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1.
Angiology ; 71(1): 70-76, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31446774

RESUMO

Both elevated resting heart rate (HR) and electrocardiographic left ventricular hypertrophy (ECG-LVH) are signs of a poor prognosis. Although elevated resting HR is a known risk factor for cardiovascular disease and target organ damage, the association between resting HR and the development of ECG-LVH is unclear. In the present study, 6860 subjects (4203 men, 2657 women, 19-89 years of age) without ECG-LVH at baseline were evaluated and followed for a mean duration of 3.7±1.4 years. During the follow-up period, 484 (7.1%) subjects developed ECG-LVH. Cox regression analysis revealed that each 10 beats/min increase in resting HR was associated with a 22% reduction in the development of ECG-LVH (95% confidence interval: 12%-30%, P < .0001) in men. While an increase in HR tended to be associated with the development of ECG-LVH in women, the relationship was not significant. In contrast to the concept that an elevated resting HR is a cardiovascular risk factor, these findings revealed that resting HR was negatively associated with the development of ECG-LVH in men.


Assuntos
Frequência Cardíaca , Hipertrofia Ventricular Esquerda/diagnóstico , Função Ventricular Esquerda , Remodelação Ventricular , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Eletrocardiografia , Feminino , Humanos , Hipertrofia Ventricular Esquerda/etiologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Fatores de Tempo , Adulto Jovem
2.
Vasc Health Risk Manag ; 15: 539-550, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31827327

RESUMO

Background: Left ventricular hypertrophy (LVH), as assessed by measurement of left ventricular mass (LVM), is one of the most important cardiovascular risk factors. It is commonly present in patients with ischemic heart disease (IHD), irrespective of the level of blood pressure; recently, oxidative stress has been shown to be an important factor in its development. The question then arises: can this risk factor be modified by antioxidant treatment (e.g., with allopurinol, a xanthine oxidase inhibitor)? Methods: This is an observational study with a cross-sectional design which explored the association between long-term (>12 months) allopurinol therapy and LV mass index (LVMI) as well as geometry in patients generally receiving standard treatments for IHD. The primary endpoint was LVMI measurement (by 2D-echocardiography) and secondary endpoints included the association of allopurinol use with LV function (ejection fraction), blood pressure, glycemic control, and lipid profile. Results: Ninety-six patients on standard anti-ischemic drug treatment (control group) and 96 patients who were additionally taking allopurinol (minimum dose 100 mg/day) were enrolled. Both groups were matched for age, sex, height, and co-morbidities, but poorer kidney function in the allopurinol group required further sub-group analysis based on renal function. Allopurinol treatment was associated with the lowest LVMI in the patients with normal serum creatinine (median LVMI; 70.5 g/m2): corresponding values were 76.0 and 87.0 in the control group with, respectively, normal and elevated serum creatinine, and 89.5 in the allopurinol group with elevated serum creatinine (P=0.027). In addition, allopurinol was associated with better glycemic control (HbA1c) with a difference of 0.8% (95% CI; 1.3, 0.2) (P=0.004) as compared with control patients. Conclusion: In our population, treatment with allopurinol (presumably because of its anti-oxidant properties) has shown a tendency to be associated with smaller LVM in IHD patients with normal serum creatinine, along with better glycemic control.


Assuntos
Alopurinol/uso terapêutico , Antioxidantes/uso terapêutico , Hipertrofia Ventricular Esquerda/tratamento farmacológico , Isquemia Miocárdica/tratamento farmacológico , Função Ventricular Esquerda/efeitos dos fármacos , Remodelação Ventricular/efeitos dos fármacos , Idoso , Idoso de 80 Anos ou mais , Alopurinol/efeitos adversos , Antioxidantes/efeitos adversos , Biomarcadores/sangue , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Estudos de Casos e Controles , Creatinina/sangue , Estudos Transversais , Feminino , Hemoglobina A Glicada/metabolismo , Humanos , Hipertrofia Ventricular Esquerda/sangue , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/sangue , Isquemia Miocárdica/diagnóstico por imagem , Isquemia Miocárdica/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
3.
Clin Interv Aging ; 14: 1657-1662, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31571845

