Abstract
Cardiovascular calcifications are frequently found in the aging population and are independent predictors of future cardiovascular events. Integrated backscatter (IB) of ultrasound reflectivity can easily quantify calcifications. For this purpose, 30 male Wistar rats received 25,000 IU/kg/day of vitamin D3 (group 1, n = 8), 18,800 IU/kg/day (group 2, n = 8), or injections with the vehicle only (group 3, n = 14), for 10 weeks. Echocardiographic calibrated IB (cIB) was measured and calculated at baseline and after 10 weeks, followed by ex vivo micro-CT and histopathology of the aortic valve, ascending aorta, and myocardium. After 10 weeks, the mean cIB value of the aortic valve was significantly higher for vitamin D3-dosed animals compared to controls. The mean cIB value of the ascending aorta and the myocardium was also significantly higher in group 1 compared to group 3. In vivo IB results were confirmed by ex vivo micro-CT and histopathology. In conclusion, IB is a non-ionizing, feasible, and reproducible tool to quantify cardiovascular calcifications in an in vivo rat model. The integration of IB in the standard echocardiographic examination for the quantification of cardiovascular calcifications could be useful for serial evaluation of treatment efficacy and for prognosis assessment.
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Abbreviations
- A:
-
Diastolic peak late velocity
- AV:
-
Aortic valve
- BSA:
-
Body surface area
- cIB:
-
Calibrated integrated backscatter
- Dec Time:
-
Deceleration time
- E:
-
Diastolic peak early velocity
- FAC:
-
Fractional area change
- IB:
-
Integrated backscatter
- Ind:
-
Indexed
- LA:
-
Long axis
- LV:
-
Left ventricle
- LVAd:
-
LV cross-sectional area at end diastole
- LVAs:
-
LV cross-sectional area at end systole
- LVOT:
-
Left venticular outflow tract
- PG:
-
Pressure gradient
- ROI(s):
-
Region(s) of interest
- ROIM :
-
ROI myocardium
- ROIAscA :
-
ROI ascending aorta
- ROIAVGLOB :
-
ROI aortic valve, global
- ROIAVLA :
-
ROI aortic valve, long axis
- ROIAVSA :
-
ROI aortic valve, short axis
- ROIAVTOT :
-
ROI aortic valve, total
- SA:
-
Short axis
- TVI:
-
Tissue Velocity Image
- VDR:
-
Vitamin D receptor
References
Stewart, B. F., Siscovick, D., Lind, B. K., Gardin, J. M., Gottdiener, J. S., Smith, V. E., et al. (1997). Clinical factors associated with calcific aortic valve disease. Cardiovascular health study. Journal of the American College of Cardiology, 29, 630–634.
Rosenhek, R. (2005). Statins for aortic stenosis. New England Journal of Medicine, 352, 2441–2443.
Taylor, A. J., Burke, A. P., O’Malley, P. G., Farb, A., Malcom, G. T., Smialek, J., et al. (2000). A comparison of the Framingham risk index, coronary artery calcification, and culprit plaque morphology in sudden cardiac death. Circulation, 101, 1243–1248.
Kawasaki, M., Takatsu, H., Noda, T., Ito, Y., Kunishima, A., Arai, M., et al. (2001). Noninvasive quantitative tissue characterization and two-dimensional color-coded map of human atherosclerotic lesions using ultrasound integrated backscatter: comparison between histology and integrated backscatter images. Journal of the American College of Cardiology, 38, 486–492.
Donnelly, K. B. (2008). Cardiac valvular pathology: comparative pathology and animal models of acquired cardiac valvular diseases. Toxicologic Pathology, 36, 204–217.
Zittermann, A., & Koerfer, R. (2008). Protective and toxic effects of vitamin D on vascular calcification: clinical implications. Molecular Aspects of Medicine, 29, 423–432.
Zittermann, A., Schleithoff, S. S., & Koerfer, R. (2007). Vitamin D and vascular calcification. Current Opinion in Lipidology, 18, 41–46.
Price, P. A., June, H. H., Buckley, J. R., & Williamson, M. K. (2001). Osteoprotegerin inhibits artery calcification induced by warfarin and by vitamin D. Arteriosclerosis, Thrombosis, and Vascular Biology, 21, 1610–1616.
Cardus, A., Panizo, S., Parisi, E., Fernandez, E., & Valdivielso, J. M. (2007). Differential effects of vitamin D analogs on vascular calcification. Journal of Bone and Mineral Research, 22, 860–866.
Price, P. A., Faus, S. A., & Williamson, M. K. (2000). Warfarin-induced artery calcification is accelerated by growth and vitamin D. Arteriosclerosis, Thrombosis, and Vascular Biology, 20, 317–327.
Droogmans, S., Franken, P. R., Garbar, C., Weytjens, C., Cosyns, B., Lahoutte, T., et al. (2007). In vivo model of drug-induced valvular heart disease in rats: pergolide-induced valvular heart disease demonstrated with echocardiography and correlation with pathology. European Heart Journal, 28, 2156–2162.
Weytjens, C., Cosyns, B., D’Hooge, J., Gallez, C., Droogmans, S., Lahoute, T., et al. (2006). Doppler myocardial imaging in adult male rats: reference values and reproducibility of velocity and deformation parameters. European Journal of Echocardiography, 7, 411–417.
Droogmans, S., Roosens, B., Cosyns, B., Degaillier, C., Hernot, S., Weytjens, C., et al. (2009). Dose dependency and reversibility of serotonin-induced valvular heart disease in rats. Cardiovascular Toxicology, 9, 134–141.
Ngo, D. T., Stafford, I., Kelly, D. J., Sverdlov, A. L., Wuttke, R. D., Weedon, H., et al. (2008). Vitamin D(2) supplementation induces the development of aortic stenosis in rabbits: interactions with endothelial function and thioredoxin-interacting protein. European Journal of Pharmacology, 590, 290–296.
