Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Nov 9:5:29.
doi: 10.1186/s40349-017-0107-x. eCollection 2017.

Multiple ultrasound cavitation-enabled treatments for myocardial reduction

Douglas L Miller  1   2 , Xiaofang Lu  1 , Chunyan Dou  1 , Yiying I Zhu  1 , Mario L Fabiilli  1 , Gabe E Owens  3 , Oliver D Kripfgans  1
Affiliations

Multiple ultrasound cavitation-enabled treatments for myocardial reduction

Douglas L Miller et al. J Ther Ultrasound. .

Abstract

Background: Ultrasound myocardial cavitation enabled treatment (MCET) is an image-guided method for tissue reduction. In this study, a strategy of fractionated (multiple) treatments was tested for efficacy.

Methods: Dahl SS rats were anesthetized and prepared for treatment with a focused ultrasound transducer in a warm water bath. Aiming at the anterior left ventricular wall was facilitated by imaging with a 10 MHz phased array (10S, GE Vivid 7, GE Vingmed Ultrasound, Horten, Norway). MCET was accomplished at 1.5 MHz by pulse bursts of 4 MPa peak rarefactional pressure amplitude, which were intermittently triggered 1:8 from the ECG during infusion of a microbubble suspension for cavitation nucleation. Test groups were sham, a 200 s treatment, three 200 s treatments a week apart, and a 600 s treatment. Treatment outcome was observed by plasma troponin after 4 h, echocardiographic monitoring and histology at 6 wk.

Results: The impacts of the fractionated treatments summed to approximately the same as the long treatment; e. g. the troponin result was 10.5 ± 3.2 for 200 s, 22.7 ± 5.4 (p < 0.001) for the summed fractionated treatments and 29.9 ± 6.4 for 600 s (p = 0.06 relative to the summed fractionated). While wall thickness was not reduced for the fractionated treatment, tissue strain was reduced by 35% in the target area relative sham (p < 0.001).

Conclusion: The ability to fractionate treatment may be advantageous for optimizing patient outcome relative to all-or nothing therapy by surgical myectomy or alcohol ablation.

Keywords: Arrhythmia; Cardiac myocyte necrosis; Hypertrophic cardiomyopathy; Myocardial contrast echocardiography.

PubMed Disclaimer

Conflict of interest statement

Ethics approval

All in vivo animal procedures were conducted with the approval and guidance of the University Committee on Use and Care of Animals of the University of Michigan.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Trends in the mean body weight for each of the groups. The steroid treatment induced a brief period of weight loss for each treatment session so that the fractionated treatment groups, both sham and exposed, had three brief periods of weight loss
Fig. 2
Fig. 2
Results for the percentage of pulse triggers resulting in premature complexes in the ECG (average ± standard deviation) for 200 s (yellow), 600 s (red) and fractionated treatment (blue). PCs were significantly less than in the 1st period for the successive periods of the 600 s treatment (†), and the total was significantly less than the total for the fractionated treatments (*)
Fig. 3
Fig. 3
The trends in echocardiographic wall thickness for the groups. Treatment induced immediate swelling which was notable the next day, then receded after 1 week and at the end of monitoring. Only the 600 s treatment gave a significant reduction in wall thickness (p < 0.01)
Fig. 4
Fig. 4
Selected examples of the hearts for each group. Photographs are shown of hearts for groups A-D (scale bar 5 mm), and corresponding histological sections (scale bar 2 mm) stained with Masson’s trichrome to reveal fibrosis (blue). For the 600 s treatment (D), the wall is noticeably thinned in the target area, including some erosion of the heart surface
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Semsarian C, Ingles J, Maron MS, Maron BJ. New perspectives on the prevalence of hypertrophic cardiomyopathy. J Am Coll Cardiol. 2015;65:1249–1254. doi: 10.1016/j.jacc.2015.01.019. - DOI - PubMed
    1. Maron BJ, Salberg L. Wiley online, a guide to hypertrophic cardiomyopathy for patients, families, and interested physicians. Chichester, West Sussex: John Wiley & Sons Ltd.; 2014.
    1. Ommen SR, Nishimura RA. Hypertrophic cardiomyopathy. Curr Probl Cardiol. 2004;29:239–291. doi: 10.1016/j.cpcardiol.2004.01.001. - DOI - PubMed
    1. Marian AJ. Contemporary treatment of hypertrophic cardiomyopathy. Tex Heart Inst J. 2009;36:194–204. - PMC - PubMed
    1. Jan MF, Todaro MC, Oreto L, Tajik AJ. Apical hypertrophic cardiomyopathy: present status. Int J Cardiol. 2016;222:745–759. doi: 10.1016/j.ijcard.2016.07.154. - DOI - PubMed

LinkOut - more resources

-