RESUMO

Purpose: Previous studies have identified that electrocardiographic pattern of left ventricular hypertrophy (ECG LVH) is associated with mortality, but studies of its correlation in the oldest-old hypertensive population is extremely limited. We investigated the correlation between ECG LVH and mortality in a hypertensive Chinese population aged 80 years and older. Patients and methods: In this study, we included 284 Chinese participants older than 80 years. All included participants with hypertension (sitting systolic blood pressure [BP] 160 to 200 mmHg; sitting diastolic BP <110 mmHg) were ascertained at the baseline. ECG LVH was defined as a Sokolow-Lyon voltage calculated as the amplitude of SV1+ (max RV5 or RV6) greater than 3.5 mV. We categorized participants into two groups by the status of baseline ECG LVH. We used Cox regression models to calculate hazard ratio (HRs) for mortality due to ECG LVH, including cardiovascular mortality and all-cause mortality. Results: In this study, with a 28-month median follow-up, a total of 35 (12.3%) patients died; 21 of those died due to cardiovascular causes. Compared with participants without ECG LVH, there was an increased risk of cardiovascular mortality in participants with ECG LVH (adjusted HR 4.25 [95% confidence interval [CI], 1.50-12.06]) but ECG LVH did not predict all-cause mortality (adjusted HR 2.31 [95% CI, 0.93-5.72]). Conclusion: Our study shows that ECG LVH predicts the risk of cardiovascular mortality in an oldest-old hypertensive Chinese population.


Assuntos
Hipertensão/mortalidade , Hipertrofia Ventricular Esquerda/mortalidade , Hipertrofia Ventricular Esquerda/fisiopatologia , Idoso de 80 Anos ou mais , Pressão Sanguínea , China/epidemiologia , Eletrocardiografia , Feminino , Humanos , Hipertensão/fisiopatologia , Masculino , Modelos de Riscos Proporcionais
4.
Hypertension ; 74(4): 843-853, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31476902

RESUMO

Preterm birth is associated with proinflammatory conditions and alterations in adult cardiac shape and function. Neonatal exposure to high oxygen, a rat model of prematurity-related conditions, leads to cardiac remodeling, fibrosis, and dysfunction. TLR (Toll-like receptor) 4 signaling is a critical link between oxidative stress, inflammation, and the pathogenesis of cardiovascular diseases. The current study sought to investigate the role of TLR4 signaling in neonatal oxygen-induced cardiomyopathy. Male Sprague-Dawley pups were kept in 80% oxygen or room air from day 3 to 10 of life and treated with TLR4 antagonist lipopolysaccharide from the photosynthetic bacterium Rhodobacter sphaeroides(LPS-RS) or saline. Echocardiography was performed at 4, 7, and 12 weeks. At 12 weeks, intraarterial blood pressure was measured before euthanization for histological and biochemical analyses. At day 10, cardiac TLR4, Il (interleukin) 18, and Il1ß expression were increased in oxygen-exposed compared with room air controls. At 4 weeks, compared with room air-saline, saline-, but not LPS-RS treated-, oxygen-exposed animals, exhibited increased left ventricle mass index, reduced ejection fraction, and cardiac output index. Findings were similar at 7 and 12 weeks. LPS-RS did not influence echocardiography in 12 weeks room air animals. Systolic blood pressure was higher in saline- but not LPS-RS treated-oxygen-exposed animals compared with room air-saline and -LPS-RS controls. LPS-RS prevented cardiac fibrosis and cardiomyocytes hypertrophy, the increased TLR4, Myd88, and Il18 gene expression, TRIF expression, and CD68+ macrophages infiltration associated with neonatal oxygen exposure, without impact in room air rats. This study indicates that neonatal exposure to high oxygen programs TLR4 activation, which contributes to cardiac remodeling and dysfunction.


Assuntos
Hiperóxia/fisiopatologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Lipopolissacarídeos/uso terapêutico , Receptor 4 Toll-Like/antagonistas & inibidores , Disfunção Ventricular Esquerda/fisiopatologia , Animais , Animais Recém-Nascidos , Citocinas/metabolismo , Modelos Animais de Doenças , Hiperóxia/complicações , Hiperóxia/metabolismo , Hipertrofia Ventricular Esquerda/etiologia , Hipertrofia Ventricular Esquerda/metabolismo , Hipertrofia Ventricular Esquerda/prevenção & controle , Masculino , Ratos , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio/metabolismo , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/metabolismo , Disfunção Ventricular Esquerda/prevenção & controle
5.
Hypertension ; 74(4): 826-832, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31476911

RESUMO

We aimed to estimate the effects of a lifelong exposure to high systolic blood pressure (SBP) on left ventricular (LV) structure and function using Mendelian randomization. A total of 5596 participants of the UK Biobank were included for whom cardiovascular magnetic resonance imaging and genetic data were available. Major exclusion criteria included nonwhite ethnicity, major cardiovascular disease, and body mass index >30 or <18.5 kg/m2. A genetic risk score to estimate genetically predicted SBP (gSBP) was constructed based on 107 previously established genetic variants. Manual cardiovascular magnetic resonance imaging postprocessing analyses were performed in 300 individuals at the extremes of gSBP (150 highest and lowest). Multivariable linear regression analyses of imaging biomarkers were performed using gSBP as continuous independent variable. All analyses except myocardial strain were validated using previously derived imaging parameters in 2530 subjects. The mean (SD) age of the study population was 62 (7) years, and 52% of subjects were female. Corrected for age, sex, and body surface area, each 10 mm Hg increase in gSBP was significantly (P<0.0056) associated with 4.01 g (SE, 1.28; P=0.002) increase in LV mass and with 2.80% (SE, 0.97; P=0.004) increase in LV global radial strain. In the validation cohort, after correction for age, sex, and body surface area, each 10 mm Hg increase in gSBP was associated with 5.27 g (SE, 1.50; P<0.001) increase in LV mass. Our study provides a novel line of evidence for a causal relationship between SBP and increased LV mass and with increased LV global radial strain.


