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Gorący I, Łoniewska B, Lewandowska K, Boroń A, Grzegorczyk M, Nowak R, Clark JSC, Ciechanowicz A. Association of the rs3039851 Insertion/Deletion in the Gene PPP3R1, Which Encodes the Regulatory Calcineurin Subunit B Type 1, with Left Ventricular Mass in Polish Full-Term Newborns. Biomedicines 2023; 11:biomedicines11051415. [PMID: 37239086 DOI: 10.3390/biomedicines11051415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/02/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The five base-pair (bp) insertion/deletion (rs3039851) polymorphism in the PPP3R1 gene, which encodes calcineurin subunit B type 1, has been found to be associated with left ventricular hypertrophy (LVH) in hypertensive patients and in athletes. The aim of this study is to analyze the possible association between PPP3R1:rs3039851 polymorphism and left ventricular mass (LVM) in full-term healthy newborns. METHODS The study group consisted of 162 consecutive, full-term, healthy newborns. Two-dimensional M-mode echocardiography was used to assess LVM. The PPP3R1:rs3039851 polymorphism was identified by PCR-RFLP in genomic DNA extracted from cord blood leukocytes. RESULTS No significant differences were found between newborns homozygous for the reference allele (5I/5I, n = 135) and newborns carrying at least one 5D allele (n = 27) for LVM standardized for body mass, body length or body surface area (LVM/BM, LVM/BL or LVM/BSA, respectively). However, the frequency of PPP3R1:rs3039851 genotypes with a 5D allele (5I/5D + 5D/5D) among newborns with the largest LVM/BM or LVM/BSA (upper tertile) was statistically significantly higher compared with the prevalence in individuals with the lowest values of both indices (lower tertile). CONCLUSIONS Our results suggest that the PPP3R1:rs3039851 polymorphism may contribute to subtle variation in left ventricular mass at birth.
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Affiliation(s)
- Iwona Gorący
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Beata Łoniewska
- Department of Neonatal Diseases, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Klaudyna Lewandowska
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Agnieszka Boroń
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Małgorzata Grzegorczyk
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Robert Nowak
- Institute of Physical Culture Sciences, University of Szczecin, 71-650 Szczecin, Poland
- Department of Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Jeremy Simon C Clark
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Andrzej Ciechanowicz
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111 Szczecin, Poland
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Marciniak M, van Deutekom AW, Toemen L, Lewandowski AJ, Gaillard R, Young AA, Jaddoe VWV, Lamata P. A three-dimensional atlas of child's cardiac anatomy and the unique morphological alterations associated with obesity. Eur Heart J Cardiovasc Imaging 2022; 23:1645-1653. [PMID: 34931224 PMCID: PMC9671403 DOI: 10.1093/ehjci/jeab271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
AIMS Statistical shape models (SSMs) of cardiac anatomy provide a new approach for analysis of cardiac anatomy. In adults, specific cardiac morphologies associate with cardiovascular risk factors and early disease stages. However, the relationships between morphology and risk factors in children remain unknown. We propose an SSM of the paediatric left ventricle to describe its morphological variability, examine its relationship with biometric parameters and identify adverse anatomical remodelling associated with obesity. METHODS AND RESULTS This cohort includes 2631 children (age 10.2 ± 0.6 years), mostly Western European (68.3%) with a balanced sex distribution (51.3% girls) from Generation R study. Cardiac magnetic resonance short-axis cine scans were segmented. Three-dimensional left ventricular (LV) meshes are automatically fitted to the segmentations to reconstruct the anatomies. We analyse the relationships between the LV anatomical features and participants' body surface area (BSA), age, and sex, and search for features uniquely related to obesity based on body mass index (BMI). In the SSM, 19 modes described over 90% of the population's LV shape variability. Main modes of variation were related to cardiac size, sphericity, and apical tilting. BSA, age, and sex were mostly correlated with modes describing LV size and sphericity. The modes correlated uniquely with BMI suggested that obese children present with septo-lateral tilting (R2 = 4.0%), compression in the antero-posterior direction (R2 = 3.3%), and decreased eccentricity (R2 = 2.0%). CONCLUSIONS We describe the variability of the paediatric heart morphology and identify anatomical features related to childhood obesity that could aid in risk stratification. Web service is released to provide access to the new shape parameters.
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Affiliation(s)
- Maciej Marciniak
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, Kings’ College London, 5th Floor Becket House, Lambeth Palace Road, London SE1 7EU, UK
| | - Arend W van Deutekom
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Paediatrics, Generation R Study Group, Erasmus MC, University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Cardiovascular Clinical Research Facility, University of Oxford, Level 1 Oxford Heart Centre, John Radliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK
| | - Liza Toemen
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Paediatrics, Generation R Study Group, Erasmus MC, University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Adam J Lewandowski
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Cardiovascular Clinical Research Facility, University of Oxford, Level 1 Oxford Heart Centre, John Radliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK
| | - Romy Gaillard
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Paediatrics, Generation R Study Group, Erasmus MC, University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
| | - Alistair A Young
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, Kings’ College London, 5th Floor Becket House, Lambeth Palace Road, London SE1 7EU, UK
| | - Vincent W V Jaddoe
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Paediatrics, Generation R Study Group, Erasmus MC, University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Pablo Lamata
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, Kings’ College London, 5th Floor Becket House, Lambeth Palace Road, London SE1 7EU, UK
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3
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Marsh CE, Thomas HJ, Naylor LH, Dembo LG, Scurrah KJ, Green DJ. Left Ventricular Adaptation to Exercise Training via Magnetic Resonance Imaging: Studies of Twin Responses to Understand Exercise THerapy. Med Sci Sports Exerc 2022; 54:1095-1104. [PMID: 35220371 DOI: 10.1249/mss.0000000000002899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Changes in left ventricular mass (LVM) and end-diastolic volume (EDV) in response to exercise training are important determinants of functional capacity in health and disease, but the impact of different exercise modalities remains unclear. METHODS Using a randomized crossover design we studied the impact of resistance (RES) and endurance (END) training using cardiac magnetic resonance imaging in previously untrained monozygotic (MZ) and dizygotic (DZ) twin pairs (n = 72; 22 MZ pairs, 14 DZ same-sex pairs; 26.1 ± 5.4 yr). Twins, as pairs, undertook 3 months of RES and 3 months of END training (order randomized), separated by a 3-month washout. RESULTS Group results revealed that END increased LVM (P < 0.001) and EDV (P = 0.007), whereas RES did not (P > 0.05). A higher proportion of individuals responded to END than RES for LVM (72% vs 38%, P < 0.001) and EDV (67% vs 40%, P = 0.003). Baseline cross-sectional intraclass correlations were higher for MZ than DZ twin pairs for all variables (e.g., LVM heritability = 0.42), but no significant correlations were apparent between pairs for change in any variable in response to either RES or END (P > 0.05). CONCLUSIONS Our findings indicate that cardiac adaptation in response to exercise is modality-specific and that low responders to one mode of exercise can be high responders to an alternative. Heritability estimates based on cross-sectional data, which suggested a genetic contribution to LVM, do not accord with estimates based on training effects, which indicated limited genetic impact on adaptation in this 3-month study of exercise training. This study has implications for understanding the physiological and health impacts of typically used exercise modalities on cardiac adaptation in previously untrained individuals.
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Affiliation(s)
- Channa E Marsh
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, AUSTRALIA
| | - Hannah J Thomas
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, AUSTRALIA
| | - Louise H Naylor
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, AUSTRALIA
| | | | - Katrina J Scurrah
- Twins Research Australia, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, AUSTRALIA
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, AUSTRALIA
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de la Rosa A, Shah M, Shiota T, Siegel R, Rader F. Comparing echocardiographic characteristics in genotype positive-phenotype positive hypertrophic cardiomyopathy and hypertensive left ventricular hypertrophy. Eur Heart J Cardiovasc Imaging 2022; 23:340-348. [PMID: 34694376 DOI: 10.1093/ehjci/jeab217] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/05/2021] [Indexed: 12/22/2022] Open
Abstract
AIMS There is little information about hypertrophic cardiomyopathy (HCM) with pathologic genetic mutations and concurrent hypertension (HTN). Hypertensive left ventricular hypertrophy (LVH) does not exclude an underlying genetic aetiology. METHODS AND RESULTS This was a single-centre case-control study of 39 adults with pathologic HCM mutations, confirmed by genetic testing, compared to 39 age- and gender-matched patients with hypertensive LVH. The gene-positive HCM cohort was further stratified by the coexisting presence or absence of HTN. Clinical and echocardiographic characteristics were compared. Of 39 gene-positive HCM, 43.6% (17/39) had concurrent HTN. The gene-positive HCM cohort had larger left atrial (LA) area (22.1 cm2 vs. 18.9 cm2, P = 0.002), more diastolic predominant pulmonary vein flow (38.5% vs. 7.7%, P = 0.001), and more moderate diastolic dysfunction (33.3% vs. 12.8%, P = 0.032) when compared with the hypertensive LVH cohort. Greater left ventricular (LV) mass (277.7 g vs. 207.7 g, P = 0.025), increased frequency of severe LVH (58.8% vs. 27.3%, P = 0.047), and more abnormal global longitudinal strain (GLS) (-14.1% vs. -16.9%, P = 0.049) was observed in the gene-positive HCM cohort with concurrent HTN. CONCLUSION Gene-positive HCM, compared to hypertensive LVH, is characterized by more advanced diastolic dysfunction and larger LA size. Gene-positive HCM patients with concomitant HTN had greater LV mass, more severe LVH, and more abnormal GLS, suggesting HTN may negatively affect the progression of myocardial dysfunction in genetic HCM. LVH out-of-proportion to pressure burden in HTN patients should raise suspicion of underlying genetic HCM.
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Affiliation(s)
- Angelo de la Rosa
- Department of Internal Medicine, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 5512, Los Angeles, CA 90048, USA
| | - Maulin Shah
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, #A3600, Los Angeles, CA 90048, USA
| | - Takahiro Shiota
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, #A3600, Los Angeles, CA 90048, USA
| | - Robert Siegel
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, #A3600, Los Angeles, CA 90048, USA
| | - Florian Rader
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, #A3600, Los Angeles, CA 90048, USA
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5
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Chen Y, Zhou D, Xiong M, Xi X, Zhang W, Zhang R, Chen L, Jiang Q, Lai N, Li X, Luo J, Li X, Feng W, Gao C, Chen J, Fu X, Hong W, Jiang M, Yang K, Lu W, Luo Y, Zhang J, Cheng Z, Liu C, Wang J. Prediction and prognosis of adverse maternal and foetal/neonatal outcomes in pulmonary hypertension: an observational study and nomogram construction. Respir Res 2022; 23:314. [PMID: 36376948 PMCID: PMC9663284 DOI: 10.1186/s12931-022-02235-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Pregnant women with pulmonary hypertension (PH) have higher mortality rates and poor foetal/neonatal outcomes. Tools to assess these risk factors are not well established. METHODS Predictive and prognostic nomograms were constructed using data from a "Development" cohort of 420 pregnant patients with PH, recorded between January 2009 and December 2018. Logistic regression analysis established models to predict the probability of adverse maternal and foetal/neonatal events and overall survival by Cox analysis. An independent "Validation" cohort comprised data of 273 consecutive patients assessed from January 2019 until May 2022. Nomogram performance was evaluated internally and implemented with online software to increase the ease of use. RESULTS Type I respiratory failure, New York Heart Association functional class, N-terminal pro-brain natriuretic peptide [Formula: see text] 1400 ng/L, arrhythmia, and eclampsia with pre-existing hypertension were independent risk factors for maternal mortality or heart failure. Type I respiratory failure, arrhythmia, general anaesthesia for caesarean section, New York Heart Association functional class, and N-terminal pro-brain natriuretic peptide [Formula: see text] 1400 ng/L were independent predictors of pulmonary hypertension survival during pregnancy. For foetal/neonatal adverse clinical events, type I respiratory failure, arrhythmia, general anaesthesia for caesarean section, parity, platelet count, fibrinogen, and left ventricular systolic diameter were important predictors. Nomogram application for the Development and Validation cohorts showed good discrimination and calibration; decision curve analysis demonstrated their clinical utility. CONCLUSIONS The nomogram and its online software can be used to analyse individual mortality, heart failure risk, overall survival prediction, and adverse foetal/neonatal clinical events, which may be useful to facilitate early intervention and better survival rates.
