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Lv S, Jiao H, Zhong X, Qu Y, Zhang M, Wang R. Association between intensity of physical activity and cognitive function in hypertensive patients: a case-control study. Sci Rep 2024; 14:10106. [PMID: 38697999 PMCID: PMC11065981 DOI: 10.1038/s41598-024-59457-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/10/2024] [Indexed: 05/05/2024] Open
Abstract
Previous studies have shown that a higher intensity of physical activity (PA) is associated with a lower risk of cognitive impairment (CI), whereas hypertension is associated with higher CI. However, there are few studies on the association between PA intensity and cognitive function in hypertensive patients. This study investigated the association between PA intensity and cognitive function in hypertensive patients. A total of 2035 hypertensive patients were included in this study, including 407 hypertensive patients with CI and 1628 hypertensive patients with normal cognitive function matched 1:4 by age and sex. The International Physical Activity Questionnaire-Long Form and the Mini-mental State Examination were used to evaluate PA intensity, total metabolic equivalents, and cognitive function in patients with hypertension. Multivariate logistic regression was used to analyze the correlation between PA intensity and CI in hypertensive patients. The Spearman correlation coefficient was used to analyze the correlation between PA intensity and the total score of each component of the MMSE and the correlation between PA total metabolic equivalents and cardiac structure in hypertensive patients. After adjusting for all confounding factors, PA intensity was negatively associated with CI in hypertensive patients (OR = 0.608, 95% CI: 0.447-0.776, P < 0.001), and this association was also observed in hypertensive patients with education level of primary school and below and junior high school and above (OR = 0.732, 95% CI: 0.539-0.995, P = 0.047; OR = 0.412, 95% CI: 0.272-0.626, P < 0.001). The intensity of PA in hypertensive patients was positively correlated with orientation (r = 0.125, P < 0.001), memory (r = 0.052, P = 0.020), attention and numeracy (r = 0.151, P < 0.001), recall ability (r = 0.110, P < 0.001), and language ability (r = 0.144, P < 0.001). PA total metabolic equivalents in hypertensive patients were negatively correlated with RVEDD and LAD (r = - 0.048, P = 0.030; r = - 0.051, P = 0.020) and uncorrelated with LVEDD (r = 0.026, P = 0.233). Higher PA intensity reduced the incidence of CI in hypertensive patients. Therefore, hypertensive patients were advised to moderate their PA according to their circumstances.
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Affiliation(s)
- Shunxin Lv
- First Clinical Medical School, Shandong University of Traditional Chinese Medicine, No. 42, Wenhua West Road, Lixia District, Jinan, Shandong, People's Republic of China
| | - Huachen Jiao
- Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 42, Wenhua West Road, Lixia District, Jinan, Shandong, People's Republic of China.
| | - Xia Zhong
- Shandong University of Traditional Chinese Medicine, Jinan, People's Republic of China
| | - Ying Qu
- Shandong University of Traditional Chinese Medicine, Jinan, People's Republic of China
| | - Mengdi Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, People's Republic of China
| | - Rui Wang
- Shandong University of Traditional Chinese Medicine, Jinan, People's Republic of China
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Sjúrðarson T, Kyhl K, Nordsborg NB, Kollslíð R, Andersen LJ, Krustrup P, Mohr M. 15 weeks of soccer training increases left ventricular mass and improves indices of left ventricular diastolic function in previously sedentary, mildly hypertensive, middle-aged women. Eur J Appl Physiol 2024; 124:1621-1629. [PMID: 38177568 PMCID: PMC11055800 DOI: 10.1007/s00421-023-05399-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE To investigate the impact of soccer training on cardiac adaptations in mildly hypertensive middle-aged women. METHODS Hypertensive premenopausal women (n = 41; age (mean ± SD): 44 ± 7 years; height: 166 ± 6 cm; weight: 78.6 ± 11.6 kg; body fat: 43.3 ± 5.2%) were randomized to soccer training (SOC, n = 21) or control (CON, n = 20). SOC performed three weekly training sessions for 15 weeks, whereas CON had no training or lifestyle changes during the same period. Cardiac structure and function were assessed by echocardiography pre-intervention and post-intervention. RESULTS Soccer training increased (P = 0.001) left ventricular mass index by 10% [95% CI 4; 15], while no changes occurred in CON (time × group interaction, P = 0.005). In addition, only SOC demonstrated a within-group increase (P = 0.01) of 8% [95% CI 2; 14] in left ventricular septum diameter. For markers of right ventricular remodelling, a within-group increase (P = 0.02) occurred for tricuspid annulus plane systolic excursion of 8% [95% CI 1; 14] in SOC only. Left atrial diameter index increased (P < 0.001) by 6% [95% CI 3; 10] after SOC, while it was unaffected in CON (time × group interaction, P = 0.02). For makers of diastolic function, SOC demonstrated a within-group increase (P = 0.02) in the average early diastolic mitral annulus velocity of 10% [95% CI 2; 19]. In addition, a reduction (P < 0.001) in mitral valve A velocity of - 19% [95% CI - 29; - 10] was observed following soccer training, which manifested in increased (P < 0.001) mitral valve E/A ratio of 34% [95% CI 16; 53] in SOC. No within-group changes were apparent in CON. CONCLUSION In sedentary, mildly hypertensive, middle-aged women, 15 weeks of soccer training increases left ventricular mass and left atrial diameter and improves indices of left ventricular diastolic function.