Assuntos
Pressão Sanguínea/fisiologia , Coração/fisiopatologia , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Função Ventricular Esquerda/fisiologia , Idoso , Índice de Massa Corporal , Feminino , Coração/diagnóstico por imagem , Humanos , Hipertensão/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Masculino , Análise da Randomização Mendeliana , Pessoa de Meia-Idade
6.
Heart Fail Clin ; 15(4): 447-453, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31472880

RESUMO

Hypertensive heart disease includes the development of diastolic dysfunction, left ventricular hypertrophy, and heart failure with preserved and reduced ejection fraction. The development of heart failure can occur because of complications of ischemic heart disease or from progression of diastolic dysfunction to heart failure with preserved ejection fraction degenerating to a dilated heart with systolic dysfunction or heart failure with reduced ejection fraction. Hypertension clinical trials have shown that the treatment of hypertension can prevent the development of heart failure. In addition, lifestyle modification with exercise and weight loss can improve diastolic function and reduce the risk for heart failure.


Assuntos
Insuficiência Cardíaca , Hipertensão , Hipertrofia Ventricular Esquerda , Comportamento de Redução do Risco , Progressão da Doença , Feminino , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/prevenção & controle , Insuficiência Cardíaca/psicologia , Humanos , Hipertensão/complicações , Hipertensão/etiologia , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/etiologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Volume Sistólico
7.
Heart Fail Clin ; 15(4): 531-541, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31472888

RESUMO

Hypertensive heart disease represents a spectrum of illnesses from uncontrolled hypertension to heart failure. The authors discuss the natural history and pathogenesis of heart failure owing to hypertensive heart disease, reviewing the important role of left ventricular hypertrophy as the inciting process leading to diastolic dysfunction and heart failure with preserved ejection fraction. They describe the various mechanisms by which a subset of patients ultimately develops systolic heart failure. They discuss management strategies for hypertensive heart disease at all stages of the disease process. Treatment in the initial stages before onset of heart failure may result in regression of disease.


Assuntos
Insuficiência Cardíaca , Hipertensão , Gerenciamento Clínico , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/fisiopatologia , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/etiologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Volume Sistólico
8.
Int J Mol Sci ; 20(16)2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31434333

RESUMO

Left ventricular hypertrophy (LVH) can be adaptive, as arising from exercise, or pathological, most commonly when driven by hypertension. The pathophysiology of LVH is consistently associated with an increase in cytochrome P450 (CYP)1B1 and mitogen-activated protein kinases (MAPKs) and a decrease in sirtuins and mitochondria functioning. Treatment is usually targeted to hypertension management, although it is widely accepted that treatment outcomes could be improved with cardiomyocyte hypertrophy targeted interventions. The current article reviews the wide, but disparate, bodies of data pertaining to LVH pathoetiology and pathophysiology, proposing a significant role for variations in the N-acetylserotonin (NAS)/melatonin ratio within mitochondria in driving the biological underpinnings of LVH. Heightened levels of mitochondria CYP1B1 drive the 'backward' conversion of melatonin to NAS, resulting in a loss of the co-operative interactions of melatonin and sirtuin-3 within mitochondria. NAS activates the brain-derived neurotrophic factor receptor, TrkB, leading to raised trophic signalling via cyclic adenosine 3',5'-monophosphate (cAMP)-response element binding protein (CREB) and the MAPKs, which are significantly increased in LVH. The gut microbiome may be intimately linked to how stress and depression associate with LVH and hypertension, with gut microbiome derived butyrate, and other histone deacetylase inhibitors, significant modulators of the melatonergic pathways and LVH more generally. This provides a model of LVH that has significant treatment and research implications.