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Affiliation(s)
- Yuqin Chen
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Dansha Zhou
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Mingmei Xiong
- grid.417009.b0000 0004 1758 4591The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510140 Guangdong People’s Republic of China
| | - Xin Xi
- grid.411606.40000 0004 1761 5917Sleep Centre and Department of Respiratory Medicine, Beijing Anzhen Hospital of Capital Medical University, Beijing, 100029 People’s Republic of China
| | - Wenni Zhang
- grid.413428.80000 0004 1757 8466Guangdong Women and Children’s Hospital, 521 Xingnan Avenue, Panyu District, Guangzhou, 511442 Guangdong People’s Republic of China
| | - Ruifeng Zhang
- grid.452290.80000 0004 1760 6316Department of Respiratory Medicine, Zhongda Hospital of Southeast University, Nanjing, 210009 People’s Republic of China
| | - Lishi Chen
- grid.417009.b0000 0004 1758 4591The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510140 Guangdong People’s Republic of China
| | - Qian Jiang
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Ning Lai
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Xiang Li
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Jieer Luo
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Xuanyi Li
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Weici Feng
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Chuhui Gao
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Jiyuan Chen
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Xin Fu
- grid.410737.60000 0000 8653 1072GMU-GIBH Joint School of Life Sciences, Guangzhou Medical University, Guangzhou, Guangdong People’s Republic of China
| | - Wei Hong
- grid.410737.60000 0000 8653 1072GMU-GIBH Joint School of Life Sciences, Guangzhou Medical University, Guangzhou, Guangdong People’s Republic of China
| | - Mei Jiang
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Kai Yang
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Wenju Lu
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Yiping Luo
- grid.413428.80000 0004 1757 8466Guangdong Women and Children’s Hospital, 521 Xingnan Avenue, Panyu District, Guangzhou, 511442 Guangdong People’s Republic of China
| | - Jun Zhang
- grid.411606.40000 0004 1761 5917Sleep Centre and Department of Respiratory Medicine, Beijing Anzhen Hospital of Capital Medical University, Beijing, 100029 People’s Republic of China
| | - Zhe Cheng
- grid.412633.10000 0004 1799 0733Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 Henan People’s Republic of China
| | - Chunli Liu
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China
| | - Jian Wang
- grid.470124.4State Key Laboratory of Respiratory Diseases, Guangdong Key Laboratory of Vascular Diseases, National Clinical Research Centre for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120 Guangdong People’s Republic of China ,Section of Physiology, Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego, La Jolla, CA USA
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Richard NA, Hodges L, Koehle MS. Elevated peak systolic blood pressure in endurance-trained athletes: Physiology or pathology? Scand J Med Sci Sports 2021; 31:956-966. [PMID: 33382462 DOI: 10.1111/sms.13914] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/17/2020] [Accepted: 12/27/2020] [Indexed: 01/21/2023]
Abstract
Blood pressure is a function of cardiac output and peripheral vascular resistance. During graded exercise testing (GXT), systolic blood pressure (SBP) is expected to increase gradually along with work rate, oxygen consumption, heart rate, and cardiac output. Individuals exposed to chronic endurance training attain a greater exercise SBP than in their untrained state and sedentary counterparts, but it is currently unknown what is considered a safe upper limit. This review discusses key studies examining blood pressure response in sedentary individuals and athletes. We highlight the physiological characteristics of highly fit individuals in terms of cardiovascular physiology and exercise blood pressure and review the state of the current literature regarding the safety of high SBP during exercise in this particular subgroup. Findings from this review indicate that a consensus on what is a normal SBP response to exercise in highly fit subjects and direct causation linking high GXT SBP to pathology is lacking. Consequently, applying GXT SBP guidelines developed for a "normal" population to endurance-trained individuals appears unsupported at this time. Lack of evidence for poor outcomes leads us to infer that elevated peak SBP in this subgroup could more likely reflect an adaptive response to training, rather than a pathological outcome. Future studies should track clinical outcomes of those achieving elevated SBP and develop athlete-specific guidelines.
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Affiliation(s)
| | - Lynette Hodges
- School of Sport, Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Michael S Koehle
- School of Kinesiology, University of British Columbia, Vancouver, Canada.,Division of Sports Medicine, University of British Columbia, Vancouver, Canada
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7
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Kim M, Kim SK. Genetic approaches toward understanding the individual variation in cardiac structure, function and responses to exercise training. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY 2021; 25:1-14. [PMID: 33361533 PMCID: PMC7756535 DOI: 10.4196/kjpp.2021.25.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/18/2020] [Accepted: 11/02/2020] [Indexed: 11/24/2022]
Abstract
Cardiovascular disease (CVD) accounts for approximately 30% of all deaths worldwide and its prevalence is constantly increasing despite advancements in medical treatments. Cardiac remodeling and dysfunction are independent risk factors for CVD. Recent studies have demonstrated that cardiac structure and function are genetically influenced, suggesting that understanding the genetic basis for cardiac structure and function could provide new insights into developing novel therapeutic targets for CVD. Regular exercise has long been considered a robust non-therapeutic method of treating or preventing CVD. However, recent studies also indicate that there is inter-individual variation in response to exercise. Nevertheless, the genetic basis for cardiac structure and function as well as their responses to exercise training have yet to be fully elucidated. Therefore, this review summarizes accumulated evidence supporting the genetic contribution to these traits, including findings from population-based studies and unbiased large genomic-scale studies in humans.
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Affiliation(s)
- Minsun Kim
- Department of Sports Science, Seoul National University of Science and Technology, Seoul 01811, Korea
| | - Seung Kyum Kim
- Department of Sports Science, Seoul National University of Science and Technology, Seoul 01811, Korea
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8
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Benschop L, Schalekamp-Timmermans S, Roeters van Lennep JE, Jaddoe VWV, Steegers EAP, Ikram MK. Cardiovascular Risk Factors Track From Mother to Child. J Am Heart Assoc 2019; 7:e009536. [PMID: 30371323 PMCID: PMC6404879 DOI: 10.1161/jaha.118.009536] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background Cardiovascular risk factors can track from mother to child by several pathways: pregnancy complications, genetic inheritance, and shared environmental risk factors after pregnancy. The degree of tracking, and to which extent this is influenced by these pathways, is unknown. We hypothesized that cardiovascular risk factors track from mother to child regardless of pregnancy complications and environmental risk factors. We determined the degree of tracking between maternal and offspring micro‐ and macrovascular cardiovascular risk factors after pregnancy and the extent to which this is influenced by pregnancy complications and shared environmental risk factors. Methods and Results We included 5624 mother‐offspring pairs from The Generation R Study, an ongoing prospective, population‐based birth cohort. Information on pregnancy complications (preeclampsia, small for gestational age, and preterm birth) was obtained through hospital charts. Mother‐offspring associations were assessed 6 years after pregnancy (central retinal arteriolar and venular calibers, body mass index, blood pressure, left atrial diameter, aortic root diameter, left ventricular mass, fractional shortening, and pulse wave velocity) and 9 years after pregnancy (body mass index and blood pressure). We observed that worse cardiovascular parameters in mothers were associated with worse cardiovascular parameters in their offspring 6 and 9 years after pregnancy (P<0.001). Results were similar when mother‐offspring pairs with a previous pregnancy complication were excluded. Conclusions Six and 9 years after pregnancy, an adverse cardiovascular profile in mothers is strongly associated with an adverse cardiovascular profile in their offspring. Results were not attenuated by environmental exposures or a previous pregnancy complication. This supports the hypothesis that cardiovascular risk factors (micro‐ and macrovascular) track from mother to child, regardless of the course of pregnancy.
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Affiliation(s)
- Laura Benschop
- 1 Department of Obstetrics and Gynecology Erasmus Medical Center Rotterdam The Netherlands
| | | | | | - Vincent W V Jaddoe
- 3 Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands.,4 Department of Pediatrics Erasmus Medical Center Rotterdam The Netherlands
| | - Eric A P Steegers
- 1 Department of Obstetrics and Gynecology Erasmus Medical Center Rotterdam The Netherlands
| | - M Kamran Ikram
- 3 Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands.,5 Department of Neurology Erasmus Medical Center Rotterdam The Netherlands
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9
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Shilly S, Merchant K, Singer P, Frank R, Gurusinghe S, Infante L, Sethna CB. Left ventricular cardiac geometry and ambulatory blood pressure in children. J Clin Hypertens (Greenwich) 2019; 21:566-571. [PMID: 30980607 PMCID: PMC8030399 DOI: 10.1111/jch.13540] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/18/2019] [Accepted: 03/28/2019] [Indexed: 01/19/2023]
Abstract
Limited information is available regarding the relationship between ambulatory blood pressure monitoring (ABPM) and cardiac geometry in hypertensive children. ABPM and 2D-echocardiography were retrospectively reviewed in children and adolescents <21 years old with primary hypertension. A total of 119 participants (median age 15.0 [IQR 12, 16] years) with hypertension were included. Left ventricular hypertrophy was diagnosed in 39.5% of participants. Normal geometry was found in 47.1%, concentric remodeling (CR) in 13.4%, concentric hypertrophy (CH) in 15.1%, and eccentric hypertrophy (EH) in 24.4% of children. After adjustment for age, sex, and body mass index z-score, awake systolic blood pressure (BP) index (BPi) (OR 1.07, 95% CI: 1.001-1.14, P = 0.045), awake diastolic BPi (OR 1.04, 95% CI: 1.00-1.09, P = 0.048), awake systolic BP load (OR 1.02, 95% CI: 1.000-1.04, P = 0.047), and sleep systolic BP load (OR 1.02, 95% CI: 1.001-1.04, P = 0.03) were directly associated with CH. No ABPM parameters were significant predictors of EH. In conclusion, ABPM parameters were found to be independent predictors of cardiac geometry, specifically CH.
