Afferent Mechanisms of Left Ventricular Remodeling

     
Dr. Scott Solomon's research focuses on understanding afferent mechanisms of left ventricular remodeling. Dr. Solomon and colleagues have developed a computer based three-dimensional finite element model of the left ventricle based on echocardiographic images in order to assess regional left ventricular wall stress in a variety of myocardial diseases. Finite element analysis, an engineering technique used routinely in structural design, is ideally suited for analysis of regional stress distribution in a geometrically irregular structure, such as the diseased left ventricle. An assessment of left ventricular regional wall stress may lead to a better understanding of the forces that result in ventricular dilatation and remodeling in a variety of myocardial diseases. Results of this work has demonstrated that regional wall stress predicts left ventricular remodeling post-MI.

 Dr. Solomon directs the Core Echo Laboratory, at Brigham and Women's Hospital and directs two major international trials of left ventricular remodeling in post-MI and heart failure patients, the VALIANT ECHO study and the OVERTURE ECHO study. VALIANT ECHO will determine whether an angiotensin receptor antagonist can attenuate left ventricular remodeling post-MI to the same or greater extent as an ACE inhibitor. 600 patients will be enrolled in 14 countries. OVERTURE ECHO will determine whether the NEP-ACE inhibitor, Omapatrilat, will improve left ventricular size and function in patients with heart failure to a greater extent than an ACE inhibitor.

Dr. Solomon directs the Noninvasive Cardiac Laboratory and co-directs the cardiac MRI program.

Solomon SD, Wolff S, Watkins H, Ridker PM, Come PC, McKenna WJ, Seidman CE, Lee RT. Left ventricular hypertrophy and morphology in familial hypertrophic cardiomyopathy associated with mutations of the ß-myosin heavy chain gene. JACC 22:498-505; 1993.

Solomon SD, Kytomaa H, Celi A, Maas L, Chou L, Caguioa E, Lee RT. Myocardial tissue characterization by autocorrelation of two-dimensional ultrasonic backscatter. J Am Soc Echocard 7:631-640; 1994.

Solomon SD, Martini M, Rosario L, Aikawa Y, Makker G, Gerson D, Greaves SC, Lee RT. Assessment of regional left ventricular wall stress following myocardial infarction by echocardiography-based structural analysis. J Am Soc Echocardiog. 1998;11:938-47.

Nass N, Goldhaber SZ, Chyu S, Solomon SD. Recovery of regional right ventricular function following thrombolysis for pulmonary embolism. Am J Cardiol. 1999 Mar 1;83(5):804-6, A10.

Solomon SD, Greaves S, Rayan M, Finn P, Pfeffer MA, Pfeffer JA. Temporal Dissociation of Left Ventricular Function and Remodeling Following Experimental Myocardial Infarction in Rats. J. Cardiac Failure. 1999; 5(3):213-223.

Aikawa Y, Rohde L, Greaves SC, Menapace F, Arnold JMO, Rouleau J, Plehn J, Pfeffer MA, Lee RT, Solomon SD. Regional wall stress predicts ventricular remodeling after anteroseptal myocardial infarction in the Healing and Early Afterload Reducing Trial (HEART): An echocardiography-based structural analysis. Am Heart J. In Press.

Solomon SD, Glynn R, Greaves SC, Ujani U, Menapance F, Arnold JMO, Rouleau J, Hennekens C, Pfeffer MA. Recovery of ventricular function following myocardial infarction: The Healing and Early Afterload Reduction Therapy (HEART) Trial. Ann Intern Med. (In press)