Assuntos
Citocromo P-450 CYP1B1/metabolismo , Hipertrofia Ventricular Esquerda/metabolismo , Animais , Citocromo P-450 CYP1B1/genética , Microbioma Gastrointestinal/fisiologia , Humanos , Hipertrofia Ventricular Esquerda/fisiopatologia , Melatonina/metabolismo , Mitocôndrias/metabolismo , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Sirtuínas/metabolismo
9.
Hypertension ; 74(3): 687-696, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31327268

RESUMO

Metabolic syndrome is a cause of coronary artery disease and type 2 diabetes mellitus. Camk2n1 resides in genomic loci for blood pressure, left ventricle mass, and type 2 diabetes mellitus, and in the spontaneously hypertensive rat model of metabolic syndrome, Camk2n1 expression is cis-regulated in left ventricle and fat and positively correlates with adiposity. Therefore, we knocked out Camk2n1 in spontaneously hypertensive rat to investigate its role in metabolic syndrome. Compared with spontaneously hypertensive rat, Camk2n1-/- rats had reduced cardiorenal CaMKII (Ca2+/calmodulin-dependent kinase II) activity, lower blood pressure, enhanced nitric oxide bioavailability, and reduced left ventricle mass associated with altered hypertrophic networks. Camk2n1 deficiency reduced insulin resistance, visceral fat, and adipogenic capacity through the altered cell cycle and complement pathways, independent of CaMKII. In human visceral fat, CAMK2N1 expression correlated with adiposity and genomic variants that increase CAMK2N1 expression associated with increased risk of coronary artery disease and type 2 diabetes mellitus. Camk2n1 regulates multiple networks that control metabolic syndrome traits and merits further investigation as a therapeutic target in humans.


Assuntos
Proteínas de Transporte/genética , Hipertensão/genética , Hipertrofia Ventricular Esquerda/genética , Síndrome Metabólica/fisiopatologia , Adiposidade/genética , Animais , Proteínas de Ligação ao Cálcio , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/fisiopatologia , Modelos Animais de Doenças , Regulação da Expressão Gênica , Humanos , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Síndrome Metabólica/genética , Distribuição Aleatória , Ratos , Ratos Endogâmicos SHR , Medição de Risco , Sensibilidade e Especificidade
11.
Medicine (Baltimore) ; 98(26): e16053, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261512

RESUMO

The present study aimed to investigate the characteristics of the ambulatory central artery stiffness index (AcASI) and its related factors. The association between AcASI and the left ventricular mass index (LVMI), and other factors related to atherosclerosis were explored.Patients with primary hypertension were enrolled into this study. Ambulatory central artery blood pressure (CABP) and ambulatory brachial artery blood pressure (BABP) were assessed using a Mobil-O-Graph NG hemomanometer, whereas AcASI and the ambulatory arterial stiffness index (AASI) were determined. LVMI was assessed by echocardiography.A total of 136 patients with primary hypertension were enrolled from May 2011 to January 2013 in Beijing Hospital. AcASI was significantly associated with AASI (r = 0.879, P < .001). AcASI was significantly lower than AASI (0.422 ±â€Š0.302 vs 0.482 ±â€Š0.270; P < .001). AcASI increased with age, ambulatory brachial mean blood pressure (MBP), and fasting glucose. AcASI was significantly associated with office pulse pressure (PP), ambulatory brachial PP, ambulatory central PP, and pulse wave velocity (PWV). AcASI, but not AASI, was significantly associated with LVMI. Receiver operator characteristic analysis indicated that AcASI and AASI could may be a predictor of left ventricular hypertrophy (LVH). Multiple regression analysis indicated that AcASI, chronic kidney disease, and hypertension course were associated with LVMI, but AASI was not.AcASI, which is obtained from ambulatory CABP monitoring, could be a new marker for the evaluation of atherosclerosis. AcASI may be stronger associated with LVH than AASI.


Assuntos
Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Rigidez Vascular , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea , Monitorização Ambulatorial da Pressão Arterial , Estudos Transversais , Ecocardiografia , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Adulto Jovem
12.
Hum Exp Toxicol ; 38(10): 1183-1194, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31256679

RESUMO

Heart failure (HF) is a leading cause of hospitalization across the world and is known to cause ill-health and heavy economic losses. In the present study, a rat model of isoproterenol (ISO, 85 mg/kg subcutaneously for two subsequent days) induced HF was developed. ISO induces HF by its direct effect, that is, rise in left ventricular end-diastolic pressure (mechanical) and indirectly by altering the baroreflex (neural), electrocardiography (electrical), and development of oxidative stress and hyperlipidemia (chemical). Fenofibrate, a hypolipidemic drug, which ameliorates myocardial energy metabolism was seen to improve the both ISO-induced oxidative stress and lipid profile and consequently improved Baroreflex Sensitivity (BRS), partial ventricular functions, and cardiac hypertrophy. Therefore, our result suggests that fenofibrate treatment protected the heart by alleviating the ISO-induced effects, that is, neural, mechanical, electrical, and chemical alterations.