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Affiliation(s)
- Steffi Shilly
- Department of Pediatrics, Division of Pediatric NephrologyCohen Children's Medical CenterNew Hyde ParkNew York
| | - Kumail Merchant
- Department of Pediatrics, Division of Pediatric NephrologyCohen Children's Medical CenterNew Hyde ParkNew York
| | - Pamela Singer
- Department of Pediatrics, Division of Pediatric NephrologyCohen Children's Medical CenterNew Hyde ParkNew York
| | - Rachel Frank
- Department of Pediatrics, Division of Pediatric NephrologyCohen Children's Medical CenterNew Hyde ParkNew York
| | - Shari Gurusinghe
- Department of Pediatrics, Division of Pediatric NephrologyCohen Children's Medical CenterNew Hyde ParkNew York
| | - Lulette Infante
- Department of Pediatrics, Division of Pediatric NephrologyCohen Children's Medical CenterNew Hyde ParkNew York
| | - Christine B. Sethna
- Department of Pediatrics, Division of Pediatric NephrologyCohen Children's Medical CenterNew Hyde ParkNew York
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A functional variant in the coding region of CAMTA2 is associated with left ventricular hypertrophy by affecting the activation of Nkx2.5-dependent transcription. J Hypertens 2016; 34:942-9. [DOI: 10.1097/hjh.0000000000000873] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Takx RA, Vliegenthart R, Schoepf UJ, Abro JA, Nance JW, Ebersberger U, Bamberg F, Carr CM, Apfaltrer P. Computed Tomography-Derived Parameters of Myocardial Morphology and Function in Black and White Patients With Acute Chest Pain. Am J Cardiol 2016; 117:333-9. [PMID: 26739395 DOI: 10.1016/j.amjcard.2015.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 11/09/2015] [Accepted: 11/09/2015] [Indexed: 01/19/2023]
Abstract
Blacks have higher mortality and hospitalization rates because of congestive heart failure compared with white counterparts. Differences in cardiac structure and function may contribute to the racial disparity in cardiovascular outcomes. Our aim was to compare computed tomography (CT)-derived cardiac measurements between black patients with acute chest pain and age- and gender-matched white patients. We performed a retrospective analysis under an institutional review board waiver and in Health Insurance Portability and Accountability Act compliance. We investigated patients who underwent cardiac dual-source CT for acute chest pain. Myocardial mass, left ventricular (LV) ejection fraction, LV end-systolic volume, and LV end-diastolic volume were quantified using an automated analysis algorithm. Septal wall thickness and cardiac chamber diameters were manually measured. Measurements were compared by independent t test and linear regression. The study population consisted of 300 patients (150 black-mean age 54 ± 12 years; 46% men; 150 white-mean age 55 ± 11 years; 46% men). Myocardial mass was larger for blacks compared with white (176.1 ± 58.4 vs 155.9 ± 51.7 g, p = 0.002), which remained significant after adjusting for age, gender, body mass index, and hypertension. Septal wall thickness was slightly greater (11.9 ± 2.7 vs 11.2 ± 3.1 mm, p = 0.036). The LV inner diameter was moderately larger in black patients in systole (32.3 ± 9.0 vs 30.1 ± 5.4 ml, p = 0.010) and in diastole (50.1 ± 7.8 vs 48.9 ± 5.2 ml, p = 0.137), as well as LV end-diastolic volume (134.5 ± 42.7 vs 128.2 ± 30.6 ml, p = 0.143). Ejection fraction was nonsignificantly lower in blacks (67.1 ± 13.5% vs 69.0 ± 9.6%, p = 0.169). In conclusion, CT-derived myocardial mass was larger in blacks compared with whites, whereas LV functional parameters were generally not statistically different, suggesting that LV mass might be a possible contributing factor to the higher rate of cardiac events in blacks.
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12
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Peterson VR, Norton GR, Redelinghuys M, Libhaber CD, Maseko MJ, Majane OHI, Brooksbank R, Woodiwiss AJ. Intrafamilial aggregation and heritability of left ventricular geometric remodeling is independent of cardiac mass in families of African ancestry. Am J Hypertens 2015; 28:657-63. [PMID: 25376640 DOI: 10.1093/ajh/hpu202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 09/23/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Whether left ventricular (LV) geometric remodeling, as indexed by relative wall thickness (RWT), aggregates in families and is inherited independent of LV mass (LVM) and additional confounders is uncertain. METHODS We determined whether RWT as assessed from 2D targeted M-mode echocardiography shows intrafamilial aggregation and heritability independent of LVM in 181 nuclear families (73 spouse pairs, 403 parent-child pairs, and 177 sibling-sibling pairs) with 16 families including 3 generations from an urban developing community of black Africans. Intrafamilial aggregation and heritability estimates (S.A.G.E. software) were assessed independent of confounders, including central aortic systolic blood pressure (SBPc) (radial applanation tonometry and SphygmoCor software). RESULTS Independent of confounders including SBPc, LV RWT was correlated in parent-child (r = 0.32, P < 0.0001) and sibling-sibling (r = 0.29, P < 0.0001), but not in spouse (r = 0.11, P = 0.33) pairs. The relationships between parent-child (r = 0.28, P < 0.0001) and sibling-sibling (r = 0.24, P < 0.001) pairs persisted with further adjustments for LVM or LVM indexed to height(2.7) (LVMI). Similarly, independent of confounders, LV RWT showed significant heritability (h(2) ± SEM = 0.56 ± 0.09, P < 0.0001) and this persisted with further adjustments for LVM (h(2) ± SEM = 0.48 ± 0.09, P < 0.0001) or LVMI (h(2) ± SEM = 0.49 ± 0.09, P < 0.0001). CONCLUSIONS In a group of African ancestry, independent of LVM, LV geometric remodeling shows significant intrafamilial aggregation and heritability. Genetic factors may in-part determine the LV geometric remodeling process independent of the extent of cardiac hypertrophy.
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Affiliation(s)
- Vernice R Peterson
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Gavin R Norton
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michelle Redelinghuys
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Carlos D Libhaber
- School of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Muzi J Maseko
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Olebogeng H I Majane
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Brooksbank
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Angela J Woodiwiss
- Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;
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Cheng S, McCabe EL, Larson MG, Chen MH, Osypiuk E, Lehman BT, Stantchev P, Aragam J, Solomon SD, Benjamin EJ, Vasan RS. Left ventricular mechanical function: clinical correlates, heritability, and association with parental heart failure. Eur J Heart Fail 2014; 17:44-50. [PMID: 25445300 DOI: 10.1002/ejhf.202] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Revised: 10/03/2014] [Accepted: 10/10/2014] [Indexed: 11/07/2022] Open
Abstract
AIMS Non-invasive measures of cardiac mechanical function may have the potential to serve as markers of risk for heart failure; however, limited data exist regarding clinical correlates and heritability of these measures in the community. METHODS AND RESULTS We used speckle-tracking echocardiography to assess LV strain and synchrony in the Framingham Offspring Study (n = 2816; mean age 67 years, 54% women). In multivariable regression analyses, male gender (vs. female, P < 0.001), higher heart rate (P < 0.0001), and presence of cardiovascular disease (P < 0.001) were associated with worse global peak strains across all planes analysed (longitudinal, transverse, circumferential, and radial). Higher diastolic blood pressure and diabetes were associated with worse longitudinal strain (P < 0.01), and greater body mass index was associated with worse radial strain (P = 0.0004). Overall, however, clinical correlates accounted for only 4-19% of the variation in measures of LV mechanical function. Select measures of LV strain were heritable: longitudinal strain (h(2) = 16%, P = 0.002), transverse strain (h(2) = 15%, P = 0.006), and circumferential strain (h(2) = 30%, P < 0.0001). Furthermore, in a subset of 1437 participants with parental data available, parental heart failure was associated with worse circumferential strain in the offspring free of heart failure (P = 0.01). CONCLUSIONS Our investigation in a large community-based sample identified heritablity and clinical correlates of LV mechanical function, and highlighted an association of parental heart failure with worse global circumferential strain in offspring.
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Affiliation(s)
- Susan Cheng
- Framingham Heart Study, Framingham, MA, USA; Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
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14
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Bouchard C, Rankinen T, Timmons JA. Genomics and genetics in the biology of adaptation to exercise. Compr Physiol 2013; 1:1603-48. [PMID: 23733655 DOI: 10.1002/cphy.c100059] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This article is devoted to the role of genetic variation and gene-exercise interactions in the biology of adaptation to exercise. There is evidence from genetic epidemiology research that DNA sequence differences contribute to human variation in physical activity level, cardiorespiratory fitness in the untrained state, cardiovascular and metabolic response to acute exercise, and responsiveness to regular exercise. Methodological and technological advances have made it possible to undertake the molecular dissection of the genetic component of complex, multifactorial traits, such as those of interest to exercise biology, in terms of tissue expression profile, genes, and allelic variants. The evidence from animal models and human studies is considered. Data on candidate genes, genome-wide linkage results, genome-wide association findings, expression arrays, and combinations of these approaches are reviewed. Combining transcriptomic and genomic technologies has been shown to be more powerful as evidenced by the development of a recent molecular predictor of the ability to increase VO2max with exercise training. For exercise as a behavior and physiological fitness as a state to be major players in public health policies will require that the role of human individuality and the influence of DNA sequence differences be understood. Likewise, progress in the use of exercise in therapeutic medicine will depend to a large extent on our ability to identify the favorable responders for given physiological properties to a given exercise regimen.
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Affiliation(s)
- Claude Bouchard
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
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15
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Association of genetic variation in calmodulin and left ventricular mass in full-term newborns. Int J Genomics 2013; 2013:410407. [PMID: 24298550 PMCID: PMC3835711 DOI: 10.1155/2013/410407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 09/20/2013] [Indexed: 11/18/2022] Open
Abstract
Calmodulin II (CALM2) gene polymorphism might be responsible for the variation in the left ventricular mass amongst healthy individuals. The aim was to evaluate the correlation between left ventricular mass (LVM) and g.474955027G>A (rs7565161) polymorphism adjacent to the CALM2 gene. Healthy Polish newborns (n = 206) were recruited. Two-dimensional M-mode echocardiography was used to assess LVM. Polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism and sequencing analyses. The carriers of the G allele of the CALM2 polymorphism had significantly higher left ventricular mass/weight (LVM/BW) values, when compared with newborns homozygous for the A allele (3.1 g/m(2) versus 2.5 g/m(2), P adjusted = 0.036). The AG genotype of CALM2 was associated with the highest values of LVM/BW, exhibiting a pattern of overdominance (2.9 g/kg versus 3.1 g/kg versus 2.5 g/kg, P adjusted = 0.037). The results of this study suggest that G>A CALM2 polymorphism may account for subtle variation in LVM at birth.