Nightingale, A. K., & Horowitz, J. D. (2005). Aortic sclerosis: not an innocent murmur but a marker of increased cardiovascular risk. Heart, 91, 1389–1393.
Di Bello, V., Giorgi, D., Viacava, P., Enrica, T., Nardi, C., Palagi, C., et al. (2004). Severe aortic stenosis and myocardial function: diagnostic and prognostic usefulness of ultrasonic integrated backscatter analysis. Circulation, 110, 849–855.
McCollough, C. H., Ulzheimer, S., Halliburton, S. S., Shanneik, K., White, R. D., & Kalender, W. A. (2007). Coronary artery calcium: a multi-institutional, multimanufacturer international standard for quantification at cardiac CT. Radiology, 243, 527–538.
Callister, T. Q., Cooil, B., Raya, S. P., Lippolis, N. J., Russo, D. J., & Raggi, P. (1998). Coronary artery disease: improved reproducibility of calcium scoring with an electron-beam CT volumetric method. Radiology, 208, 807–814.
Shavelle, D. M., Budoff, M. J., Buljubasic, N., Wu, A. H., Takasu, J., Rosales, J., et al. (2003). Usefulness of aortic valve calcium scores by electron beam computed tomography as a marker for aortic stenosis. American Journal of Cardiology, 92, 349–353.
Messika-Zeitoun, D., Aubry, M. C., Detaint, D., Bielak, L. F., Peyser, P. A., Sheedy, P. F., et al. (2004). Evaluation and clinical implications of aortic valve calcification measured by electron-beam computed tomography. Circulation, 110, 356–362.
Postnov, A. A., Vinogradov, A. V., Van Dyck, D., Saveliev, S. V., & De Clerck, N. M. (2003). Quantitative analysis of bone mineral content by X-ray microtomography. Physiological Measurement, 24, 165–178.
Ogle, M. F., Kelly, S. J., Bianco, R. W., & Levy, R. J. (2003). Calcification resistance with aluminum-ethanol treated porcine aortic valve bioprostheses in juvenile sheep. Annals of Thoracic Surgery, 75, 1267–1273.
Persy, V., Postnov, A., Neven, E., Dams, G., De Broe, M., D’Haese, P., et al. (2006). High-resolution X-ray microtomography is a sensitive method to detect vascular calcification in living rats with chronic renal failure. Arteriosclerosis, Thrombosis, and Vascular Biology, 26, 2110–2116.
van den Broek, F. A., Beems, R. B., van Tintelen, G., Lemmens, A. G., Fielmich-Bouwman, A. X., & Beynen, A. C. (1997). Co-variance of chemically and histologically analysed severity of dystrophic cardiac calcification in mice. Laboratory Animals, 31, 74–80.
Gaillard, V., Jover, B., Casellas, D., Cordaillat, M., Atkinson, J., & Lartaud, I. (2008). Renal function and structure in a rat model of arterial calcification and increased pulse pressure. Am J Physiol Renal Physiol, 295, F1222–F1229.
Lartaud-Idjouadiene, I., Lompre, A. M., Kieffer, P., Colas, T., & Atkinson, J. (1999). Cardiac consequences of prolonged exposure to an isolated increase in aortic stiffness. Hypertension, 34, 63–69.
Norman, P. E., & Powell, J. T. (2005). Vitamin D, shedding light on the development of disease in peripheral arteries. Arteriosclerosis, Thrombosis, and Vascular Biology, 25, 39–46.
Wong, C. Y., O’Moore-Sullivan, T., Leano, R., Byrne, N., Beller, E., & Marwick, T. H. (2004). Alterations of left ventricular myocardial characteristics associated with obesity. Circulation, 110, 3081–3087.
Khan, Z., Boughner, D. R., & Lacefield, J. C. (2008). Anisotropy of high-frequency integrated backscatter from aortic valve cusps. Ultrasound in Medicine and Biology, 34, 1504–1512.
Ngo, D. T., Wuttke, R. D., Turner, S., Marwick, T. H., & Horowitz, J. D. (2004). Quantitative assessment of aortic sclerosis using ultrasonic backscatter. Journal of the American Society of Echocardiography, 17, 1123–1130.
Ortlepp, J. R., Hoffmann, R., Ohme, F., Lauscher, J., Bleckmann, F., & Hanrath, P. (2001). The vitamin D receptor genotype predisposes to the development of calcific aortic valve stenosis. Heart, 85, 635–638.
Drolet, M. C., Arsenault, M., & Couet, J. (2003). Experimental aortic valve stenosis in rabbits. Journal of the American College of Cardiology, 41, 1211–1217.
Drolet, M. C., Couet, J., & Arsenault, M. (2008). Development of aortic valve sclerosis or stenosis in rabbits: role of cholesterol and calcium. Journal of Heart Valve Disease, 17, 381–387.
Acknowledgments
This study was supported with a grant from AstraZeneca and Pfizer, Belgium. Bram Roosens has received a scholarship from the OZR, Vrije Universiteit Brussel (2008–2009). Tony Lahoutte is a Senior Clinical Investigator of the Research Foundation—Flanders (Belgium) (FWO). The authors wish to thank Mrs. Cindy Peleman and Mr. Patrick Roncarati for their outstanding technical assistance.
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Roosens, B., Droogmans, S., Hostens, J. et al. Integrated Backscatter for the In Vivo Quantification of Supraphysiological Vitamin D3-Induced Cardiovascular Calcifications in Rats. Cardiovasc Toxicol 11, 244–252 (2011). https://doi.org/10.1007/s12012-011-9118-y
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DOI: https://doi.org/10.1007/s12012-011-9118-y