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Affiliation(s)
- Tórur Sjúrðarson
- Centre of Health Science, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Kyhl
- Centre of Health Science, Department of Medicine, The Faroese National Hospital, Tórshavn, Faroe Islands
- Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
| | - Nikolai B Nordsborg
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Rudi Kollslíð
- Centre of Health Science, Department of Medicine, The Faroese National Hospital, Tórshavn, Faroe Islands
| | - Lars Juel Andersen
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, 5250, Odense M, Denmark
- Danish Institute for Advanced Study (DIAS), University of Southern Denmark, Odense M, Denmark
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Magni Mohr
- Centre of Health Science, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands.
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, 5250, Odense M, Denmark.
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Cao J, Ma X, Deng Y, Wang H, Zhang S, Zhao L, Cao F. Comparative analysis of the clinical features of nonvalvular atrial fibrillation among Tibetan, Han, and Hui patients in Qinghai Province, China. Heart Lung 2024; 66:9-15. [PMID: 38518405 DOI: 10.1016/j.hrtlng.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/29/2024] [Accepted: 03/10/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Global nonvalvular AF rises, impacting health severely. In Qinghai, China's diverse setting, studying AF among varied ethnic groups is crucial OBJECTIVES: The purpose of this study was to compares cardiac features in AF among Tibetan, Han, and Hui patients to develop tailored prevention and treatment strategies for this region, the goal was to enhance the understanding of AF and provide an empirical basis for developing prevention and treatment strategies specific to this region METHODS: This study included a total of 3445 Tibetan, Han, and Hui patients diagnosed with nonvalvular atrial fibrillation and treated at the Qinghai Cardiovascular and Cerebrovascular Specialist Hospital, China, between January 2019 and January 2021. We analyzed the differences in cardiac structure, comorbidities, and other influencing factors among the different ethnic groups RESULTS: We found significant differences in gender, age, smoking history, lone atrial fibrillation, left heart failure, dilated cardiomyopathy, and diabetes between Tibetan, Han, and Hui patients (P < 0.05). Tibetan, Han, and Hui patients also differed with regard to left ventricular end-diastolic volume, left ventricular ejection fraction, fractional shortening, NT-proBNP, glycated hemoglobin, red blood cell distribution width, platelet count, platelet hematocrit, platelet distribution width, homocysteine (Hcy), C-reactive protein, and superoxide dismutase (SOD) (P < 0.05) CONCLUSION: Our study revealed variations in comorbidities, cardiac structure, and blood indexes among Tibetan, Han, and Hui AF patients, highlighting distinct patterns in complications and biomarker levels across ethnic groups.
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Affiliation(s)
- Jiandong Cao
- Qinghai Province Cardio Cerebrovascular Disease Specialist Hospital, No.7 of Zhuanchang Road, Chengzhong District, Xining City, Qinghai Province 810012, China
| | - Xiaofeng Ma
- Qinghai Province Cardio Cerebrovascular Disease Specialist Hospital, No.7 of Zhuanchang Road, Chengzhong District, Xining City, Qinghai Province 810012, China.
