Key result
Post-MI systolic dysfunction cuts diaphragm mass by ~17% in preclinical models.
Why the study?
The relative impairment of the diaphragm and other skeletal muscles in systolic ventricular dysfunction was unclear.
Absolute Event Rate: 622% vs 750%
p-value: p=<0.0005
Systolic ventricular dysfunction in rats causes selective diaphragm atrophy related to infarct size, accompanied by increased IGF-I expression in the diaphragm.
May link systolic dysfunction to diaphragm atrophy experimentally; leaves open relevance to human HF symptoms or outcomes.
In order to examine the relative impairment of the diaphragm and other skeletal muscles in systolic ventricular dysfunction (VD), their structure and function were compared between rats with VD induced by left coronary artery ligation (n = 17) and sham-operated rats (Co, n = 10). In addition, in an attempt to unravel the mechanism of the observed impairment, we examined alterations in insulin-like growth factor-I (IGF-I) serum levels and IGF-I expression in the liver, diaphragm, and gastrocnemius. In a second series of rats (VD, n = 5 and Co, n = 5) hemodynamic measurements were performed. All measurements were performed 3 mo after the operation. Infarct size averaged 32 +/- 10 and 44 +/- 20% in the two series, respectively (NS). Hemodynamic measurements revealed a decrease in left ventricular peak systolic pressure of 19% (p < 0. 05). Significant diaphragm atrophy (weight: 622 +/- 52 mg in VD versus 750 +/- 54 mg in Co, p < 0.0005), without alterations in diaphragm contractile properties was present in VD animals. For all animals combined, the reduction in diaphragm weight was related to infarct size (r = -0.74, p < 0.001). No alterations were observed in the other inspiratory and peripheral muscles. ATPase staining of the diaphragm showed atrophy of type I and type IIx/b fibers, their cross-sectional area (CSA) being reduced by 13 and 16%, respectively (p < 0.05). There were no signs of myopathic alterations. IGF-I expression was increased by 55% in the diaphragm of rats with VD (p < 0.05). IGF-I expression in the liver and gastrocnemius and serum IGF-I levels were unaltered. These data suggest the presence of compensatory mechanisms aimed at minimizing diaphragmatic fiber atrophy. We conclude that systolic VD caused: (1) selective diaphragm atrophy, which was related to infarct size; (2) a decrease in diaphragm type I and IIx/b CSA not associated with myopathic changes; (3) an increase in the IGF-I mRNA content of the diaphragm. The selective diaphragm involvement in the present study may be related to the moderate degree of ventricular dysfunction induced.
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Stassijns et al. (1998) studied Systolic ventricular dysfunction (n=37). Left coronary artery ligation vs. Sham operation was evaluated on Diaphragm weight (p=<0.0005). Systolic ventricular dysfunction induced by coronary ligation caused significant diaphragm atrophy in rats (622 mg vs 750 mg in controls, p < 0.0005).
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