Assuntos
Barorreflexo/efeitos dos fármacos , Metabolismo Energético/efeitos dos fármacos , Fenofibrato/uso terapêutico , Insuficiência Cardíaca/prevenção & controle , Hipolipemiantes/farmacologia , Função Ventricular Esquerda/efeitos dos fármacos , Animais , Pressão Sanguínea/efeitos dos fármacos , Modelos Animais de Doenças , Eletrocardiografia/efeitos dos fármacos , Insuficiência Cardíaca/metabolismo , Insuficiência Cardíaca/fisiopatologia , Frequência Cardíaca/efeitos dos fármacos , Hipertrofia Ventricular Esquerda/metabolismo , Hipertrofia Ventricular Esquerda/fisiopatologia , Hipertrofia Ventricular Esquerda/prevenção & controle , Peroxidação de Lipídeos/efeitos dos fármacos , NADPH Oxidases/genética , Ratos Wistar
13.
Biomed Res Int ; 2019: 1656123, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31360702

RESUMO

Aims: We performed the current study primarily to characterize the independent association of blood pressure with heart rate-corrected QT (QTc) interval after adjusting for cardiovascular confounding factors and left ventricular mass (LVM) in a large general population in China. Methods: All enrolled 10,553 permanent residents with age ≥ 35 years from Liaoning Province were investigated by a questionnaire and then subjected to physical examinations, laboratory analyses, and electrocardiogram (ECG) as well as echocardiogram at the same visit. Multivariate linear and logistic regression analyses were conducted to assess the independent association of blood pressure with QTc interval. Results: Hypertensive subjects had significantly longer QTc interval and higher prevalence of prolonged QTc interval compared with normotensive ones in all subgroups stratified by gender and left ventricular hypertrophy (LVH) (all Ps ≤ 0.001). Multiple relevant clinical confounding factors and LVM were all adjusted in the multivariate linear and logistic regression analyses. As a result, both systolic blood pressure (SBP) and diastolic blood pressure (DBP) were independently associated with QTc interval (ß = 0.12 and 0.16, respectively; Ps < 0.001). Furthermore, as categorical variables, hypertension was independently associated with prolonged QTc interval (OR = 1.71; P < 0.001). Sex-specific analyses revealed that the independent associations were detected in both males and females (all Ps < 0.001). Conclusions: These key findings of the current study highlighted the fact that hypertension was significantly associated with prolonged QTc interval and the correlations were independent of confounding factors and LVM.


Assuntos
Eletrocardiografia , Frequência Cardíaca , Hipertensão , Hipertrofia Ventricular Esquerda , Adulto , Idoso , Pressão Sanguínea , China/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/epidemiologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais
14.
Nutrients ; 11(8)2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31357464

RESUMO

Olive oil and its derivatives have been described to exert beneficial effects on hypertensive states and cardiovascular disease prevention. We studied the effects of chronic consumption of extra virgin olive oil (EVOO), enriched in bioactive compounds from olive fruit and leaves, on blood pressure, endothelial function, oxidative and inflammatory status, and circulating cholesterol levels, in spontaneously hypertensive rats (SHR). Thirty SHR were randomly assigned to three groups: a control untreated SHR group, an SHR group (1 mL/rat/day) of a control olive oil (17.6 mg/kg of phenolic compounds), and an SHR group (1 mL/rat/day) of the enriched EVOO (750 mg/kg of phenolic compounds) for eight weeks. Ten Wistar Kyoto rats (WKY) were included as healthy controls. Long-term administration of the enriched EVOO decreased systolic blood pressure and cardiac hypertrophy, and improved the ex vivo aortic endothelial dysfunction measured in SHR. Moreover, enriched oil supplementation reduced the plasma levels of Angiotensin II and total cholesterol, and the urinary levels of endothelin-1 and oxidative stress biomarkers, while pro-inflammatory cytokines were unaffected. In conclusion, sustained treatment with EVOO, enriched in bioactive compounds from the olive fruit and leaves, may be an effective tool for reducing blood pressure and cholesterol levels alone or in combination with pharmacological anti-hypertensive treatment.


Assuntos
Suplementos Nutricionais , Alimentos Fortificados , Hipertensão/prevenção & controle , Hipertrofia Ventricular Esquerda/prevenção & controle , Azeite de Oliva/administração & dosagem , Animais , Biomarcadores/sangue , Pressão Sanguínea , Colesterol/sangue , Modelos Animais de Doenças , Hipertensão/sangue , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/sangue , Hipertrofia Ventricular Esquerda/fisiopatologia , Mediadores da Inflamação/sangue , Masculino , Estresse Oxidativo , Ratos Endogâmicos SHR , Ratos Endogâmicos WKY , Vasodilatação , Função Ventricular Esquerda , Remodelação Ventricular
15.
J Hum Genet ; 64(9): 891-898, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31213654

