scholarly journals Effect of fosinopril on progression of the asymptomatic carotid atherosclerosis and left ventricular hypertrophy in hypertensive patients

2006 ◽  
Vol 134 (3-4) ◽  
pp. 106-113 ◽  
Author(s):  
Ivan Tasic ◽  
Dragan Mijalkovic ◽  
Dragan Djordjevic ◽  
Branko Lovic ◽  
Dimitrije Jankovic ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Ace Inhibitor ◽  
Intima Media Thickness ◽  
Left Ventricle Mass ◽  
Hypertensive Patients ◽  
Left Ventricle Hypertrophy ◽  
Group A ◽  
The Common ◽  
Group B ◽  
Ventricle Hypertrophy

INTRODUCTION The cardiovascular changes (vascular structure changes, hypertrophy of the left ventricle) contribute to both the increased cardiovascular morbidity and the mortality of essential hypertension. Therefore, modern treatment strategies should not only target blood pressure (BP) reduction but also normalize cardiovascular structure and function. OBJECTIVE Aim of the study was to determine the effect of the ACE inhibitor Fosinopril on the Intima-media thickness of the common carotid artery and on the left ventricle mass after 9-month treatment of hypertensive patients. METHOD The study included 40 patients with the arterial hypertension and the left ventricle hypertrophy verified by echocardiography. The patients were randomized on A) ACE-inhibitor - Fosinopril and 6) without ACE inhibitor - atenolol, and they were followed up 9 months. The groups were not different by age, sex, and metabolic status. Color Duplex ultrasonography of the carotid arteries was performed by Acuson Sequia C236 with high-frequency linear probe of 8 MHz. The Intima-media thickness of the common carotids on the left and the right was measured in diastole at 1.5. cm from the highest point of bifurcation under maximal magnification. Using the same device, the left ventricle mass and other parameters of the left ventricle were determined in M-mode and by means of 2D image. RESULTS After 9 months, BP In both groups Was reduced In similar range (group A: systolic BP from 158 to 137 mmHg, and diastolic BP from 94 to 85 mmHg, and group B; systolic BP from 164 to 137 mmHg, and diastolic BP from 87 to 84 mmHg). The thickness of the intimomedial complex in patients using Fosinopril was decreased by 0.0278 ? 0.03 mm, while in the group of patients that did not use the ACE-inhibitor, it was increased by 0.078 ?0.13 mm. The left ventricle mass in patients using Fosinopril was decreased by 5 grams (312 ? 72 g vs. 307 ? 77 g), while in group B patients, it was increased by 15 grams (323 ? 79 g vs. 328 ? 58 g. Diastolic function expressed through relation E/A was improved minimally in the group A, while it worsened by 0.1 in the group B. After 9 months, serious cardiovascular events were recorded (one infarction of myocardium and one hospitalization due to the unstable angina pectoris) in two patients of the group A, while four patients of the group B. had serious CV events (1 cerebrovascular stroke and 3 hospitalizations due to unstable angina pectoris). CONCLUSION The results of our study showed that the application of Fosinopril in patients with the arterial hypertension and the left ventricle hypertrophy could efficiently block further progression of the intima-medial thickness of the common carotid artery, reduce the left ventricle mass, and improve. diastolic function of the left ventricle.

scholarly journals Compelling therapy of LVH: straight (and not-so-straight) inferences from evidence

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Ravi Tejraj Mehta ◽  
Anil Pareek ◽  
Shruti Dharmadhikari
Keyword(s):  
Left Ventricle ◽  
Review Of Literature ◽  
Left Ventricle Mass ◽  
Hypertensive Patients ◽  
Korean Society ◽  
Hypertension Guidelines ◽  
Left Ventricle Hypertrophy ◽  
Paradoxical Finding ◽  
Beneficial Action ◽  
Ventricle Hypertrophy

AbstractWe have read with interest the Korean Society of Hypertension guidelines for the management of hypertension and congratulate the Society for an extensive review of literature while drafting the guidelines. The guidelines indicate preferring ACE-I and CCB over diuretics in patients with left ventricle hypertrophy. However, in landmark head-to-head comparison trials, the thiazide-like diuretic chlorthalidone has been shown to be superior to ACE-I and CCB in decreasing left ventricle mass and preventing heart failure in hypertensive patients. Also, we put forth the paradoxical finding that mere regression of LVH may not always translate into reduction in risk of HF; and that the pleiotropic effects of chlorthalidone may be the explanation behind its beneficial action in HF.

scholarly journals P2856Predictors of survival in hypertensive patients with left ventricle hypertrophy

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
B Guzik ◽  
L McCallum ◽  
K Zmudka ◽  
A Jardine ◽  
T J Guzik ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Hypertensive Patients ◽  
Left Ventricle Hypertrophy ◽  
Ventricle Hypertrophy