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16
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Family history of cardiovascular disease and offspring echocardiographic left ventricular structure and function: the Asklepios Study. J Am Soc Echocardiogr 2013; 26:1290-1297.e2. [PMID: 23993692 DOI: 10.1016/j.echo.2013.07.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Indexed: 11/21/2022]
Abstract
BACKGROUND Moderate to small heritability has been observed for left ventricular (LV) structure and function in genetic epidemiology and genomewide association studies. The aim of this study was to explore whether this would be mirrored in an independent association between LV structure and function and a family history (FH) of cardiovascular disease (CVD) in a large population of middle-aged adults. METHODS Subjects enrolled in the Asklepios Study, a population-based sample of 2,524 male and female volunteers, aged 35 to 55 years, free of overt CVD at baseline, were studied. LV structure and function were assessed using transthoracic echocardiography (by a single sonographer). FH data spanning 4 generations were acquired using a questionnaire. RESULTS In unadjusted analyses, only small effects of FH of CVD on LV structure (relative wall thickness, P = .042; interventricular septal thickness, P = .002; LV mass, P = .038; allometrically adjusted LV mass, P = .014) and diastolic function (mitral annular e', P = .02) were observed. After adjusting for the more adverse risk factor profile associated with FH, no significant associations persisted. These results did not appreciably change using a more extended definition of FH of CVD or FH of hypertension. CONCLUSIONS A positive FH for CVD was associated with differences in offspring cardiac structure and function, largely mediated by (but not independent from) a more adverse risk profile in those subjects with positive FH.
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17
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Patel SS, Mahoney LT, Burns TL. Is a shorter atrioventricular septal length an intermediate phenotype in the spectrum of nonsyndromic atrioventricular septal defects? J Am Soc Echocardiogr 2012; 25:782-9. [PMID: 22542274 DOI: 10.1016/j.echo.2012.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Indexed: 10/28/2022]
Abstract
BACKGROUND Atrioventricular septal defects (AVSDs) account for 7% of all congenital cardiovascular malformations. The atrioventricular septum (AVS) is the portion of the septal tissue that separates the right atrium from the left ventricle; deficiency of the AVS contributes to the AVSD phenotype. A study of case and control families was performed to identify whether an intermediate phenotype consisting of a shortened AVS existed in relatives of children with AVSDs. METHODS AVS length (AVSL) was measured on the echocardiograms of clinically unaffected parents and siblings from families that were identified through children with nonsyndromic AVSDs and in families with no histories of congenital heart disease. RESULTS No significant differences were seen between case and control family members in terms of gender, age, weight, and height. AVSLs were significantly shorter in case parents compared with control parents. Similar findings were noted within the sibling groups. There was significant evidence for two-component distributions in the case parent, case sibling, and control sibling groups after standardizing AVSL for age and body surface area. Heritability of AVSL standardized for age and body surface area was 0.82 and 0.71 in nonsyndromic case and control families, respectively. CONCLUSIONS Evidence for two-component distributions from the analysis of AVSL standardized for age and body surface area for case parents and case siblings suggests the presence of an intermediate phenotype for nonsyndromic AVSD. The high heritability in the control families suggests that there may be polygenic involvement in the determination of AVSL. Broadening the definition of AVSD to include those with shortened AVSL may increase the power of genetic association and mapping studies to identify susceptibility genes for AVSD.
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Affiliation(s)
- Sonali S Patel
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
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18
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Della-Morte D, Beecham A, Rundek T, Wang L, McClendon MS, Slifer S, Blanton SH, Di Tullio MR, Sacco RL. A follow-up study for left ventricular mass on chromosome 12p11 identifies potential candidate genes. BMC MEDICAL GENETICS 2011; 12:100. [PMID: 21791083 PMCID: PMC3199748 DOI: 10.1186/1471-2350-12-100] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 07/26/2011] [Indexed: 11/14/2022]
Abstract
Background Left ventricular mass (LVM) is an important risk factor for cardiovascular disease. Previously we found evidence for linkage to chromosome 12p11 in Dominican families, with a significant increase in a subset of families with high average waist circumference (WC). In the present study, we use association analysis to further study the genetic effect on LVM. Methods Association analysis with LVM was done in the one LOD critical region of the linkage peak in an independent sample of 897 Caribbean Hispanics. Genotype data were available on 7085 SNPs from 23 to 53 MB on chromosome 12p11. Adjustment was made for vascular risk factors and population substructure using an additive genetic model. Subset analysis by WC was performed to test for a difference in genetic effects between the high and low WC subsets. Results In the overall analysis, the most significant association was found to rs10743465, downstream of the SOX5 gene (p = 1.27E-05). Also, 19 additional SNPs had nominal p < 0.001. In the subset analysis, the most significant difference in genetic effect between those with high and low WC occurred with rs1157480 (p = 1.37E-04 for the difference in β coefficients), located upstream of TMTC1. Twelve additional SNPs in or near 6 genes had p < 0.001. Conclusions The current study supports previously identified evidence by linkage for a genetic effect on LVM on chromosome 12p11 using association analysis in population-based Caribbean Hispanic cohort. SOX5 may play an important role in the regulation of LVM. An interaction of TMTC1 with abdominal obesity may contribute to phenotypic variation of LVM.
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Affiliation(s)
- David Della-Morte
- Department of Neurology, Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
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de Jonge LL, van Osch-Gevers L, Willemsen SP, Steegers EA, Hofman A, Helbing WA, Jaddoe VW. Growth, Obesity, and Cardiac Structures in Early Childhood. Hypertension 2011; 57:934-40. [DOI: 10.1161/hypertensionaha.110.163303] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Layla L. de Jonge
- From the Generation R Study Group (L.L.d.J., V.W.V.J.) and Departments of Paediatrics (L.L.d.J., L.v.O.-G., W.A.H., V.W.V.J.), Epidemiology (L.L.d.J., A.H., V.W.V.J.), Biostatistics (S.P.W.), and Obstetrics and Gynaecology (E.A.P.S.), Erasmus Medical Center, Rotterdam, The Netherlands
| | - Lennie van Osch-Gevers
- From the Generation R Study Group (L.L.d.J., V.W.V.J.) and Departments of Paediatrics (L.L.d.J., L.v.O.-G., W.A.H., V.W.V.J.), Epidemiology (L.L.d.J., A.H., V.W.V.J.), Biostatistics (S.P.W.), and Obstetrics and Gynaecology (E.A.P.S.), Erasmus Medical Center, Rotterdam, The Netherlands
| | - Sten P. Willemsen
- From the Generation R Study Group (L.L.d.J., V.W.V.J.) and Departments of Paediatrics (L.L.d.J., L.v.O.-G., W.A.H., V.W.V.J.), Epidemiology (L.L.d.J., A.H., V.W.V.J.), Biostatistics (S.P.W.), and Obstetrics and Gynaecology (E.A.P.S.), Erasmus Medical Center, Rotterdam, The Netherlands
| | - Eric A.P. Steegers
- From the Generation R Study Group (L.L.d.J., V.W.V.J.) and Departments of Paediatrics (L.L.d.J., L.v.O.-G., W.A.H., V.W.V.J.), Epidemiology (L.L.d.J., A.H., V.W.V.J.), Biostatistics (S.P.W.), and Obstetrics and Gynaecology (E.A.P.S.), Erasmus Medical Center, Rotterdam, The Netherlands
| | - Albert Hofman
- From the Generation R Study Group (L.L.d.J., V.W.V.J.) and Departments of Paediatrics (L.L.d.J., L.v.O.-G., W.A.H., V.W.V.J.), Epidemiology (L.L.d.J., A.H., V.W.V.J.), Biostatistics (S.P.W.), and Obstetrics and Gynaecology (E.A.P.S.), Erasmus Medical Center, Rotterdam, The Netherlands
| | - Willem A. Helbing
- From the Generation R Study Group (L.L.d.J., V.W.V.J.) and Departments of Paediatrics (L.L.d.J., L.v.O.-G., W.A.H., V.W.V.J.), Epidemiology (L.L.d.J., A.H., V.W.V.J.), Biostatistics (S.P.W.), and Obstetrics and Gynaecology (E.A.P.S.), Erasmus Medical Center, Rotterdam, The Netherlands
| | - Vincent W.V. Jaddoe
- From the Generation R Study Group (L.L.d.J., V.W.V.J.) and Departments of Paediatrics (L.L.d.J., L.v.O.-G., W.A.H., V.W.V.J.), Epidemiology (L.L.d.J., A.H., V.W.V.J.), Biostatistics (S.P.W.), and Obstetrics and Gynaecology (E.A.P.S.), Erasmus Medical Center, Rotterdam, The Netherlands
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Jin Y, Kuznetsova T, Bochud M, Richart T, Thijs L, Cusi D, Fagard R, Staessen JA. Heritability of left ventricular structure and function in Caucasian families. ACTA ACUST UNITED AC 2011; 12:326-32. [PMID: 21398654 DOI: 10.1093/ejechocard/jer019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
AIMS The aim of this study was to investigate the heritability as well as genetic and environmental correlations of left ventricular (LV) structural and functional traits in complex pedigrees of a Caucasian population. METHODS AND RESULTS We randomly recruited 459 white European subjects from 52 families (50% women; mean age 45 years). LV structure was measured by M-mode and 2D echocardiography and LV function was measured by conventional Doppler and tissue Doppler imaging (TDI). Other measurements included blood pressure, anthropometric, and biochemical measurements. We estimated the heritability of LV traits while adjusting for covariables, including sex, age, body height and weight, systolic and diastolic blood pressures, and heart rate. With full adjustment, heritability of LV mass was 0.23 (P= 0.025). The TDI-derived mitral annular velocities Ea and Aa showed moderate heritability (h(2)= 0.36 and 0.53, respectively), whereas the mitral inflow A peak had weak heritability (h(2) = 0.25) and the E peak was not heritable (h(2) = 0.11). We partitioned the total phenotypic correlation when it reached significance, into a genetic and an environmental component. The genetic correlations were 0.61 between the E and Ea peaks and 0.90 between the A and Aa peaks. CONCLUSION Our study demonstrated moderate heritability for LV mass as well as the mitral annular Ea and Aa peaks. We also found significant genetic correlations between the E and Ea peaks and between the A and Aa peaks. Our current findings support the ongoing research to map and detect genetic variants that contribute to the variation in LV mass and other LV structural and functional phenotypes.
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Affiliation(s)
- Yu Jin
- The Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 35, Leuven, Belgium
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Protective effect of the 1742(C/G) polymorphism of human cardiotrophin-1 against left ventricular hypertrophy in essential hypertension. J Hypertens 2011; 28:2219-26. [PMID: 20683337 DOI: 10.1097/hjh.0b013e32833da326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Experimental and clinical evidence supports a role of cardiotrophin-1 (CT-1) in the development of hypertensive left ventricular hypertrophy (LVH). The goal of this study was to investigate the relationship between human CT-1 genetic background and LVH in essential hypertension. METHODS A total of 900 individuals were genotyped for the 1742(C/G) polymorphism of the human CT-1 gene. Serum CT-1 levels were assessed by ELISA in 681 individuals. Left ventricular parameters were determined by two-dimensional echocardiography in 297 individuals. RESULTS The prevalence of the GG genotype of the 1742(C/G) polymorphism was reduced in essential hypertension (8.4% in normotensive individuals, 4.9% in hypertensive patients, P = 0.046 versus CC/CG individuals) and in LVH (11.5% in nonhypertrophic normotensive individuals, 12.2% in nonhypertrophic hypertensive patients, 2.6% in hypertensive patients with LVH, P = 0.008 versus CC/CG individuals). Apart from this, GG individuals presented lower serum concentration of CT-1 (GG, 147.1 ± 10.5 fmol/ml; CC/CG, 187.1 ± 4.8 fmol/ml; P = 0.036) and left ventricular mass index (GG, 91 ± 6 g/m; CC/CG, 119 ± 3 g/m; P = 0.002). Multivariate analyses showed that the 1742(C/G) polymorphism was a significant determinant of both left ventricular mass index and serum CT-1, after adjusting for confounding factors. Finally, in-vitro studies supported the functionality of the 1742(C/G) polymorphism. CONCLUSION Our results indicate that the 1742(C/G) polymorphism of the human CT-1 gene is associated with LVH in hypertension and that the GG genotype may have a protective role. It is suggested that CT-1 is one of the mediators of this association.
