scholarly journals Serum Aldosterone Is Related to Left Ventricular Geometry and Function in Young Adults with Never-Treated Primary Hypertension

2019 ◽  
Vol 8 (7) ◽  
pp. 1045 ◽  
Author(s):  
Seong-Mi Park ◽  
Mi-Na Kim ◽  
Sua Kim ◽  
Wan-Joo Shim
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Left Ventricular ◽  
Primary Hypertension ◽  
Lv Function ◽  
Amino Terminal ◽  
Serum Aldosterone ◽  
Lv Mass ◽  
And Function ◽  
Normal Controls

Background: Although aldosterone has been demonstrated to induce left ventricular (LV) hypertrophy not only in primary aldosteronism but also in primary hypertension (HT), it can be affected by multiple factors, including age, and the effect of aldosterone on LV function is controversial. This study was to investigate the relationship of aldosterone to changes in LV geometry and function in young adults with never-treated HT. Methods: Seventy-five consecutive patients (age, 29.8 ± 6.3 years) with never-treated HT and 45 normal controls were enrolled. Echocardiographic values and LV global longitudinal strain (LVGLS) were obtained. Serum aldosterone concentration (SAC) and serum procollagen type III amino-terminal peptide (PIIINP) level were obtained in HT patients. Results: HT patients had higher LV mass index, higher relative wall thickness (RWT), and worse LV function than normal controls. LVGLS and e’ velocity were worse in HT patients with normal geometry than in normal controls. SAC was well correlated with LV mass index, RWT, e’ velocity, LVGLS, and PIIINP (all p < 0.05). LV geometry pattern was most related to SAC among clinical parameters (p = 0.019). LVGLS was most related to LV geometry and diastolic blood pressure. In contrast, e’ velocity was most related to PIIINP. Conclusion: Our findings may indicate that in young patients with never-treated HT, aldosterone significantly contributes to changes in LV geometry and functional impairment through its pro-hypertrophic and myocardial fibrosis effects beyond blood pressure.

scholarly journals Cardiac-restricted overexpression or deletion of tissue inhibitor of matrix metalloproteinase-4: differential effects on left ventricular structure and function following pressure overload-induced hypertrophy

2014 ◽  
Vol 307 (5) ◽  
pp. H752-H761 ◽  
Author(s):  
William M. Yarbrough ◽  
Catalin Baicu ◽  
Rupak Mukherjee ◽  
An Van Laer ◽  
William T. Rivers ◽  
...  
Keyword(s):  
Pressure Overload ◽  
Left Ventricular ◽  
Lv Function ◽  
Type I ◽  
Matrix Remodeling ◽  
Protective Effects ◽  
Ecm Remodeling ◽  
Hypertrophic Response ◽  
Lv Mass ◽  
And Function

Historically, the tissue inhibitors of matrix metalloproteinases (TIMPs) were considered monochromatic in function. However, differential TIMP profiles more recently observed with left ventricular (LV) dysfunction and matrix remodeling suggest more diverse biological roles for individual TIMPs. This study tested the hypothesis that cardiac-specific overexpression (TIMP-4OE) or deletion (knockout; TIMP-4KO) would differentially affect LV function and structure following pressure overload (LVPO). LVPO (transverse aortic constriction) was induced in mice (3.5 ± 0.1 mo of age, equal sex distribution) with TIMP-4OE ( n = 38), TIMP-4KO ( n = 24), as well as age/strain-matched wild type (WT, n = 25), whereby indexes of LV remodeling and function such as LV mass and ejection fraction (LVEF) were determined at 28 days following LVPO. Following LVPO, both early (7 days) and late (28 days) survival was ∼25% lower in the TIMP-4KO group ( P < 0.05). While LVPO increased LV mass in all groups, the relative hypertrophic response was attenuated with TIMP-4OE. With LVPO, LVEF was similar between WT and TIMP-4KO (48 ± 2% and 45 ± 3%, respectively) but was higher with TIMP-4OE (57 ± 2%, P < 0.05). With LVPO, LV myocardial collagen expression (type I, III) increased by threefold in all groups ( P < 0.05), but surprisingly this response was most robust in the TIMP-4KO group. These unique findings suggest that increased myocardial TIMP-4 in the context of a LVPO stimulus may actually provide protective effects with respect to survival, LV function, and extracellular matrix (ECM) remodeling. These findings challenge the canonical belief that increased levels of specific myocardial TIMPs, such as TIMP-4 in and of themselves, contribute to adverse ECM accumulation following a pathological stimulus, such as LVPO.

