Cross-sectional associations between questionnaire-measured physical activity and tissue doppler indices of left ventricular diastolic function.

BACKGROUND: The prevalence of left ventricular (LV) diastolic dysfunction has been increasing over the past decade, and to date, effective pharmacotherapies that enhance LV diastolic function have not yet been identified. Though some data has demonstrated the beneficial effects of exercise training on LV diastolic function, little is known about the adaptations of diastolic function to daily physical activity (PA). Accordingly, our study aimed to investigate the impact of daily PA on tissue Doppler indices of LV diastolic function. METHODS: A total of 432 participants were enrolled for clinically indicated echocardiography from July 2019 to July 2020 at Peking University People's Hospital. Participants aged ≥ 18 years were included if they had stable PA in the past six months and normal LV systolic function. A questionnaire was used to collect demographic characteristics, medical history, and daily PA. According to PA Guidelines for Americans, we identified these participants into low-intensity PA (LPA) group and moderate-high-intensity PA (MHPA) group. Propensity score matching (PSM) was performed to match potential confounding factors between the two groups. The clinical characteristics and echocardiographic parameters between LPA group and MHPA group were compared using student's t-test, Mann-Whitney U test, and chi-square test as appropriate. RESULTS: After matching potential confounding factors using PSM with a 1:3 matching ratio, our final analysis included 86 cases in the MHPA group and 214 cases in the LPA group. All demographic characteristics and comorbidities were statistically similar between the two groups. Compared to the LPA group, the MHPA group showed higher septal e' (7.9 ± 2.9 cm/s versus 7.2 ± 2.6 cm/s, P = 0.047). Other echocardiographic parameters associated with LV diastolic function concerning lateral e' and average E/e', also trended towards improved LV diastolic function in the MHPA group, but failed to reach statistical significance. CONCLUSIONS: Our study demonstrated that moderate-high-intensity daily PA was associated with improved septal e', suggesting that moderate-high-intensity PA could potentially ameliorate LV diastolic dysfunction.

Catestatin could ameliorate proliferating changes of target organs in spontaneously hypertensive rats.

BACKGROUND: Catestatin, a chromogranin A-derived peptide, is a potent antagonist of nicotine-evoked catecholamine release. We know that catecholamine plays an important role in cardiovascular remodeling induced by hypertension, therefore we hypothesized that catestatin would affect target-organ structure during hypertension. METHODS: Twelve spontaneously hypertensive rats (SHRs) were randomized to SHR control group and catestatin group, the normal control group was comprised of six healthy Wistar-Kyoto rats of the same age. Tail-cuff blood pressure and pulse rate were obtained at weeks 1, 4 and 8. At the end of the eight-week period, the heart, abdominal aorta and left kidney were excised and weighed, VG staining was done and the intima-media thickness of vessels and the collagen volume fraction were assessed by an image acquisition and analysis system. The proliferating cell nuclear antigen (PCNA) was observed by immunohistochemistry, and real time reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the mRNA levels of proliferative genes including cyclin A, ki67 and PCNA in the abdominal aorta. RESULTS: All the parameters in SHR observed in the present study increased significantly compared to Wistar Kyoto rats (P < 0.01). With intervention with catestatin, the systolic blood pressure decreased slightly but it was not significantly different from the SHR control, the cardiac mass index and left ventricular mass index both decreased significant ly, the collagen volume fraction decreased by nearly 30% in the heart, by 25% in vessels and by 10% in the kidney, and the intima-media thickness and expression of proliferative genes, including cyclin A, ki67 and PCNA, in the abdominal aorta also decreased significant ly. CONCLUSIONS: The present study indicated that catestatin could ameliorate proliferating changes of heart, kidney and vessels during hypertension, especially to the deposition of interstitial collagen. Blood pressure was not the main factor to mediate this effect, which suggested that catestatin could become a novel protective factor for hypertensive target organs.

[Novel mutations of cardiac troponin T in Chinese patients with hypertrophic cardiomyopathy].