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Lam CSP, Liu X, Yang Q, Larson MG, Pencina MJ, Aragam J, Redfield MM, Benjamin EJ, Vasan RS. Familial aggregation of left ventricular geometry and association with parental heart failure: the Framingham Heart Study. ACTA ACUST UNITED AC 2010; 3:492-8. [PMID: 20884845 DOI: 10.1161/circgenetics.110.941088] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Data regarding the familial aggregation of left ventricular (LV) geometry and its relations to parental heart failure (HF) are limited. METHODS AND RESULTS We evaluated concordance of LV geometry within 1093 nuclear families in 5758 participants of the original (parents) (n=2351) and offspring (n=3407) cohorts of the Framingham Heart Study undergoing routine echocardiography in mid- to late adulthood. LV geometry was categorized based on cohort- and sex-specific 80th percentile cutoffs of LV mass and relative wall thickness (RWT) into normal (both <80th percentile), concentric remodeling (LV mass <80th percentile; RWT >80th percentile), concentric hypertrophy (both >80th percentile), and eccentric hypertrophy (LV mass >80th percentile; RWT <80th percentile). Within nuclear families, LV geometry was concordant among related pairs (parent-child, sibling-sibling) (P=0.0015) but not among unrelated spousal pairs (P=0.60), a finding that remained unchanged after adjusting for clinical covariates known to influence LV remodeling (age, systolic blood pressure, body mass index), excluding individuals with prevalent HF and myocardial infarction, and varying the thresholds for defining LV geometry. The prevalence of abnormal LV geometry was higher in family members of affected individuals, with recurrence risks of 1.4 for concentric remodeling (95% CI, 1.2 to 1.7) and eccentric hypertrophy (95% CI, 1.1 to 1.8) and 3.9 (95% CI, 3.2 to 4.6) for concentric hypertrophy. In a subset of 1497 offspring, we observed an association between parental HF (n=458) and eccentric hypertrophy in offspring (P<0.0001). CONCLUSIONS Our investigation of a 2-generational community-based sample demonstrates familial aggregation of LV geometry, with the greatest recurrence risk for concentric LV geometry, and establishes an association between eccentric LV geometry and parental HF.
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Affiliation(s)
- Carolyn S P Lam
- National Heart, Lung, and Blood Institute Framingham Heart Study, 73 Mt Wayte Ave, Framingham, MA 01702, USA
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Lam CSP, Vasan RS. Heart failure risk: lessons from the family. CONGESTIVE HEART FAILURE (GREENWICH, CONN.) 2010; 16:139-140. [PMID: 20662864 PMCID: PMC3007119 DOI: 10.1111/j.1751-7133.2010.00155.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Dencker M, Thorsson O, Karlsson MK, Lindén C, Wollmer P, Andersen LB. Objectively measured daily physical activity related to cardiac size in young children. Scand J Med Sci Sports 2009; 19:664-8. [DOI: 10.1111/j.1600-0838.2008.00842.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Leibowitz D, Dresner-Pollak R, Dvir S, Rokach A, Reznik L, Pollak A. Association of an estrogen receptor‐alpha gene polymorphism with left ventricular mass. Blood Press 2009; 15:45-50. [PMID: 16492615 DOI: 10.1080/08037050500539569] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The development of left ventricular hypertrophy (LVH) is influenced by gender and by sex hormones including estrogens. This study hypothesized that genetic variation in the TA repeat regulatory region of the estrogen receptor alpha gene (ESR1) is related to left ventricular mass. METHODS Consecutive patients undergoing coronary angiography with echocardiographic studies were studied. The length of the dinucleotide repeat thymine and adenine (TA) upstream of exon 1 in the ESR1 gene was determined. The mean number of TA repeats (n = 18) categorized the subjects into long, short and mixed allele genotypes. RESULTS Ninety-two patients (mean age 60.3+/-12.6 years, 63 males, 29 females) were entered into the study. When LV mass indexed to body surface area was examined in the three genotype groups, a significant difference between the groups was noted with lower LV mass in the short allele group (p < 0.03). When the short allele group was compared with subjects with at least one long allele, a highly significant difference in left ventricular mass index was noted (86.9 g/m2 vs 101.3 g/m2, p < 0.009). CONCLUSION. The ESR1 TA repeat polymorphism may influence left ventricular mass. Patients with at least one long allele exhibit a tendency to higher LV mass.
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Affiliation(s)
- David Leibowitz
- Department of Cardiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
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Tang W, Devereux RB, Li N, Oberman A, Kitzman DW, Rao DC, Hopkins PN, Claas SA, Arnett DK. Identification of a pleiotropic locus on chromosome 7q for a composite left ventricular wall thickness factor and body mass index: the HyperGEN Study. BMC MEDICAL GENETICS 2009; 10:40. [PMID: 19426520 PMCID: PMC2692848 DOI: 10.1186/1471-2350-10-40] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Accepted: 05/09/2009] [Indexed: 01/19/2023]
Abstract
BACKGROUND Left ventricular (LV) mass and wall thickness are closely associated with measures of body size and blood pressure and also correlated with systolic and diastolic function, suggesting a contribution of common physiologic mechanisms, including pleiotropic genes, to their covariation. METHODS Doppler echocardiography was performed in 434 African-American (1344 individuals) and 284 white families (1119 individuals). We conducted a genome-wide linkage scan for LV mass, LV structure and function, and composite factors derived from a factor analysis of LV structure and function in the HyperGEN Study population. RESULTS Factor analysis identified (i) a LV wall thickness factor correlated strongly with interventricular septal thickness (IVSTd) and posterior wall thickness (PWTd) and (ii) a LV diastolic filling factor strongly correlated with early and atrial phase peak transmitral filling velocities. The LV phenotypes and composite factor scores were analyzed in multipoint variance components linkage model implemented in SOLAR with 387 microsatellite markers. In whites, the two highest LODs were 3.42 for LV atrial phase peak filling velocity at 144 cM on chromosome 1 and 3.12 for the LV wall thickness factor at 160 cM on chromosome 7. The peak LODs of the component traits (IVSTd and PWTd) clustered at the same region as the composite factor. Adjusting the factor score for body mass index (BMI) substantially reduced the peak LOD at this region (LOD = 1.92). Bivariate linkage analysis of the composite factor with BMI improved LOD to 3.42 at 158 cM. Also in whites, suggestive linkage was observed on chromosomes 2 and 4 for LV mass, chromosomes 3, 5, 10, and 17 for LV atrial phase peak filling velocity, and chromosome 10 for LV diastolic filling factor. In African Americans, suggestive linkage was observed on chromosome 12 for LV mass, chromosome 21 for IVSTd, and chromosome 3 for LV internal diameter at end-diastole. CONCLUSION Our study suggests that a region on chromosome 7 contains pleiotropic genes contributing to the variations of both LV wall thickness and BMI in whites.
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Affiliation(s)
- Weihong Tang
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Richard B Devereux
- Division of Cardiology, Weill Cornell Medical College, New York, NY, USA
| | - Na Li
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, USA
| | - Albert Oberman
- Division of Preventive Medicine, University of Alabama-Birmingham, Birmingham, Alabama, USA
| | - Dalane W Kitzman
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Dabeeru C Rao
- Division of Biostatistics, Washington University School of Medicine, St Louis, MO, USA
| | - Paul N Hopkins
- Cardiovascular Genetics, University of Utah, Salt Lake City, UT, USA
| | - Steven A Claas
- Department of Epidemiology, University of Alabama-Birmingham, Birmingham, Alabama, USA
| | - Donna K Arnett
- Department of Epidemiology, University of Alabama-Birmingham, Birmingham, Alabama, USA
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Left ventricular mass and incident hypertension in individuals with initial optimal blood pressure: the Strong Heart Study. J Hypertens 2008; 26:1868-74. [PMID: 18698223 DOI: 10.1097/hjh.0b013e3283050899] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Metabolic abnormalities have been shown to predict 8-year incident arterial hypertension in individuals with optimal blood pressure. As echocardiographic left ventricular mass has also been reported to predict incident hypertension in individuals with baseline blood pressure of less than 140/90 mmHg, we determined whether left ventricular mass predicts 4-year incident hypertension also in individuals with initial optimal blood pressure (<120/80 mmHg), independent of metabolic factors influencing blood pressure. METHODS We studied 777 of 3257 members of the American Indian population-based Strong Heart Study cohort with optimal blood pressure (34% men, 45% obese, and 35% diabetic), aged 57 +/- 7 years, and without prevalent cardiovascular disease. RESULTS Over 4 years, 159 individuals (20%, group H) developed hypertension (blood pressure >/=140/90 mmHg). They had a greater baseline BMI, waist girth, and blood pressure (112/69 vs. 109/68 mmHg, all P < 0.03) than those remaining normotensive (group N), with similar lipid profile and renal function. At baseline, left ventricular mass was significantly greater in group H than in group N (P < 0.004). The difference in left ventricular mass was confirmed after controlling for initial BMI, systolic blood pressure, homeostatic model assessment index, and diabetes. The probability of incident hypertension increased by 36% for each standard deviation of left ventricular mass index (P = 0.006), independent of covariates. Participants with left ventricular mass of more than 159 g (75th percentile of distribution) had 2.5-fold (95% confidence interval, 1.4-3.6; P < 0.001) higher adjusted risk of incident hypertension than those below this value. CONCLUSION Left ventricular mass predicts incident arterial hypertension in individuals with initially optimal blood pressure. This association is independent of body build, prevalent diabetes, and initial blood pressure.