Abstract 14069: Subclinical Impairment of Left Ventricular Function in Stage A Subjects in a Community-based Population

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Takuya Hasegawa ◽  
Masanori Asakura ◽  
Hideaki Kanzaki ◽  
Hiroshi Asanuma ◽  
Seiji Takashio ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Dysfunction ◽  
Left Ventricular ◽  
Community Dwelling ◽  
Lv Function ◽  
Mitral Annular Velocity ◽  
Lv Mass ◽  
Lv Diastolic Dysfunction

Introduction: Stage A heart failure (HF) is defined as an asymptomatic state with HF risk factors of hypertension, diabetes, obesity, metabolic syndrome, and atherosclerotic disease in the absence of obvious left ventricular (LV) structural changes including LV hypertrophy (LVH). ACC/AHA guidelines recommend us to treat these risk factors of Stage A HF patients to prevent the progression of HF, hinting us to investigate the prevalence of subclinical impairment of LV function in Stage A subjects in general populations. Methods: We studied 1162 community-dwelling subjects without obvious heart diseases (mean age, 63±11 years; 448 men, 714 women, 63% with hypertension and 11% with diabetes) in the annual health checkup in a rural community, Arita-cho, Saga, Japan. The population was divided into 3 groups; the subjects without either LVH or the HF risk factors ("Stage 0"), the subjects with the HF risk factors in the absence of LVH (Stage A) , and the subjects in the presence of LVH (Stage B). LV systolic and diastolic function were estimated by mitral annular velocity in systole (s'), and the waves of transmitral flow (E) and mitral annular velocity (e'), respectively. LVH was defined as the top quintile of LV mass index. Results: The subjects in Stage A had the lower and higher values of s' and E/e', respectively, and the higher prevalence of LV diastolic dysfunction than those in Stage 0, while 45% of Stages A subjects showed LV diastolic dysfunction (Table). In multivariate logistic analyses, age, systolic blood pressure and LV mass were independent determinants of s', whereas either overlapped or different risk factors, such as age, sex, systolic blood pressure, and body mass index emerged as the determinants for E/e'. Conclusions: Even without obvious LV remodeling, subclinical LV systolic and diastolic impairment was observed in Stage A subjects. The disparity of the risk factors between LV systolic and diastolic dysfunction may indicate their pathophysiological differences.

Abstract 05: Longer Duration of Obesity Beginning in Young Adulthood is Associated with Greater Left Ventricular Mass and Worse Left Ventricular Function in Middle-Age: The CARDIA Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Jared P Reis ◽  
Norrina B Allen ◽  
Bethany Barone-Gibbs ◽  
Joyce M Lee ◽  
Cora E Lewis ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Young Adulthood ◽  
Middle Age ◽  
Left Ventricular ◽  
Lv Function ◽  
Obesity Epidemic ◽  
Lv Mass ◽  
Table Model ◽  
And Function

Background: As a result of the obesity epidemic, individuals are becoming obese at a younger age than in previous generations. Yet, few studies have determined the consequences of a longer duration of obesity. The present study examined whether the duration of obesity beginning early in adulthood is associated with left ventricular (LV) structure and function in middle-age. Methods: We studied 2,545 white and black adults aged 18-30 years without obesity [body mass index (BMI) <30 kg/m 2 ] at baseline in 1985-86 or clinically apparent heart disease through year 25 (2010-11) in the multicenter, community-based CARDIA study. Duration of obesity (years with BMI ≥30.0 kg/m 2 ) was calculated using repeat measurements of BMI performed 2, 5, 7, 10, 15, 20, and 25 years after baseline. Outcomes included LV mass and ejection fraction from an echocardiogram performed during the 25-year follow-up examination. Results: During follow-up, 994 participants became obese (39.1%); mean duration of obesity was 14.1 years. After adjustment for demographic and behavioral covariates, including year 25 BMI, a longer duration of obesity was associated with a greater LV mass and a lower ejection fraction (Table, model 1). Further adjustment for intermediate clinical covariates, including antihypertensive medication use, systolic blood pressure, heart rate, and diabetes only modestly attenuated these associations (Table, model 2). These associations were similar across white and black men and women (p-interaction>0.10, for all). Conclusions: Longer duration of obesity from young adulthood to middle-age was associated with significantly greater LV mass and marginally lower LV function in midlife, independent of concurrent BMI.

Changes in Left Ventricular Anatomy and Function on CAPD

1983 ◽  
Vol 3 (3_suppl) ◽  
pp. 26-28 ◽  
Author(s):  
Frans H.H. Leenen ◽  
Donna L. Smith ◽  
Ramesh Khanna ◽  
Dimitrios G. Oreopoulos
Keyword(s):  
Volume Overload ◽  
Left Ventricular ◽  
Lv Function ◽  
Lv Mass ◽  
Consistent Manner ◽  
Eccentric Hypertrophy ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
And Function

In 17 patients with end-stage renal disease, we evaluated the effects of treatment with CAPD on L V anatomy and function by M -mode echocardiography. All patients had a history of hypertension and had echocardiographic evidence of increased LV mass related to both concentric and eccentric hypertrophy. On CAPD, blood pressure returned to normal in a consistent manner. L V mass decreased in most (14/17) patients as a result of a decrease in both L V wall thickness and LV dimension. Initially four of the 17 patients had diminished LV function. On CAPD, LV function improved in three of these four and no patient showed deterioration. These results indicate that CAPD improves L V hypertrophy and L V function by normalizing both pressure and volume overload.