MO777HISTOLOGICAL AND IMMUNOPHENOTYPICAL VESSEL CHANGES IN CHRONIC KIDNEY DISEASE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Aikaterini Lysitska ◽  
Nikiforos Galanis ◽  
Ioannis Skandalos ◽  
Eustathios Mitsopoulos ◽  
Nikolaos Antoniadis ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Internal Carotid ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Atherosclerotic Lesions ◽  
Ckd Stage ◽  
Group A ◽  
The Common ◽  
Group B

Abstract Background and Aims Recent studies suggest thw possibility of activating immune mechanism in the onset and progression of atherosclerotic disease. The aim of the present study was to evaluate the role of immune mechanisms in the vessel of patients with Chronic Kidney Disease (CKD) and the association with clinical and laboratory indicators of atherosclerosis. Method Patients with CKD stage V, in whom a radiocephalic arteriovenous fistula (RC-AVF) was created, were included in the study. Patients were divided in two groups, group A was consisted of patients who were on stage V, pre-dialysis, and being prepared to start on hemodialysis (HD), and those who had already been on HD for at least 3 years, and were having a new RC-AVF formation, due to previous failure, group B. Inclusion criteria were: age 25-80 years, gradual deterioration of renal function up to stage V or under dialysis for more than 3 years. All patients should have been under close follow up for at least 3 years prior to enrolment, with adequate control of diabetes, hypertension, dyslipidemia, secondary hyperparathyroidism and anemia. The control group included healthy volunteers of similar age, sex and ethnicity, who agreed to have a radial artery biopsy during an orthopedic procedure because of a fracture. All patients were informed and signed the consent form. Patients’ history, primary disease and comorbid conditions, medication and clinical examination were recorded based on hospital outpatients’ files. Prior to the scheduled day of RC-AVF creation, all patients underwent laboratory examination, included hematological and serum biochemical analyses. The histological characteristics, inflammatory activation and immunophenotypic alterations of the radial artery wall were estimated and their association with the severity of calcification and atherosclerosis were studied. Presence and severity of atherosclerotic lesions in CKD patients was assessed based on the measurement of common carotid intima – media thickness (IMT) of the common and internal carotid on both sides. Results Significant correlation was fount between inflammatory infiltration [expression of CD3(+), CD20(+), CD68(+) cells], cellular activation [CD34(+), a-SMA(+) cells] and calcification regulators (MPG, RANKL, OPG) with the degree of vascular calcification, as this was estimated and classified based on Verhoff’s Elastic and von Kossa staining Forty five patients with chronic kidney disease (CKD), stage V, either pre-dialysis (p=25) (group A) or on hemodialysis (HD) (p=20) (group B) were included in the study. There were no significant differences in age, sex, race, and also in the frequency of hypertension, diabetes mellitus or smoking habits between patients and controls. Presence and severity of atherosclerotic lesions in CKD patients was assessed based on the measurement of common carotid intima – media thickness (IMT) of the common and internal carotid on both sides. Conclusion Atherosclerotic disease in Chronic KidnEy Disease and its clinical effects appear to be directly related to inflammatory ifiltration of blood vessels by T, B lymphocytes, macrophages and myofibrolasts, as well as factors that affect calcification.

scholarly journals Association of Plasma Renalase and Left Ventricle Mass Index in Heart Failure Patients Stratified to the Category of the Ejection Fraction: A Pilot Study

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Dijana Stojanovic ◽  
Valentina Mitic ◽  
Dejan Petrovic ◽  
Miodrag Stojanovic ◽  
Aleksandra Ignjatovic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Plasma Concentration ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Statistical Significance ◽  
Left Ventricle Mass ◽  
Reduced Ejection Fraction ◽  
Heart Failure Patients ◽  
Left Ventricle Hypertrophy ◽  
Ventricle Hypertrophy

Heart failure represents a growing health problem, with increasing morbidity and mortality globally. According to the mechanisms involved in the pathogenesis of heart failure, many biomarkers have been proposed for the timely diagnosis and prognostication of patients with heart failure, but other than natriuretic peptides, none of them has gained enough clinical significance. Renalase, a new protein derived from kidneys was demonstrated to metabolize catecholamines and to have a cardioprotective role. The aim of the study was to determine whether renalase and brain natriuretic peptide (BNP) concentration could be used to differentiate heart failure patients stratified to the category of the ejection fraction and whether plasma renalase could be used as a biomarker for left ventricle hypertrophy in all subgroups of heart failure patients. We included patients diagnosed with heart failure and stratified them to the three subgroups according to the ejection fraction. Regarding echocardiographic parameters, HFmrEF had an intermediate profile in between HFrEF and HFpEF, with statistical significance in most evaluated parameters. BNP concentration was significantly different in all three subgroups (p<0.001), and renalase was statistically higher in HFrEF (p=0.007) compared to the HFmrEF and HFpEF, where its results were similar, without statistical significance. Renalase plasma concentration was demonstrated to be highly and positively associated with left ventricle mass index in HFrEF (p=0.029), as well as increased plasma concentration of BNP (p=0.006). In the HFmrEF group of patients, body mass index was positively associated with LVMI (p=0.05), while in the patients with HFpEF, diabetes mellitus was demonstrated to have a positive association with LVMI (p=0.043). These findings suggest that renalase concentration may be measured in order to differentiate patients with reduced ejection fraction. Plasma renalase concentrations positively correlated with left ventricle hypertrophy in patients with reduced ejection fraction, being strongly associated with increased left ventricular mass index.