RESUMO

Anderson-Fabry disease (AFD) is an X-linked lysosomal storage disorder caused by abnormalities in the α-galactosidase (Gal) A gene (GLA; MIM:300644). The reduced activity of the lysosomal enzyme, α-galactosidase A (α-Gal A) leads to classic early manifestations and vascular disease of the heart, kidneys, and brain. As a high-risk screening for symptomatic AFD using an enzymatic assay on dried blood spot samples, we enrolled 2325 individuals (803 females and 1522 males; median age: 66 years) with cardiac, renal, or neurological manifestations that met at least one of the following criteria: (a) family history of early-onset cardiovascular diseases; (b) typical classic manifestations, such as acroparesthesias, clustered angiokeratoma, cornea verticillata, and hypo-anhidrosis; (c) proteinuria; (d) receiving dialysis; (e) left ventricular hypertrophy on electrocardiography or echocardiography; or (f) history of stroke. Ninety-two patients displayed low α-Gal A activity. Four males and two females had different pathogenic GLA mutations (0.26%) including a novel mutation c.908-928del21. Four males (0.17%) harbored the GLA c.196G>C (p.E66Q) variant. This simple screening protocol using dried blood spot samples is useful for early diagnosis of AFD in high-risk and underdiagnosed patients suffering from various cardiac, renal, or neurological manifestations.


Assuntos
Ecocardiografia , Eletrocardiografia , Doença de Fabry , Hipertrofia Ventricular Esquerda , Mutação , Acidente Vascular Cerebral , alfa-Galactosidase/genética , Idoso , Doença de Fabry/diagnóstico por imagem , Doença de Fabry/enzimologia , Doença de Fabry/genética , Doença de Fabry/fisiopatologia , Feminino , Testes Genéticos , Humanos , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/enzimologia , Hipertrofia Ventricular Esquerda/genética , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/enzimologia , Acidente Vascular Cerebral/genética , Acidente Vascular Cerebral/fisiopatologia
16.
PLoS One ; 14(5): e0217637, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31141818

RESUMO

BACKGROUND: Left ventricular mass normalization for body size is recommended, but a question remains: what is the best body size variable for this normalization-body surface area, height or lean body mass computed based on a predictive equation? Since body surface area and computed lean body mass are derivatives of body mass, normalizing for them may result in underestimation of left ventricular mass in overweight children. The aim of this study is to indicate which of the body size variables normalize left ventricular mass without underestimating it in overweight children. METHODS: Left ventricular mass assessed by echocardiography, height and body mass were collected for 464 healthy boys, 5-18 years old. Lean body mass and body surface area were calculated. Left ventricular mass z-scores computed based on reference data, developed for height, body surface area and lean body mass, were compared between overweight and non-overweight children. The next step was a comparison of paired samples of expected left ventricular mass, estimated for each normalizing variable based on two allometric equations-the first developed for overweight children, the second for children of normal body mass. RESULTS: The mean of left ventricular mass z-scores is higher in overweight children compared to non-overweight children for normative data based on height (0.36 vs. 0.00) and lower for normative data based on body surface area (-0.64 vs. 0.00). Left ventricular mass estimated normalizing for height, based on the equation for overweight children, is higher in overweight children (128.12 vs. 118.40); however, masses estimated normalizing for body surface area and lean body mass, based on equations for overweight children, are lower in overweight children (109.71 vs. 122.08 and 118.46 vs. 120.56, respectively). CONCLUSION: Normalization for body surface area and for computed lean body mass, but not for height, underestimates left ventricular mass in overweight children.


Assuntos
Coração/fisiopatologia , Hipertrofia Ventricular Esquerda/epidemiologia , Sobrepeso/epidemiologia , Obesidade Pediátrica/epidemiologia , Adolescente , Composição Corporal/fisiologia , Estatura , Índice de Massa Corporal , Tamanho Corporal , Superfície Corporal , Criança , Pré-Escolar , Ecocardiografia , Gorduras/metabolismo , Feminino , Ventrículos do Coração/fisiopatologia , Humanos , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Tamanho do Órgão , Sobrepeso/fisiopatologia , Obesidade Pediátrica/fisiopatologia , Valores de Referência
17.
BMC Cardiovasc Disord ; 19(1): 103, 2019 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-31046690