Abstract 19900: Impact of Baseline Fitness in Young Adulthood and Age Related Fitness Changes on Cardiac Structure and Function in Middle Age: The CARDIA Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Ambarish Pandey ◽  
Norrina Allen ◽  
Colby Ayers ◽  
Jared Reis ◽  
Henrique Moreira ◽  
...  
Keyword(s):  
Young Adults ◽  
Risk Factor ◽  
Young Adulthood ◽  
Middle Age ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Structure And Function ◽  
Lv Function ◽  
Increased Risk ◽  
And Function

Introduction: Low cardiorespiratory fitness (CRF) in mid-life is a significant risk factor for heart failure (HF) at a later age. However, the contribution of CRF in early adulthood to HF risk is not well understood. Because of the established association of subclinical abnormalities in left ventricular (LV) structure and function with HF risk, we studied the association between early life CRF levels and measures of LV structure and function in middle-age. Methods: We included the Coronary Artery Risk Development in Young Adults (CARDIA) study participants who had a maximal exercise treadmill test (modified Balke protocol) at year 0 and an echocardiogram at year 25. Percent change in CRF [ΔCRF (%)] was calculated in the subgroup of participants who had a repeat CRF test at year 20. Associations of baseline CRF and ΔCRF (%) with measures of LV structure [end-diastolic volume (LVEDV), relative wall thickness (RWT)] and function [global longitudinal strain (GLS), Septal & Lateral E/e`] were assessed using multivariable linear regression. Results: We included 3,433 participants (baseline age: 25 years, 55% women) in the study. After adjustment for baseline characterstics, cumulative cardiovascular risk factor burden, and baseline and follow up body mass index (BMI), lower baseline CRF was associated with higher septal E/e`(β = -0.05, p = 0.01), higher lateral E/e` (β = -0.06, p = 0.008), and lower LVEDV (β = 0.07, p = 0.004). In contrast, CRF was not associated with GLS (p = 0.22) and RWT (p=0.27). Among participants with repeat CRF test (n =2,544), ΔCRF (%) was associated with LVEDV but not with measures of LV function. The association of baseline CRF with E/e` did not attenuate after additional adjustment for ΔCRF (%) (Table). Conclusions: Lower CRF in young adulthood is associated with subclinical abnormalities in diastolic function in middle age. These findings suggest that low CRF may identify young adults at increased risk of HF with preserved ejection fraction in later life.

scholarly journals Blood pressure in athletic preparticipation evaluation and the implication for cardiac remodelling

Heart ◽  
2019 ◽  
Vol 105 (16) ◽  
pp. 1223-1230 ◽  
Author(s):  
Kristofer Hedman ◽  
Kegan J Moneghetti ◽  
Jeffrey W Christle ◽  
Shadi P Bagherzadeh ◽  
Myriam Amsallem ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Volume Ratio ◽  
Left Ventricular ◽  
Lv Function ◽  
Sports Cardiology ◽  
Hypertension Guidelines ◽  
Lv Mass ◽  
Male Sex ◽  
Mass Volume ◽  
The Relationship

ObjectivesTo explore blood pressure (BP) in athletes at preparticipation evaluation (PPE) in the context of recently updated US and European hypertension guidelines, and to determine the relationship between BP and left ventricular (LV) remodelling.MethodsIn this retrospective study, athletes aged 13–35 years who underwent PPE facilitated by the Stanford Sports Cardiology programme were considered. Resting BP was measured in both arms; repeated once if ≥140/90 mm Hg. Athletes with abnormal ECGs or known hypertension were excluded. BP was categorised per US/European hypertension guidelines. In a separate cohort of athletes undergoing routine PPE echocardiography, we explored the relationship between BP and LV remodelling (LV mass, mass/volume ratio, sphericity index) and LV function.ResultsIn cohort 1 (n=2733, 65.5% male), 34.3% of athletes exceeded US hypertension thresholds. Male sex (B=3.17, p<0.001), body mass index (BMI) (B=0.80, p<0.001) and height (B=0.25, p<0.001) were the strongest independent correlates of systolic BP. In the second cohort (n=304, ages 17–26), systolic BP was an independent correlate of LV mass/volume ratio (B=0.002, p=0.001). LV longitudinal strain was similar across BP categories, while higher BP was associated with slower early diastolic relaxation.ConclusionIn a large contemporary cohort of athletes, one-third presented with BP levels above the current US guidelines’ thresholds for hypertension, highlighting that lowering the BP thresholds at PPE warrants careful consideration as well as efforts to standardise measurements. Higher systolic BP was associated with male sex, BMI and height and with LV remodelling and diastolic function, suggesting elevated BP in athletes during PPE may signify a clinically relevant condition.

