The intention of this study was to determine a lower limit for this exchange rate by investigating the effect of perfusion on relaxation time. Studies were performed in the isolated perfused cardioplegic rat heart. After slice-selective inversion, the spin lattice relaxation rate of myocardium within the slice was studied as a function of perfusion and compared with a mathematical model which predicts relaxation rate as a function of perfusion and intracapillary-extravascular exchange rate. A linear relationship was found between relaxation rate T(-1) and perfusion P normalized by perfusate/tissue partition coefficient of water, lambda: deltaT(-1) = m x deltaP/lambda with 0.82 < or = m < or = 1.06. Insertion of experimental data in the model revealed that a lower bound of the exchange rate from intra- to extravascular space is 6.6 s(-1) (4.5 s(-1), P < 0.05), i.e., the intracapillary lifetime of a water molecule is less than 150 ms (222 ms, P < 0.05). Based on this finding, the T1 mapping after slice-selective inversion could become a valuable noncontrast NMR method to measure variations of perfusion.