RESUMO

BACKGROUND: Left ventricle mass (LVM) can be influenced by various conditions including hypertension and/or inherent cardiomyopathies. Dysglycemia is also thought to exert an anabolic effect on heart tissue by hyperinsulinemia and thereby promoting increased LVM. The primary aim of this study was to assess the influence of dysglycemia on LVM evaluated by an oral glucose tolerance test (OGTT) in patients admitted with a first myocardial infarction (MI) without hypertension. The secondary aim was to assess the impact of dysglycemia on major adverse cardiovascular events (MACE) and all-cause mortality during long-term follow-up. METHODS: Patients admitted with a first MI without known history of hypertension were included. All patients without previously known type 2 diabetes mellitus (T2DM) had a standardized 2-hour OGTT performed and were categorized as: normal glucose tolerance (NGT), impaired fasting glucose (IFG)/impaired glucose tolerance (IGT) and newly detected T2DM (new T2DM). LVM was measured by echocardiography using Devereaux formula and indexed by body surface area. Multivariate linear regression analysis was used to assess the impact of confounders (dysglycemia by OGTT, known T2DM, age, sex and type of MI) on LVM. Cox proportional hazard model was used to assess the impact of dysglycemia on all-cause mortality and a composite endpoint of MACE (all-cause mortality, MI, revascularisation due to stable angina, coronary artery bypass graft, ischemic stroke or hemorrhagic stroke). RESULTS: Two-hundred-and-five patients were included and followed up to 14 years. In multivariate regression analysis, LVM was only significantly increased in patients categorized as new T2DM (ß = 25.3; 95% CI [7.5-43.0]) and known T2DM (ß = 37.3; 95% CI [10.0-64.5]) compared to patients with NGT. Patients with new T2DM showed higher rates of MACE and all-cause mortality compared to patients with IFG/IGT and NGT; however no significantly increased hazard ratio was detected. CONCLUSIONS: Dysglycemia is associated with increasing LVM in normotensive patients with a first acute myocardial infarction and the strongest association was observed in patients with new T2DM and patients with known T2DM. Dysglycemia in normotensive patients with a first MI is not an independent predictor of neither MACE nor all-cause mortality during long-term follow-up compared to normotensive patients without dysglycemia.


Assuntos
Glicemia/metabolismo , Transtornos do Metabolismo de Glucose/sangue , Hipertrofia Ventricular Esquerda/fisiopatologia , Infarto do Miocárdio/epidemiologia , Função Ventricular Esquerda , Remodelação Ventricular , Idoso , Biomarcadores/sangue , Dinamarca , Ecocardiografia , Feminino , Seguimentos , Transtornos do Metabolismo de Glucose/diagnóstico , Transtornos do Metabolismo de Glucose/mortalidade , Teste de Tolerância a Glucose , Humanos , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/mortalidade , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/mortalidade , Admissão do Paciente , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo
18.
Med Sci Monit ; 25: 3390-3396, 2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-31064975

RESUMO

BACKGROUND This study aimed to explore the association of angiotensin converting enzyme (ACE) gene insertion/deletion polymorphisms with left ventricular hypertrophy (LVH) in Han and Uighur hypertension-OSAHS (obstructive sleep apnea hypopnea syndrome) patients in China. MATERIAL AND METHODS A total of 162 Han and 72 Uygur patients with hypertension-OSAHS were independently subdivided into an LVH group and a non-LVH (NLVH) group based on the left ventricular mass index. The insertion/deletion polymorphisms of ACE gene were determined by polymerase chain reaction. The association of ACE gene insertion/deletion polymorphisms with LVH was assessed by chi-squared test. Logistic regression analysis was performed to obtain the odds ratios and 95% confidence intervals for the risk of LVH after adjusting for confounding factors. RESULTS In Uighur patients, the distributions of D allele and DD genotype showed significant differences between the LVH group and the NLVH group. The difference of DD genotype remained significant after multivariate adjustment. In contrast, no significant differences were observed in the distributions of D allele and DD genotype between the LVH group and the NLVH group in Han patients. Moreover, moderate-severe OSAHS was an independent risk factor for LVH. CONCLUSIONS D allele and DD genotype of ACE gene are possible genetic markers for the risk of LVH in Uighur but not Han hypertension-OSAHS patients.


Assuntos
Hipertrofia Ventricular Esquerda/genética , Peptidil Dipeptidase A/genética , Apneia Obstrutiva do Sono/genética , Adulto , Alelos , Grupo com Ancestrais do Continente Asiático/genética , China , Grupos Étnicos/genética , Feminino , Frequência do Gene/genética , Genótipo , Humanos , Hipertensão/complicações , Hipertensão/genética , Hipertrofia Ventricular Esquerda/fisiopatologia , Mutação INDEL/genética , Masculino , Pessoa de Meia-Idade , Peptidil Dipeptidase A/fisiologia , Reação em Cadeia da Polimerase , Polimorfismo Genético/genética , Fatores de Risco , Apneia Obstrutiva do Sono/complicações
19.
Diab Vasc Dis Res ; 16(5): 450-457, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31081361