scholarly journals Cardiovascular risk and unproportional high weight of left ventrical myocardium in climacteric women

2014 ◽  
Vol 95 (3) ◽  
pp. 315-322
Author(s):  
A R Sadykova ◽  
A R Shamkina ◽  
R I Gizyatoullova
Keyword(s):  
Left Ventricle ◽  
Arterial Hypertension ◽  
Left Ventricular Mass ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Left Ventricle Mass ◽  
Ventricular Mass ◽  
Left Ventricle Hypertrophy ◽  
Ventricle Hypertrophy

Aim. To study the distribution of cardiovascular risk factors, target organ damage, associated clinical conditions and to stratify the 10-year risk of arterial hypertension complications in menopausal females depending on presence of inappropriately high left ventricular mass. Methods. 107 females from city of Kazan aged 42-59 years entered the study, including 11 women with normal blood pressure, 16 patients with high normal blood pressure, and 80 patients with hypertension according to All-Russia scientific Society of Cardiologists classification (2010) with disease duration of 0-34 years. Mean age of patients with hypertension was 51.4±4.0 years. Patients with secondary hypertension were excluded from the study. All patients underwent a questionnaire survey, physical examination, biochemical blood test, ECG, echocardiography, and cervical extracranial vessel ultrasonography. Actual left ventricle mass was calculated according to R.B. Devereux et al. (1977) and was adjusted to the body surface area. Proper left ventricle mass was defined by G. Simone et al. (1998). Disproportion coefficient was calculated as a ratio of actual left ventricle mass to proper left ventricle mass. Left ventricle hypertrophy was diagnosed using the Sokolow-Lyon index and left ventricle mass index ≥ 110 g/m2 (Echo-signs of left ventricle hypertrophy). Results. In menopausal women, inappropriately high left ventricular mass was associated with significantly (р 0.05, Fisher exact test) higher frequency of obesity, especially its abdominal type, as well as target organ damage, including Echo-signs of left ventricle hypertrophy, very high added 10-year risk of developing arterial hypertension complications. It was also associated with significantly (р 0.05, the U-criterion) higher mean values of waist circumference, waist to hip circumference ratio, body mass index, total number of damaged target organs and 10-year risk for developing arterial hypertension complications. Conclusion. Distinguishing the patients with inappropriately high left ventricular mass among menopausal women is important for planning the measures to prevent cardiovascular events.

scholarly journals Short-Term Prognosis Value of sST2 for an Unfavorable Outcome in Hypertensive Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Anca Daniela Farcaş ◽  
Mihaela Mocan ◽  
Florin Petru Anton ◽  
Mocan-Hognogi Larisa Diana ◽  
Roxana Mihaela Chiorescu ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Multivariate Logistic Regression Analysis ◽  
Unfavorable Outcome ◽  
Short Term ◽  
Left Ventricle Mass ◽  
Hypertensive Patients ◽  
Diagnosis And Prognosis ◽  
Group A ◽  
Group B

Background. sST2 represents a useful biomarker for the diagnosis and prognosis of patients with heart failure, but limited data is available on its role in patients with hypertension. The aim of this study is to evaluate the short-term prognosis value of sST2 for an unfavorable outcome in hypertensive patients. Methods. This was a prospective observational study which enrolled 80 patients with hypertension, who were followed for one year. All patients underwent clinical, laboratory (including sST2), and echocardiographic assessment at baseline. The patients were grouped according to the cardiovascular (CV) events reported during the follow-up: group A (with CV events) and group B (without CV events). Results. Overall, 59 CV events were reported during the follow-up period. Compared to group B, the patients in group A had significantly higher sST2 levels, a higher number of CV risk factors, and a higher left ventricle mass. Except for the diastolic dysfunction parameters, the echocardiographic findings were similar in the two groups. Patients in group A had a lower E/A ratio, larger deceleration time, and increased telediastolic pressure as quantified by the E/E′ ratio than those in group B. Multivariate logistic regression analysis showed that sST2 and fasting plasma glucose at baseline were independent predictors for the CV events reported during the follow-up period. sST2 levels>28.5 ng/mL were associated with poor clinical outcomes (p=0.006, Kaplan-Meier analysis). Conclusions. sST2 levels were correlated with the risk of adverse CV outcomes in hypertensive patients and may represent a useful prognostic marker in these patients.

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