OBJECTIVE: To screen the cardiac troponin T (TNNT2) mutations in Chinese patients with hypertrophic cardiomyopathy (HCM) and to analyze the potential link between the genotype and the phenotype. METHODS: Clinical features of 100 probands with HCM and some family members were evaluated, 200 unrelated normal subjects served as control. The exons and flanking introns of TNNT2 were amplified with PCR and direct sequencing was used to screen TNNT2 mutations/polymorphisms. RESULTS: Two novel missense mutations were detected in 2 HCM patients: R92W and R286H. These 2 mutations were not found in 200 non-HCM controls. A five-basepair insertion/deletion polymorphism in intron 3 of TNNT2 was identified in this HCM cohort but was not related to the phenotype. CONCLUSIONS: Two missense mutations, R92W and R286H, were found in 2/100 patients with HCM, TNNT 2 mutation is relatively low in Chinese patients with HCM.

Effect of orlistat-assisted weight loss on endothelium-dependent vasodilation in obese Chinese subjects with hypertension.

The present study aims to evaluate the effects of orlistat-assisted weight loss on endothelium-dependent vasodilation by ultrasonography in obese Chinese subjects with hypertension. Thirty obese hypertensive patients (mean age: 46.6 +/- 10.3 yr, male:12) were given 120 mg of orlistat 120 mg three times daily for 12 weeks, without a concomitant hypocaloric diet or anti-hypertensive drugs. Fifteen concurrent blood pressure, age, and gender-matched, nonobese hypertensive patients (mean age: 46.6 +/- 11.3 yr, male:6) served as the control. The height, body weight, waist circumference (WC), and blood pressure were measured and flow-mediated dilation (FMD) and the nitroglycerin-mediated dilation (NMD) of brachial artery was determined by high-resolution ultrasound before and after 12 weeks treatment with orlistat. The baseline parameters were comparable between the two groups, while body mass index (BMI) and WC were greater in the obese group (p < 0.01). Before treatment, the brachial artery diameter was increased by 9.6% following reactive hyperemia in the obese group, significantly lower than that in the control group (13.3%, P < 0.01). Nitroglycerin-mediated dilation was not difference between the two groups. After 12 weeks of orlistat treatment, the brachial artery diameter was increased by 14.2%, and the FMD was significantly improved (P < 0.01), associated with a significant reduction in weight, BMI, WC, and blood pressures. Nitroglycerin-mediated dilation was not significantly affected. On multiple regression analysis, improvement in FMD was determined by change of body weight (Beta = -0.555, P = 0.001), after adjustments for height, heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), and WC. Orlistat can effectively reduce body weight and blood pressure and improve endothelium-dependent FMD in obese Chinese hypertensives.

[Novel MYBPC3 mutations in Chinese patients with hypertrophic cardiomyopathy].

OBJECTIVE: To screen the MYBPC3 gene mutations in Han Chinese patients with hypertrophic cardiomyopathy (HCM). METHODS: Sixty-six patients with HCM were enrolled for the study. The exons in the functional regions of MYBPC3 were amplified with PCR and the products were sequenced. RESULTS: Four novel mutations and four common polymorphisms were identified in this patient cohort. A Lys301fs mutation in exon10 was evidenced in a H30, and when he was 47 years old, he had the chest tightness, shortness of breath with septal hypertrophy of 18.7mm; a Asp463stop mutation in exon17 was detected in a H48, he was 24 years old 24-year-old when a medical examination showed ventricular septal hypertrophy of 15.4 mm; both Gly523Arg mutation in exon18 and Tyr847His mutation in exon26 were found in a H53 with onset age 36 years old, feeling chest tightness after excise and his ventricular septal hypertrophy was 27 mm that time. MYBPC3 mutations occurred in 4.5% patients in this cohort. These mutations were not found in 100 non-HCM control patients. CONCLUSION: MYBPC3 mutation is presented in a small portion of Han Chinese patients with HCM.

[Plasma hydrogen sulfide and homocysteine levels in hypertensive patients with different blood pressure levels and complications].