RESUMO

OBJECTIVE: Although reported to be independent of obesity, the longitudinal changes of left ventricular structure and function have not been well characterized in normal-weight individuals with type 2 diabetes compared with overweight/obese individuals with type 2 diabetes. METHODS: A total of 558 participants in the Korean Genome and Epidemiology Study who underwent tissue Doppler echocardiography at baseline (cycle 4) and after 8 years (cycle 8) were classified into three groups based on body mass index and diabetes status: (1) normal-weight individuals without type 2 diabetes, (2) normal-weight individuals with type 2 diabetes and (3) overweight/obese individuals with type 2 diabetes. RESULTS: Only overweight/obese individuals with type 2 diabetes group had higher adjusted left ventricular mass index and lower tissue Doppler imaging early diastolic velocity and E/Em ratio compared with the normal-weight individuals without type 2 diabetes group at baseline and after 8 years. Participants in overweight/obese individuals with type 2 diabetes group also showed the higher prevalence and odds of left ventricular hypertrophy (16.0%; adjusted odds ratio: 2.24; 95% confidence interval: 1.22-5.06) and left ventricular diastolic dysfunction (49.1%; 3.45; 1.01-4.32). Among participants with normal left ventricular structure and function at baseline, only overweight/obese individuals with type 2 diabetes group was associated with greater incidence of left ventricular hypertrophy (relative risk: 2.28; 1.04-4.98) over 8 years but not diastolic dysfunction. CONCLUSION: Cross-sectional and longitudinal observations suggest that increasing body mass index category and its associated metabolic abnormalities at baseline are associated with an increased risk for left ventricular hypertrophy and greater impairment in left ventricular diastolic parameters.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Cardiomiopatias Diabéticas/epidemiologia , Hipertrofia Ventricular Esquerda/epidemiologia , Obesidade/epidemiologia , Disfunção Ventricular Esquerda/epidemiologia , Função Ventricular Esquerda , Remodelação Ventricular , Adulto , Idoso , Índice de Massa Corporal , Estudos Transversais , Diabetes Mellitus Tipo 2/diagnóstico , Cardiomiopatias Diabéticas/diagnóstico por imagem , Cardiomiopatias Diabéticas/fisiopatologia , Ecocardiografia Doppler , Feminino , Humanos , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/fisiopatologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/fisiopatologia , Prevalência , Prognóstico , Estudos Prospectivos , República da Coreia/epidemiologia , Medição de Risco , Fatores de Risco , Fatores de Tempo , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/fisiopatologia
20.
Int J Cardiovasc Imaging ; 35(9): 1673-1681, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31093896

RESUMO

The aim of this study was to investigate the grading of diastolic dysfunction (DD) in relation to hemodialysis in patients with end stage renal disease (ESRD) on hemodialysis (HD) Cardiovascular disease is prevalent in patients with ESRD and accounts for significant morbidity and mortality. Left ventricular hypertrophy (LVH) is common in ESRD but little is known about the impact of HD on currently recommended grading schemes for DD. Comprehensive echocardiographic data was obtained in consecutive patients with ESRD before (n = 247) and immediately after (n = 239) standard HD regimen. Grading of DD was performed according to current recommendations both pre- and post HD. Prior to HD, DD was classified as present in 83 patients (34%), indeterminate in 51 patients (21%) and absent in 113 patients (45%). Patients with DD at baseline compared to those without were older [67.3 years (13.1) vs. 63.2 (14.3), p = 0.037], were more likely to have diabetic- or hypertensive ESRD (43.4% vs. 35.4%, p = ns) and LVMi was significantly higher [119 g/cm2 (27.5) vs. 103 g/cm2 (24.3), p < 0.001]. After HD [mean HD time = 221 min (27.6), mean ultrafiltration volume = 2 L (1.1)], 39 patients (16%) exhibited sustained DD. These patients were older [69.4 years (14.5) vs. 65.0 years (13.9), p = 0.071], were more likely to have diabetic- or hypertensive ESRD (59% vs. 36%, p = 0.010). Myocardial adverse remodeling was more advanced with higher LVMi [127.4 g/m2 (27.5) vs. 106.5 g/m2 (25.3), p < 0.001], lower LVEF [44.7% (11.0) vs. 54.5% (8.7), p < 0.001] and more impaired GLS [- 13.4% (4.3) vs. - 15.8% (4.0), p = 0.006]. Echocardiographic evaluation of diastolic function in patients with ESRD on HD is critically dependent on timing relative to dialysis. The presence of sustained DD after volume unloading by HD identifies a population of patients with an adverse phenotype of blunted vascular response and severe cardiac remodeling.


Assuntos
Hipertrofia Ventricular Esquerda/fisiopatologia , Falência Renal Crônica/terapia , Rim/fisiopatologia , Diálise Renal , Volume Sistólico , Disfunção Ventricular Esquerda/fisiopatologia , Função Ventricular Esquerda , Idoso , Diástole , Ecocardiografia Doppler em Cores , Ecocardiografia Doppler de Pulso , Feminino , Humanos , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Disfunção Ventricular Esquerda/diagnóstico por imagem , Remodelação Ventricular
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