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Association of beta (1)-adrenergic receptor gene polymorphisms with left ventricular hypertrophy in human essential hypertension. Clin Biochem 2008; 41:773-8. [DOI: 10.1016/j.clinbiochem.2008.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Revised: 01/09/2008] [Accepted: 02/03/2008] [Indexed: 12/12/2022]
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Kapuku GK, Ge D, Vemulapalli S, Harshfield GA, Treiber FA, Snieder H. Change of genetic determinants of left ventricular structure in adolescence: longitudinal evidence from the Georgia cardiovascular twin study. Am J Hypertens 2008; 21:799-805. [PMID: 18443564 DOI: 10.1038/ajh.2008.178] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Genetic contribution to left ventricular (LV) structure is generally recognized, but whether and how this influence varies by ethnicity or with age is unknown. METHODS Participants were 517 European-American (EA) and African-American (AA) twin pairs (mean age: 14.6 +/- 3.0) at visit 1 and 422 EA and AA twin pairs at follow-up 4.1 years later. Echocardiograms were obtained on both visits. Data were analyzed using the structural equation modeling software Mx. RESULTS Body mass index (BMI) was a strong predictor for all LV measures at both visits 1 and 2, accounting for 3.5-24.2% of the total variance. Hemodynamics explained up to 4.5% additional LV measures variance. After adjusting for BMI, LV measures showed substantial heritability (range: 21-71%). Best-fitting longitudinal models revealed considerable novel genetic effects on the interventricular septum, posterior wall-, and relative wall thickness (RWT) (but not LV internal diameter), accounting for 32-41% of the phenotypic variance at visit 2, with no significant gender and ethnic effects. There was a gender difference for LV mass index in AAs (P < 0.01), with a significant influence of novel genetic effects in males (47%), but not in females. No gender difference was seen in EAs, with 34% of the phenotypic variance at visit 2 attributable to novel genetic effects. CONCLUSIONS The heritability of cardiac structure and geometry was equally substantial in both AAs and EAs. Significant novel genetic influences were detected for all measures but LV inner diameter and LV mass index in AA females. Further developmental genetic studies are warranted to elucidate the nature of the emerging gene effects during the transition from adolescence to adulthood.
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Abstract
PURPOSE OF REVIEW Cardiac hypertrophy is a common phenotypic response of the heart to stimulants. It is associated with increased morbidity and mortality in various cardiovascular disorders. Genetic factors are important determinants of phenotypic expression of cardiac hypertrophy, whether in single-gene disorders or in complex traits. We focus on the molecular genetics of cardiac hypertrophy in various conditions with an emphasis on hypertrophic cardiomyopathy, a genetic paradigm of cardiac hypertrophic response. RECENT FINDINGS The molecular genetic basis of cardiac hypertrophy in single-gene disorders has been partially elucidated. Likewise, the impact of genetics on the expression of cardiac hypertrophy in the general population has been demonstrated. Identification of mutations in the Z disk proteins has expanded the spectrum of causal mutations beyond the thin and thick filaments of the sarcomeres. In addition, modifier loci have been mapped and shown to impart considerable effects on the expression of cardiac hypertrophy in hypertrophic cardiomyopathy. Elucidation of the molecular genetics of sarcomeric hypertrophic cardiomyopathy and many of the phenocopies has highlighted the limitations of clinical diagnosis as a determinant of management and prognostic advice. The findings have raised the importance of diagnosis and treatment algorithms, which are based on both genotype and phenotype information. SUMMARY Cardiac hypertrophy, regardless of the cause, is the phenotypic consequence of complex interactions between genetic and nongenetic factors.
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Affiliation(s)
- Ali J Marian
- The Brown Foundation Institute of Molecular Medicine, Center for Cardiovascular Genetic Research, The University of Texas Health Science Center, Houston, Texas 77030, USA.
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Brady TM, Fivush B, Flynn JT, Parekh R. Ability of blood pressure to predict left ventricular hypertrophy in children with primary hypertension. J Pediatr 2008; 152:73-8, 78.e1. [PMID: 18154904 DOI: 10.1016/j.jpeds.2007.05.053] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2006] [Revised: 04/18/2007] [Accepted: 05/18/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine whether casual blood pressure (BP) or ambulatory BP monitoring (ABPM) measurements obtained at the initial visit of a child with confirmed hypertension (HTN) might predict left ventricular hypertrophy (LVH), possibly obviating the need for echocardiography. STUDY DESIGN We conducted a cross-sectional study of 184 children aged 3 to 20 years who were referred for initial evaluation of elevated BP at 3 tertiary care centers. Casual BP and various ambulatory BP variables were analyzed to determine their association with LVH, defined after echocardiography by cardiologist diagnosis or a left ventricular mass index equal to or greater than the sex-specific 95th percentile. RESULTS A total of 41% of children who had echocardiograms had LVH. Children with LVH were significantly more likely to be non-white and have a higher body mass index z-score. There was no difference in casual systolic or diastolic BP index in children with hypertension who had LVH and children with hypertension without LVH. Children with systolic or diastolic BP loads > or = 50% were no more likely to have LVH than children with loads < 50%. CONCLUSION LVH is common in children with newly diagnosed HTN. The initial examination of these children should include echocardiography, because neither the severity of casual BP elevation nor the presence of abnormal ambulatory BP results at initial diagnosis are predictive of LVH.
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Affiliation(s)
- Tammy M Brady
- Department of Pediatrics, Division of Pediatric Nephrology, Johns Hopkins University, Baltimore, Maryland, USA.
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de Simone G, Tang W, Devereux RB, Hunt SC, Kitzman DW, Rao DC, Arnett DK. Assessment of the interaction of heritability of volume load and left ventricular mass: the HyperGEN offspring study. J Hypertens 2007; 25:1397-402. [PMID: 17563561 DOI: 10.1097/hjh.0b013e328126851e] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Left ventricular mass (LVM) is more closely associated with volume load than pressure load. We assessed whether part of the genetic heritability of LVM can be explained by stroke volume (SV) inheritance. METHODS Echocardiographic LVM, SV and peripheral resistance were measured in 527 families with at least two relatives from the HyperGEN study (51% African-American, 43% men, 44% obese, 53% hypertensive). Included were 1792 subjects without prevalent cardiovascular disease, diabetes and renal failure. Ethnic-specific genetic correlations were estimated using a variance components procedure (SOLAR). RESULTS Significant genetic correlations existed between LVM and SV after adjusting for age, sex, race, field center, systolic blood pressure, number of antihypertensive medications, and body mass index (rhog = 0.93 in African-Americans and 0.70 in Caucasians; both P < 0.0001). Urinary Na excretion or serum creatinine did not influence these correlations. After adjusting for covariates, heritability of LVM was greater (h = 0.46 in African-Americans and 0.47 in Caucasians; both P < 0.0001) than that for SV (h = 0.18 in African-Americans and 0.29 in Caucasians; both P < 0.02). Heritability of LVM slightly decreased in African-Americans (h = 0.34), but not in Caucasians (h = 0.45; both P < 0.0001) when SV was added to covariates. Heritability of SV almost disappeared by addition of LVM into the model in African-Americans (h = 0.04, P = not significant), whereas it was slightly reduced in Caucasians (h = 0.20, P < 0.005). CONCLUSION LVM and SV share a common genetic profile, but with only a modest reciprocal influence. Variability of LVM has some effect on calculated heritability of SV, especially in African-Americans, whereas the role of heritable volume load in determining the variability of LVM was modest only in African-Americans.
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Rame JE, Drazner MH, Post W, Peshock R, Lima J, Cooper RS, Dries DL. Corin I555(P568) Allele Is Associated With Enhanced Cardiac Hypertrophic Response to Increased Systemic Afterload. Hypertension 2007; 49:857-64. [PMID: 17296875 DOI: 10.1161/01.hyp.0000258566.95867.9e] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Corin activates pro–A-type naturetic peptide and pro–B-type naturetic peptide into biologically active molecules. We recently identified a minor allele in the corin gene defined by 2 highly linked single nucleotide polymorphisms (T555I and Q568P), which was associated with hypertension in blacks. Because of the direct antihypertrophic effects of the natriuretic peptide system, we hypothesized that the minor corin I555(P568) allele would be associated with an enhanced hypertrophic response to pressure overload. The relationship between systolic blood pressure and indexed left ventricular mass, derived from cardiac MRI, was analyzed in the Dallas Heart Study as a function of corin allele status. The Multi-Ethnic Study of Atherosclerosis was used as a validation cohort. All of the analyses were limited to self-identified blacks without treatment for hypertension. In addition, we genotyped 2114 markers highly informative for African ancestry in the Dallas Heart Study and derived a covariate representing African ancestry for multivariate models. In adjusted analysis, the corin I555(P568) allele was an independent predictor of left-ventricular mass in subjects with elevated systolic blood pressure. Linear spline regression analysis confirmed a significant interaction (
P
=0.002) between the corin I555(P568) allele and systolic blood pressure as a predictor of left ventricular mass in subjects with systolic blood pressure >120 mm Hg, and this nonlinear interaction was replicated in the Multi-Ethnic Study of Atherosclerosis. In the Dallas Heart Study, the corin I555(P568) allele was also associated with an increased odds for prevalent left ventricular hypertrophy in the presence of untreated hypertension. These data suggest that the corin I555(P568) allele represents a cardiac hypertrophy-sensitizing genetic locus in systemic hypertension.
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Affiliation(s)
- J Eduardo Rame
- Division of Cardiology, University of California San Francisco, USA
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Fox ER, Taylor J, Taylor H, Han H, Samdarshi T, Arnett D, Myerson M. Left ventricular geometric patterns in the Jackson cohort of the Atherosclerotic Risk in Communities (ARIC) Study: clinical correlates and influences on systolic and diastolic dysfunction. Am Heart J 2007; 153:238-44. [PMID: 17239683 DOI: 10.1016/j.ahj.2006.09.013] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2005] [Accepted: 09/16/2006] [Indexed: 01/19/2023]
Abstract
BACKGROUND The distribution and determinants of left ventricular (LV) geometric patterns and their relation to LV function in African Americans is not well described despite higher rates of LV hypertrophy and cardiovascular mortality reported in this group. PURPOSE This study investigates the distribution and clinical correlates of LV geometric patterns and how these patterns relate to function in a population-based African American cohort. METHODS The study population included participants in the Jackson cohort of ARIC, who underwent echocardiograms between 1993 and 1995. We defined 4 geometric patterns (normal geometry, concentric remodeling [CR], eccentric hypertrophy [EH], and concentric hypertrophy [CH]) according to LV mass index and relative wall thickness. Multiple logistic regression was used to assess the association of geometric patterns to systolic dysfunction and diastolic dysfunction, adjusting for traditional coronary risk factors. RESULTS There were 1849 participants in the study population (mean age 59 years, 65% women). Concentric remodeling and CH were highly prevalent. Concentric hypertrophy and EH groups had the highest rates of hypertension, obesity, and diabetes mellitus. Compared to the normal geometric pattern, EH was related to systolic dysfunction (OR 24.27, CI 6.71-87.80), and CH was related to diastolic dysfunction 1.58 (1.04-2.39). Concentric remodeling was not related to systolic or diastolic dysfunction. CONCLUSION In this large middle-aged African American cohort, CR and CH are prevalent. Hypertension, diabetes mellitus, and obesity are associated with both CH and EH. Concentric hypertrophy is strongly associated with diastolic dysfunction; EH is strongly associated with systolic dysfunction. Concentric remodeling, however, is not related to either systolic or diastolic dysfunction.
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Affiliation(s)
- Ervin R Fox
- The NHLBI's Jackson Heart Study, Jackson, MS 39216, USA.