OBJECTIVE: The present study was designed to observe the plasma concentrations of hydrogen sulfide (H(2)S) and homocysteine (HCY) in hypertensive patients with different blood pressure levels and complications. METHODS: A total of 165 outpatients with essential hypertension were involved in this study (84 males, 81 females, mean age 59.81 +/- 10.60 years old). There were 28 new-onset untreated, 137 ever-treated patients. Among ever-treated patients, blood pressure was normal in 38, grade 1 hypertension in 43, grade 2 and 3 hypertension in 56 patients. Thirty-two patients were accompanied with coronary heart disease (CAD), and 42 patients were accompanied with stroke. A total of 32 age- and sex-matched healthy controls (18 males) were also recruited. Plasma H(2)S and HCY concentrations were determined in all patients and controls. RESULTS: (1) Plasma H(2)S levels were significantly lower (P < 0.05) and HCY levels were significantly higher (P < 0.01) in ever-treated hypertensive patients compared with controls. (2) Plasma HCY levels were significantly higher in patients with hypertension history > 6 months and complicated with CAD compared to patients without CAD. (3) Plasma H(2)S concentrations in patients with stroke history > 5 years were significantly lower than that in patients without stroke (P < 0.01). Plasma HCY concentrations were increased in proportion to stroke history. (4) In ever-treated hypertensive patients, plasma H(2)S concentrations in patients with grade 2 and 3 hypertension were significantly lower (P < 0.05) and HCY levels significantly higher (P < 0.01) than that in patients with well-controlled blood pressure. CONCLUSION: Hyperhomocysteinemia and the novel signaling gasotransmitter H(2)S might play important roles in the pathogenesis and development of hypertension.

[Effects of intracoronary autologous bone marrow mononuclear cells transplantation in patients with anterior myocardial infarction].

OBJECTIVES: To investigate the efficacy of intracoronary transfer of autologous bone marrow mononuclear cells (ABMMNCs) to patients with myocardial infarction (MI) on left ventricular function and myocardial perfusion. METHODS: Thirty-five patients with MI (> 4 weeks) were enrolled in this prospective, open-labeled study (20 patients in cell transplantation group; 15 patients in control group). All patients were treated by standard drug therapy and percutaneous coronary intervention (PCI). Baseline and 3 months follow-up evaluations included complete clinical and laboratory examinations, six minutes walk test, echocardiography, Dual-isotope simultaneous acquisition single photon emission computed tomography (DISA-SPECT) and cardiac magnetic resonance imaging (MRI). RESULTS: Baseline parameters were similar between the two groups. NYHA classification and six minutes walk test at 3 months follow-up were also similar between the two groups. However, left ventricular ejection fraction (LVEF) determined by echocardiography and DISA-SPECT was significantly higher; regional wall motion measured by echocardiography and cardiac MRI, myocardial viability and myocardial perfusion in the infarct zone assessed by DISA-SPECT were all significantly improved than before transplantation and than that in control group at 3 months follow-up. CONCLUSIONS: Our results indicate that intracoronary transplantation of ABMMNCs could improve the left ventricular systolic function and beneficially affect myocardial perfusion up to 3 months post transplantation in patients with myocardial infarction.

[Analysis of MYH7, MYBPC3 and TNNT2 gene mutations in 10 Chinese pedigrees with familial hypertrophic cardiomyopathy and the correlation between genotype and phenotype].

OBJECTIVE: The aim of this study was to screen the disease-causing gene mutations and investigate the genotype-phenotype correlation in 10 Chinese pedigrees with familial hypertrophic cardiomyopathy (HCM). METHODS: There are 91 family members from these 10 pedigrees and 5 members were normal mutated carriers, 23 members were HCM patients (14 male) aged from 1.5 to 73 years old. The functional regions of myosin heavy chain gene (MYH7), cardiac myosin-binding protein C (MYBPC3) and cardiac troponin T gene (TNNT2) were screened with PCR and direct sequencing technique. Clinical information from all patients was also evaluated in regard to the genotype. RESULTS: Mutations were found in 5 out of 10 pedigrees. Mutations in MYH7 (Arg663His, Glu924Lys and Ile736Thr) were found in 3 pedigrees and 3 patients from these pedigrees suffered sudden death at age 20-48 years old during sport. Mutations in MYBPC3 were found in 2 pedigrees, 1 with complex mutation (Arg502Trp and splicing mutation IVS27 + 12C > T) and 1 with novel frame shift mutation (Gly347fs) and the latter pedigree has sudden death history. No mutation was identified in TNNT2. CONCLUSIONS: Although the Han Chinese is a relatively homogeneous ethnic group, different HCM gene mutations were responsible for familiar HCM suggesting the heterogeneity nature of the disease-causing genes and HCM MYH7 mutations are associated with a higher risk of sudden death in this cohort. Furthermore, identical mutation might result in different phenotypes suggesting that multiple factors might be involved in the pathogenesis of familiar HCM.