Cyclophilin A is associated with peripheral artery disease and chronic kidney disease in geriatrics: The Tianliao Old People (TOP) study.

Cyclophilin A (CyPA), secreted by vascular smooth muscle cells in response to oxidative stress, is important in the pathogenesis of progressive peripheral arterial occlusion disease (PAOD), which is common among chronic kidney disease. We explored the prevalence of PAOD in Taiwan's elderly (≥ 65 years old) population and its association with CyPA and renal function. Residents of Tianliao District, a rural community in southern Taiwan, were surveyed. An ankle-brachial index (ABI) < 0.91 was defined as PAOD. Chronic kidney disease (CKD) was defined based on eGFR levels < 60 mL/min/1.73 m(2). Serum CyPA was measured. Of the 473 participants, 68 (14.4%) had PAOD. Multiple logistic regression analysis showed PAOD was significantly associated with lower eGFR, lower BMI, higher glycated hemoglobin and higher pulse pressure. Serum CyPA levels in participants with PAOD were significantly higher than those with normal ABI values (47.3 ± 0.4 vs. 25.5 ± 0.2 ng/mL, p < 0.001). Moreover, eGFR inversely correlated with serum CyPA level (p < 0.05) in participants with CKD, but not in participants with normal renal function. In conclusion, with a prevalence of PAOD as high as 14.4% in an elderly community, CyPA might be the link between PAOD and advanced impaired renal function.

Evaluation of left atrial function in physiological and pathological left ventricular myocardial hypertrophy by real-time tri-plane strain rate imaging.

BACKGROUND: We investigated the difference between left ventricular (LV) hypertrophy caused by primary hypertension and physiological LV hypertrophy in athletes as seen in left atrial (LA) function by real-time tri-plane strain rate imaging. HYPOTHESIS: A real-time tri-plane imaging technique using the same phase of the same cardiac circle was used to synchronously demonstrate the section of apical 4-chamber, 2-chamber, and apical left ventricle long axis. METHODS: We measured standard Doppler echocardiographic quantitative analysis and the strain rate peak values of each LA wall in the systolic phase, in the early stage of diastole, and in the advanced stage of diastole and made a comparison of these values. RESULTS: The alteration of configuration and function of the left atrium in hypertensive patients is an early sign of the myocardial damage caused by hypertension. Strain rate imaging could sensitively reflect LA function changes in the early stages of hypertension. While physiological, myocardial hypertrophy is a benign reaction, LA function is significantly different from that of hypertension. CONCLUSIONS: Real-time tri-plane strain rate imaging techniques could simultaneously analyze 3 sections, which shortens scanning time and depletes the influence of variations of different cardiac cycles on quantitative analysis of local myocardial segments of the left atrium. This would improve the comparability of myocardial movement of different segments so that we could more comprehensively and accurately evaluate the systolic and diastolic function of the left atrium in primary hypertension and physiological LV hypertrophy in athletes.