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Cardiac Hypertrophy. CARDIOVASCULAR MEDICINE 2007. [DOI: 10.1007/978-1-84628-715-2_54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Rubattu S, Bigatti G, Evangelista A, Lanzani C, Stanzione R, Zagato L, Manunta P, Marchitti S, Venturelli V, Bianchi G, Volpe M, Stella P. Association of Atrial Natriuretic Peptide and Type A Natriuretic Peptide Receptor Gene Polymorphisms With Left Ventricular Mass in Human Essential Hypertension. J Am Coll Cardiol 2006; 48:499-505. [PMID: 16875975 DOI: 10.1016/j.jacc.2005.12.081] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2005] [Revised: 12/07/2005] [Accepted: 12/13/2005] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The goal of our study was to investigate the relationships between atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and type A natriuretic peptide receptor (NPRA) gene polymorphisms and left ventricular structure in human essential hypertension. BACKGROUND Experimental evidence supports a key role for natriuretic peptides in the modulation of cardiac mass. This relationship has not yet been described in human disease. METHODS A total of 203 hypertensive patients were studied by mono-bidimensional echocardiography. Three markers of the ANP gene (-C664G, G1837A, and T2238C polymorphisms) and a microsatellite marker of both NPRA and BNP genes were characterized. RESULTS Patients carrying the ANP gene promoter allelic variant had increased left ventricular mass index (117.4 +/- 1.7 g vs. 95.7 +/- 1.7 g, p = 0.005), left ventricular posterior wall thickness (1.14 +/- 0.07 cm vs. 0.96 +/- 0.01 cm, p < 0.0001), left ventricular septal thickness (1.12 +/- 0.10 cm vs. 1.04 +/- 0.01 cm, p = 0.01), and relative wall thickening (47.5 +/- 4.1% vs. 39.4 +/- 5.3%, p = 0.001) as compared with the wild-type genotype. These associations were independent from anthropometric factors and major clinical features and were confirmed in a large subgroup of never-treated hypertensive patients (n = 148). Carrier status of the ANP gene promoter allelic variant was associated with significantly lower plasma proANP levels: 1,395 +/- 104 fmol/ml versus 3,110 +/- 141 fmol/ml in hypertensive patients carrying the wild-type genotype (p < 0.05). A significant association for NPRA gene variants with left ventricular mass index and left ventricular septal thickness was found. The analysis of BNP did not reveal any effect on cardiac phenotypes. CONCLUSIONS Our findings show that the ANP/NPRA system significantly contributes to ventricular remodeling in human essential hypertension.
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Affiliation(s)
- Speranza Rubattu
- IRCCS Neuromed, Polo Molisano University of Rome La Sapienza, Pozzilli, Italy.
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Sharma P, Middelberg RPS, Andrew T, Johnson MR, Christley H, Brown MJ. Heritability of left ventricular mass in a large cohort of twins. J Hypertens 2006; 24:321-4. [PMID: 16508579 DOI: 10.1097/01.hjh.0000202815.18083.03] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Left ventricular hypertrophy is recognized as one of the most important independent predictors of adverse cardiovascular outcome. The aetiology of LVH includes a number of well-recognized causes but there is considerable interest in the genetics of cardiac muscle hypertrophy. We used a large prospective twin database in order to establish the heritability of left ventricular mass (LVM). METHODS Normotensive twins were prospectively recruited. Demographic data were collected. The LVM was determined using the Penn formulae derived from data collected from echocardiography. RESULTS A total of 376 Caucasian twin pairs (182 monozygotic and 194 dizygotic) aged 25-79 years were recruited. All subjects were normotensive with no significant differences in blood pressure (mean blood pressure: monozygotic twins, 132/83 mmHg; dizygotic twins, 131/82 mmHg) or body mass index between the monozygotic and dizygotic twins. The mean LVM for monozygotic twins was 140.9 g, compared with 140.2 g for dizygotic twins. Heritability estimates suggest that the genetic variance of LVM is 0.59 (95% confidence interval, 0.5-0.67). No common shared environmental effects were identified under this model. CONCLUSION Our data from the largest set of twin pairs studied to date show that LVM has a sizeable genetic basis that is probably polygenic. This result has important implications for the understanding of normal and abnormal cardiac morphology at the molecular level.
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Affiliation(s)
- Pankaj Sharma
- Department of Clinical Neuroscience, Hammersmith Hospitals & Imperial College, London, UK.
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Souzeau E, Llamas B, Bélanger S, Picard S, Deschepper CF. A genetic locus accentuates the effect of volume overload on adverse left ventricular remodeling in male and female rats. Hypertension 2005; 47:128-33. [PMID: 16344368 DOI: 10.1161/01.hyp.0000196732.22719.47] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although increased left ventricular (LV) mass is highly predictive of cardiovascular morbidity and mortality in humans, it has never been verified in an experimental model that naturally occurring alleles linked to increased LV mass under basal conditions also associate with worsened cardiovascular prognosis. Because we have shown previously that locus Cm24 on chromosome 5 was responsible for differences in LV mass between WKY and WKHA rats, we used WKY.WKHA-(D5Rat45-D5Rat245) congenic rats (where locus Cm24 has been transferred from WKHA into WKY rats) to test how naturally occurring gene variants present in Cm24 would, in addition to their effects under basal conditions, affect LV mass remodeling and/or function in the context of overload. Volume overload was induced in WKY, WKHA, and WKY.WKHA congenic rats by surgical creation of an aorto-caval fistula. In females, the fistula had no effect on the hearts of WKY rats, yet it induced dilated eccentric hypertrophy and isolated diastolic dysfunction in WKHA and WKY.WKHA congenic rats, along with signs of congestive heart failure. In males, the surgical maneuver induced only mild or inconsistent responses in WKY rats but had much more pronounced effects in WKHA and WKY.WKHA congenic rats. Altogether, our data show that a genetic locus that induces, under basal conditions, either mild or no concentric LV remodeling in either male or female rats, respectively, associates with LV dilatation and dysfunction in both sexes when the hearts are additionally challenged.
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Affiliation(s)
- Emmanuelle Souzeau
- Experimental Cardiovascular Biology Research Unit, Institut de Recherches Cliniques de Montréal, Quebec, Canada
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Llamas B, Jiang Z, Rainville ML, Picard S, Deschepper CF. Distinct QTLs are linked to cardiac left ventricular mass in a sex-specific manner in a normotensive inbred rat inter-cross. Mamm Genome 2005; 16:700-11. [PMID: 16245027 DOI: 10.1007/s00335-005-0041-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2005] [Accepted: 05/20/2005] [Indexed: 01/19/2023]
Abstract
Genetic mapping of the progeny of an F(2) inter-cross between WKY and WKHA rats had previously allowed us to detect male-specific linkage between locus Cm 24 and left ventricular mass index (LVMI). By further expanding that analysis, we detected additional loci that were all linked to LVMI in a sex-specific manner despite their autosomal location. In males, we detected one additional locus (Lvm 8) on Chromosome 5 (LOD=3.4), the two loci Lvm 13 (LOD=4.5) and Lvm 9 (LOD=2.8) on Chromosome 17, and locus Lvm 10 (LOD=4.2) on Chromosome 12. The locus Lvm 13 had the same boundaries as locus Cm 26 previously reported by others using a different cross. None of these loci showed linkage to LVM in females. In contrast, we identified in females the novel locus Lvm 11 on Chromosome 15 (LOD=2.8) and locus Lvm 12 (LOD=2.7) that had the same boundaries on Chromosome 3 as locus Cm 25 detected previously by others using a cross of other normotensive strains. In prepubertal males, there were no differences in the width of cardiomyocytes from WKY and WKHA rats, but cardiomyocytes from WKHA became progressively wider than that of WKY as sexual maturation progressed. Altogether, these results provide evidence that distinct genes may influence LVMI of rats in a sex-dependent manner, maybe by involving sex-specific interactions of sex steroids with particular genes involved in the determination of LVMI and/or cardiomyocyte width.
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Affiliation(s)
- Bastien Llamas
- Experimental Cardiovascular Biology Research Unit, Institut de Recherches Cliniques de Montréal (IRCM), Montreal, Quebec, Canada, H2W 1R7
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Juo SHH, Di Tullio MR, Lin HF, Rundek T, Boden-Albala B, Homma S, Sacco RL. Heritability of left ventricular mass and other morphologic variables in Caribbean Hispanic subjects: the Northern Manhattan Family Study. J Am Coll Cardiol 2005; 46:735-7. [PMID: 16098447 PMCID: PMC2692931 DOI: 10.1016/j.jacc.2005.05.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
| | - Marco R. Di Tullio
- Division of Cardiology, PH 3-342, Columbia-Presbyterian Medical Center, 630 West 168th Street, New York, NY 10032, E-mail:
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Inomata H, Watanabe T, Iizuka Y, Liang YQ, Mashimo T, Nabika T, Ikeda K, Yanai K, Gotoda T, Yamori Y, Isobe M, Kato N. Identification of quantitative trait loci for cardiac hypertrophy in two different strains of the spontaneously hypertensive rat. Hypertens Res 2005; 28:273-81. [PMID: 16097372 DOI: 10.1291/hypres.28.273] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cardiac hypertrophy and left ventricular hypertrophy are known to be substantially controlled by genetic factors. As an experimental model, we undertook genome-wide screens for cardiac mass in F2 populations bred from the stroke-prone spontaneously hypertensive rats (SHRSP) and normal spontaneously hypertensive rats (SHR) and Wistar Kyoto rats (WKY) of a Japanese colony. Two F2 cohorts were independently produced: F2(SHRSP x WKY) (110 male and 110 female rats) and F2(SHR x WKY) (151 male rats). The ratio of heart weight to body weight (Hw/Bw) was evaluated at 12 months of age in F2(SHRSP x WKY) after salt-loading for 7 months, and at around 15 weeks of age in F2(SHR x WKY) who had been fed a normal rat chow diet. Subsequent to an initial screen with 251 markers in F2(SHRSP x WKY) male progeny, 170 and 161 markers were selected and characterized in F2(SHRSP x WKY) female progeny and F2(SHR x WKY) male progeny, respectively. Markers from four chromosomal regions showed suggestive or significant linkage to Hw/Bw. The strongest and the most consistent linkage was found in the vicinity of D3Mgh16 on rat chromosome (RNO) 3 (a maximal log of the odds score reached 4.0 to 6.6 across the F2 populations studied). In the other three regions on RNO6, RNO10 and RNO13, the degree of linkage was more prominent in either males or females. These data provide solid evidence for a "principal" RNO3 quantitative trait loci regulating Hw/Bw in SHRSP and SHR, and also suggest the possible presence of sexual dimorphism in regard to genetic susceptibility for cardiac hypertrophy.
