title: Coronary flow reserve and heart failure in experimental coxsackievirus myocarditis. A transthoracic Doppler echocardiography study.
abstract: The objective of this study was to apply transthoracic Doppler echocardiography (TTDE) in mice to study coronary flow reserve (CFR), an index of coronary microvascular function, in mild and severe forms of experimental viral myocarditis. Regarding methodology, BALB/c mice were infected with cardiotropic coxsackieviruses causing either a mild (Nancy strain) or a severe (Woodruff strain) myocarditis. Left ventricular dimensions, fractional shortening, and CFR (ratio of left coronary artery flow velocity during maximal adenosine-induced vasodilatation to rest) were measured by TTDE before infection and again 1 or 2 wk after infection. As a result, the resting flow velocity did not change after infection. In contrast, CFR reduced significantly 1 wk after infection with either virus variant [from 2.5 (SD 0.3) to 1.4 (SD 0.1) in severe and from 2.4 (SD 0.4) to 2.1 (SD 0.3) in mild myocarditis], being significantly lower in the severe than mild myocarditis. CFR remained low in severe myocarditis 2 wk after infection. Fractional shortening decreased to the same levels 1 wk after infection with either virus variant [from 0.54 (SD 0.02) to 0.43 (SD 0.03) in severe and from 0.51 (SD 0.03) to 0.44 (SD 0.02) in mild myocarditis, P < 0.05]. However, 2 wk after infection, mice with severe myocarditis had enlarged left ventricles and lower fractional shortening [0.31 (SD 0.03)] than mice with mild myocarditis [0.47 (SD 0.02), P < 0.01]. In conclusion, CFR measured with TTDE is reduced in coxsackievirus myocarditis in mice. Low CFR is associated with progressive heart failure, indicating that dysfunction of coronary microcirculation is a determinant of poor outcome in viral myocarditis.
authors.affiliation: Department of Clinical Physiology, Turku University Central Hospital, Kiinamyllynkatu 6-8, 20520 Turku, Finland. antti.saraste@utu.fi
authors.forename: Antti
authors.initials: A
authors.lastname: Saraste
authors.forename: Ville
authors.initials: V
authors.lastname: Kytö
authors.forename: Markku
authors.initials: M
authors.lastname: Saraste
authors.forename: Tytti
authors.initials: T
authors.lastname: Vuorinen
authors.forename: Jaakko
authors.initials: J
authors.lastname: Hartiala
authors.forename: Pekka
authors.initials: P
authors.lastname: Saukko
mesh_terms: D000818:Animals; D003326:Coronary Circulation / Q000502:physiology*; D003384:Coxsackievirus Infections / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D004452:Echocardiography; D006333:Heart Failure / Q000473:pathology / Q000503:physiopathology*; D006334:Heart Function Tests; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D009205:Myocarditis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D009206:Myocardium / Q000473:pathology; D016277:Ventricular Function, Left