Abstract 2113: Early End-organ Alterations Due To High Blood Pressure In Children

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Reinhard G Ketelhut ◽  
Ulrich Rode ◽  
Jörg Schröter
Keyword(s):  
Blood Pressure ◽  
Diastolic Function ◽  
High Blood Pressure ◽  
Diastolic Pressure ◽  
Left Ventricular ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Lv Function ◽  
Cardiovascular Morbidity And Mortality ◽  
Lv Mass

Introduction : Increased left ventricular (LV) mass is known to be an important risk for future cardiovascular morbidity and mortality. Since high blood pressure can be observed more often in early childhood a study was designed to evaluate the influence of blood pressure (BP) on LV mass and function in children. Methods: 2-D-guided-echocardiography and Doppler-echocardiography were performed in 103 children (aged 14.1±0.9 years, 58 girls). BP, LV-mass-index (LVMI) and diastolic function (E/A ratio) were measured and calculated by standardized formula and procedure. Results: Systolic BP (SBP) was significantly higher in boys (124.8±10.6 mmHg) when compared with girls (120.5±8.4 mmHg) (p<0.01). There were no significant differences in diastolic pressure. LVMI was significantly lower in girls (57.6±8.9 g/m 2 ) than in boys (68.3±11.2 g/m 2 ) (p<0.01). There was a negative correlation between SBP and E/A ratio as a measure of LV diastolic function (p<0.01). Hypertensives had a 17% higher LVMI (78±11g/m 2 versus 67±11g/m 2 ; p<0.05), and a 20% lower E/A ratio (1.58±0.3 versus 1.97±0.42) than their normotensive counterparts (p<0.01). Conclusion: Despite the young age of participants with higher blood pressure they had prognostically adverse preclinical cardiovascular disease, including LV hypertrophy and evidence of impaired LV function. Therefore children should be encouraged to enter preventive programs as a primary and early strategy against future cardiovascular morbidity and mortality.

Urine Albumin to Creatinine Ratio and Echocardiographic Left Ventricular Structure and Function in Patients with Essential Hypertension

2011 ◽  
Vol 9 (2) ◽  
pp. 90 ◽  
Author(s):  
Rohola Hemmati ◽  
Mojgan Gharipour ◽  
Hasan Shemirani ◽  
Alireza Khosravi ◽  
Elham Khosravi ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Peak Velocity ◽  
Left Ventricular ◽  
Lv Function ◽  
Creatinine Ratio ◽  
Uncomplicated Hypertension ◽  
Urine Albumin ◽  
Lv Dysfunction ◽  
Mitral Annulus Velocity ◽  
Lv Mass

Background:Appearance of microalbuminuria, particularly in patients with hypertension, might be associated with a higher prevalence of left ventricular (LV) dysfunction and geometric abnormalities. This study was undertaken to determine whether high urine albumin to creatinine ratio (UACR) as a sensitive marker for microalbuminuria can be associated with LV hypertrophy (LVH) and systolic and diastolic LV dysfunction.Methods:The study population consisted of 125 consecutive patients with essential uncomplicated hypertension. Urine albumin and creatinine concentration was determined by standard methods. LVH was defined as a LV mass index >100 g/m2 of body surface area in women and >130 g/m2 in men. Echocardiographic LV systolic and diastolic parameters were measured.Results:The prevalence of microalbuminuria in patients with essential hypertension was 5.6 %. UACR was significantly no different in patients with LVH than in patients with normal LV geometry (21.26 ± 31.55 versus 17.80 ± 24.52 mg/mmol). No significant correlation was found between UACR measurement and systolic and diastolic function parameters, including early to late diastolic peak velocity (E/A) ratio (R=-0.192, p=0.038), early diastolic peak velocity to early mitral annulus velocity (E/E') ratio (R=-0.025, p=0.794), LV ejection fraction (R=0.008, p=0.929), and LV mass (R=-0.132, p=0.154). According to the receiver operator characteristic (ROC) curve analysis, UACR measurement was not an acceptable indicator of LVH with areas under the ROC curves 0.514 (95 % confidence interval 0.394–0.634). The optimal cut-off value for UACR for predicting LVH was identified at 9.4, yielding a sensitivity of 51.6 % and a specificity of 48.3 %.Conclusion:In patients with uncomplicated essential hypertension, abnormal systolic and diastolic LV function and geometry cannot be effectively predicted by the appearance of microalbuminuria.

Sign in / Sign up

Export Citation Format

Share Document