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Affiliation(s)
- Hyoe Inomata
- Department of Gene Diagnostics and Therapeutics, Research Institute, International Medical Center of Japan, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
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43
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Hannukainen JC, Kujala UM, Toikka J, Heinonen OJ, Kapanen J, Vahlberg T, Kaprio J, Kalliokoski KK. Cardiac structure and function in monozygotic twin pairs discordant for physical fitness. J Appl Physiol (1985) 2005; 99:535-41. [PMID: 15817727 DOI: 10.1152/japplphysiol.00107.2005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cross-sectional studies in athletes and untrained subjects suggest that exercise training induces adaptations in cardiac structure and function. However, the role of genetic variation on the results has largely been ignored in these studies. The purpose of this study was to investigate the effects of long-term volitionally increased physical activity on electrocardiographic and echocardiographic parameters in male monozygotic twin pairs discordant for physical activity and fitness. On the basis of the mailed questionnaires, a telephone interview, and the inclusion criteria, 12 pairs of young adult male monozygotic twins were recruited from a Finnish twin cohort. All subjects completed a maximal oxygen uptake (V̇o2 max) test and electrocardiography and echocardiography studies. Nine pairs had at least 9% difference in V̇o2 max and were selected for further analysis and for a second echocardiography study. Twins were divided into the more (MAG) and less active group (LAG), according to their V̇o2 max. On average, MAG had 18% higher V̇o2 max compared with LAG. In electrocardiography, MAG had 29% ( P = 0.02) higher Cornell voltage and 37% ( P = 0.01) higher right-side hypertrophy index. In echocardiography, no significant differences were observed between the groups, and left ventricular mass index was only 7% ( P = 0.16) higher in MAG. These results show that the volitionally increased physical activity that has led to an 18% increase in cardiorespiratory fitness induces greater changes in electro- than echocardiographic parameters. Electrocardiographic changes were suggestive of left ventricular hypertrophy, and echocardiography showed a similar but statistically nonsignificant trend.
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Affiliation(s)
- Jarna C Hannukainen
- Turku PET Centre, Department of Biostatics, University of Turku, PO Box 52, FIN-20521 Turku, Finland.
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Liljedahl U, Kahan T, Malmqvist K, Melhus H, Syvänen AC, Lind L, Kurland L. Single nucleotide polymorphisms predict the change in left ventricular mass in response to antihypertensive treatment. J Hypertens 2005; 22:2321-8. [PMID: 15614026 DOI: 10.1097/00004872-200412000-00014] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Our aim was to determine whether the change in left ventricular (LV) mass in response to antihypertensive treatment could be predicted by multivariate analysis of single nucleotide polymorphisms (SNPs) in candidate genes reflecting pathways likely to be involved in blood pressure control. METHODS Patients with mild to moderate primary hypertension and LV hypertrophy were randomized in a double-blind fashion to treatment with either the angiotensin II type 1 receptor antagonist irbesartan (n = 48) or the beta1 adrenoreceptor blocker atenolol (n = 49). A microarray-based minisequencing system was used for genotyping 74 SNPs in 25 genes. These genotypes were related to the change in LV mass index by echocardiography, after 12 weeks treatment as monotherapy, using stepwise multiple regression analysis. RESULTS The blood pressure reductions were similar and significant in both treatment groups. Two SNPs in two separate genes (the angiotensinogen T1198C polymorphism, corresponding to the M235T variant and the apolipoprotein B G10108A polymorphism) for those treated with irbesartan, and the adrenoreceptor alpha2A A1817G for those treated with atenolol, significantly predicted the change in LV mass. The predictive power of these SNPs was independent of the degree of blood pressure reduction. CONCLUSION SNPs in the angiotensinogen, apolipoprotein B, and the alpha2 adrenoreceptor gene predicted the change in LV mass during antihypertensive therapy. These results illustrate the potential of using microarray-based technology for SNP genotyping in predicting individual drug responses.
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Dwyer JP, Kostka V, Harrap SB, Di Nicolantonio R. Sequence analysis of the fibroblast growth factor 2 gene from the spontaneously hypertensive and hypertrophic heart rats. Clin Exp Hypertens 2004; 26:209-18. [PMID: 15132299 DOI: 10.1081/ceh-120030230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
We have previously reported a quantitative trait locus associated with pressure-independent cardiac hypertrophy in the spontaneously hypertensive rat (SHR) of the Okamoto strain. This locus (Lvm1; left ventricular mass locus 1) contains the gene Fgf2 that codes for the potent cardiac growth factor, Fibroblast Growth Factor 2 (FGF2). Given that FGF2 appears essential for the induction of certain forms of cardiac hypertrophy in the rat, we proposed this gene as a candidate for the cardiac enlargement seen in the SHR. Previous reports of elevated FGF2 mRNA levels in the SHR, led us to hypothesise that nucleotide sequence variations occurring in the coding regions or in putative transcriptional factor binding sites within the Fgf2 promoter might play a role in cardiac hypertrophy in this strain. Given that we have also recently derived from the SHR a rat strain that develops spontaneous cardiac hypertrophy in the absence of hypertension (the Hypertrophic Heart Rat; HHR), we also took the opportunity to examine the sequence of its Fgf2 promoter and coding region. However, extensive sequence analysis of the promoter and coding regions of the SHR and HHR Fgf2 genes failed to reveal any nucleotide variations between strains. Thus, we conclude that variations in the nucleotide sequence of the promoter and coding region of the SHR Fgf2 gene do not play a role in the cardiac hypertrophy of the SHR and HHR strains.
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Affiliation(s)
- Jeremy P Dwyer
- Department of Physiology, University of Melbourne, Victoria, Australia
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Sakka Y, Babazono T, Sato A, Ujihara N, Iwamoto Y. ACE gene polymorphism, left ventricular geometry, and mortality in diabetic patients with end-stage renal disease. Diabetes Res Clin Pract 2004; 64:41-9. [PMID: 15036826 DOI: 10.1016/j.diabres.2003.10.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2003] [Revised: 09/18/2003] [Accepted: 10/07/2003] [Indexed: 11/25/2022]
Abstract
The objectives of this study were to determine the association between angiotensin converting enzyme (ACE) gene polymorphism and left ventricular (LV) geometry, and to clarify independent effects of ACE genotype on mortality after commencing dialysis in diabetic patients with end-stage renal disease (ESRD). A total of 106 diabetic patients, 71 men and 35 women, 11 type 1 and 95 type 2 diabetic, 57 +/- 12 (mean +/- standard deviation (S.D.)) years of age, who started dialysis were studied. Patients with cardiac diseases and those treated with ACE inhibitors were excluded because of potential effects on LV performance. Echocardiographic examination was performed within +/-2 months of the start of dialysis. Relation between ACE genotype and LV mass index (LVMI) or relative wall thickness (RWT) at onset of dialysis, and impact of ACE genotype on survival after commencing dialysis were evaluated. There were no significant differences in LVMI or RWT in the three ACE genotype groups at onset of dialysis. However, mortality of patients with the ACE-DD genotype was significantly higher than patients with the DI and II genotypes (hazard ratio, 2.318; P=0.043), based on a survival analysis with a mean follow-up duration of 60 months. The higher mortality in patients with the DD genotype was confirmed to be independent of LV hypertrophy and increases in RWT. In diabetic patients with ESRD, ACE genotype has no association with LV mass or RWT at the start of dialysis, but does have an independent impact on patient survival thereafter.
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MESH Headings
- Creatinine/blood
- Diabetes Mellitus, Type 1/enzymology
- Diabetes Mellitus, Type 1/genetics
- Diabetes Mellitus, Type 1/mortality
- Diabetic Nephropathies/blood
- Diabetic Nephropathies/enzymology
- Diabetic Nephropathies/genetics
- Diabetic Nephropathies/mortality
- Echocardiography
- Female
- Genotype
- Hematocrit
- Humans
- Kidney Failure, Chronic/blood
- Kidney Failure, Chronic/enzymology
- Kidney Failure, Chronic/genetics
- Kidney Failure, Chronic/mortality
- Male
- Middle Aged
- Peptidyl-Dipeptidase A/genetics
- Polymorphism, Genetic/genetics
- Sex Characteristics
- Survival Analysis
- Ventricular Dysfunction, Left/epidemiology
- Ventricular Function, Left/physiology
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Affiliation(s)
- Yumiko Sakka
- Division of Nephrology and Hypertension, Diabetes Center, Tokyo Women's Medical University School of Medicine, 8-1 Kawadacho, Shinjukuku, Tokyo 162-8666, Japan
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Nystrom FH. Meta-analysis suggests regression of left ventricular hypertrophy during antihypertensive treatment is linked to reduced risk of cardiovascular disease. EVIDENCE-BASED CARDIOVASCULAR MEDICINE 2004; 8:22-3; discussion 24-5. [PMID: 16379885 DOI: 10.1016/j.ebcm.2003.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
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Sartori M, Parotto E, Pagnin E, Cattelan F, Ceolotto G, Papparella I, Lenzini L, Cal?? LA, Semplicini A. G-Protein ??3-Subunit Gene C825T Polymorphism and Cardiovascular Risk. High Blood Press Cardiovasc Prev 2004. [DOI: 10.2165/00151642-200411030-00003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Abstract
Experimental and clinical studies provide evidence that hypertension is causally related to adverse cardiac structural changes, such as LA enlargement, LV hypertrophy and myocardial fibrosis, and functional changes inclusive of LV systolic and diastolic dysfunction. These changes are induced by both hemodynamic and nonhemodynamic factors. There is accumulating evidence from several small and large clinical trials that various classes of antihypertensive therapy prevent and regress LVH and myocardial fibrosis. Prevention and reversal of LVH are associated with an improvement in cardiac function and with a decline in risk of adverse cardiovascular outcomes. Prevention of LVH should be a priority in subjects with hypertension. In patients with hypertensive heart disease, the components of therapy must comprise optimization of BP and regression of LVH. Future targets of therapy in hypertensive heart disease may include regression of myocardial fibrosis, normalization of LA size, and improvement in LV diastolic function.
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Affiliation(s)
- Satish Kenchaiah
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
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Siegel AK, Planert M, Rademacher S, Mehr AP, Kossmehl P, Wehland M, Stoll M, Kreutz R. Genetic loci contribute to the progression of vascular and cardiac hypertrophy in salt-sensitive spontaneous hypertension. Arterioscler Thromb Vasc Biol 2003; 23:1211-7. [PMID: 12775577 DOI: 10.1161/01.atv.0000079509.20542.c9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The salt-sensitive Dahl rat and the spontaneously hypertensive rat develop comparable spontaneous hypertension on a low-salt diet, whereas only the salt-sensitive Dahl rat strain develops a striking increase in blood pressure and cardiovascular hypertrophy on a high-salt diet. We set out to identify quantitative trait loci (QTLs) contributing to the progression of salt-induced organ damage in hypertension by studying an F2 population derived from both strains. METHODS AND RESULTS We determined systolic blood pressure (SBP), vascular aortic hypertrophy (AH), cardiac left ventricular (LV) hypertrophy (LVH), and LV fibrosis in 230 male F2-animals on a high-salt diet. A strong correlation between AH and LVH was found (r=0.58, P<0.0001), and genome-wide QTL mapping detected suggestive or significant QTLs in overlapping chromosomal fragments for AH and LVH on chromosomes 1, 3, and 19, respectively. A significant influence of SBP on the extent of LVH and AH was evident at all QTLs, although significant linkage to SBP (together with LVH) was only found on chromosome 9. No QTLs for LV fibrosis were detected. CONCLUSIONS This study demonstrates a strong correlation between AH and LVH in salt-sensitive hypertension and identifies QTLs contributing to the progression of cardiovascular hypertrophy in this condition.
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