| | - Yong Deng
- Qinghai Province Cardio Cerebrovascular Disease Specialist Hospital, No.7 of Zhuanchang Road, Chengzhong District, Xining City, Qinghai Province 810012, China
| | - Hong Wang
- Qinghai Province Cardio Cerebrovascular Disease Specialist Hospital, No.7 of Zhuanchang Road, Chengzhong District, Xining City, Qinghai Province 810012, China
| | - Shengqi Zhang
- Qinghai Province Cardio Cerebrovascular Disease Specialist Hospital, No.7 of Zhuanchang Road, Chengzhong District, Xining City, Qinghai Province 810012, China
| | - Longxiang Zhao
- Qinghai University Affiliated Hospital, Xining City, Qinghai Province 810001, China
| | - Feifei Cao
- Qinghai Province Cardio Cerebrovascular Disease Specialist Hospital, No.7 of Zhuanchang Road, Chengzhong District, Xining City, Qinghai Province 810012, China
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Massarotto RJ, Campbell AJ, Kreiter E, Claydon VE, Cote AT. Effects of detraining on left ventricular mass in endurance-trained individuals: a systematic review and meta-analysis. Eur J Prev Cardiol 2024; 31:415-424. [PMID: 37821393 DOI: 10.1093/eurjpc/zwad327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 10/13/2023]
Abstract
AIMS Detraining refers to a loss of training adaptations resulting from reductions in training stimulus due to illness, injury, or active recovery breaks in a training cycle and is associated with a reduction in left ventricular mass (LVM). The purpose of this study was to conduct a systematic review and meta-analysis to determine the influence of detraining on LVM in endurance-trained, healthy individuals. METHODS AND RESULTS Using electronic databases (e.g. EMBASE and MEDLINE), a literature search was performed looking for prospective detraining studies in humans. Inclusion criteria were adults, endurance-trained individuals with no known chronic disease, detraining intervention >1 week, and pre- and post-detraining LVM reported. A pooled statistic for random effects was used to assess changes in LVM with detraining. Fifteen investigations (19 analyses) with a total of 196 participants (ages 18-55 years, 15% female) met inclusion criteria, with detraining ranging between 1.4 and 15 weeks. The meta-analysis revealed a significant reduction in LVM with detraining (standardized mean difference = -0.586; 95% confidence interval = -0.817, -0.355; P < 0.001). Independently, length of detraining was not correlated with the change in LVM. However, a meta-regression model revealed length of the detraining, when training status was accounted for, was associated with the reduction of LVM (Q = 15.20, df = 3, P = 0.0017). Highly trained/elite athletes had greater reductions in LVM compared with recreational and newly trained individuals (P < 0.01). Limitations included relatively few female participants and inconsistent reporting of intervention details. CONCLUSION In summary, LVM is reduced following detraining of one week or more. Further research may provide a greater understanding of the effects of sex, age, and type of detraining on changes in LVM in endurance-trained individuals.
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Affiliation(s)
- Raffaele J Massarotto
- Integrative Cardiovascular Physiology Laboratory, School of Human Kinetics, Trinity Western University, 25000 University Drive, Langley, BC V2Y 1Y1, Canada
- Cardiovascular Physiology Laboratory, Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada
| | - Allison J Campbell
- Integrative Cardiovascular Physiology Laboratory, School of Human Kinetics, Trinity Western University, 25000 University Drive, Langley, BC V2Y 1Y1, Canada
- Cardiovascular Physiology Laboratory, Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada
| | - Elizabeth Kreiter
- Norma Marion Alloway Library, Trinity Western University, 25000 University Drive, Langley, V2Y 1Y1, Canada
| | - Victoria E Claydon
- Cardiovascular Physiology Laboratory, Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada
| | - Anita T Cote
- Integrative Cardiovascular Physiology Laboratory, School of Human Kinetics, Trinity Western University, 25000 University Drive, Langley, BC V2Y 1Y1, Canada
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Mancusi C, Manzi MV, Lembo M, Fucile I, Basile C, Bardi L, Morisco C, De Luca N, Bossone E, Trimarco B, Izzo R, de Simone G, Esposito G. Normalization of ascending aorta dimension for body size influences pathophysiologic correlation in hypertensive patients: the Campania Salute Network. Eur J Prev Cardiol 2023; 30:1774-1780. [PMID: 37409686 DOI: 10.1093/eurjpc/zwad224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/27/2023] [Accepted: 07/04/2023] [Indexed: 07/07/2023]
Abstract
AIMS In the present study, we assessed correlates and their consistency of ascending aorta (AscAo) measurement in treated hypertensive patients. METHODS AND RESULTS A total of 1634 patients ≥ 18 years old with available AscAo ultrasound were included. Ascending aorta was measured at end-diastole with leading edge to leading edge method, perpendicular to the long axis of the aorta in parasternal long-axis view at its maximal identifiable dimension. Correlations of AscAo and AscAo normalized for height (AscAo/HT) or body surface area (AscAo/BSA) with demographics and metabolic profile were explored. Multi-variable regression was also used to identify potential confounders influencing univariate correlations. Sensitivity analysis was performed using cardiovascular (CV) outcome. Correlations with age, estimated glomerular filtration rate, systolic blood pressure (BP), and heart rate (HR) were similar among the three aortic measures. Women exhibited smaller AscAo but larger AscAo/BSA than men with AscAo/HT offsetting the sex difference. Obesity and diabetes were associated with greater AscAo and AscAo/HT but with smaller AscAo/BSA (all P < 0.001). In multi-variable regression model, all aortic measure confirmed the sign of their relations with sex and metabolic profile independently of age, BP, and HR. In Kaplan-Mayer analysis, only dilated AscAo and AscAo/HT were significantly associated with increased risk of CV events (both P < 0.008). CONCLUSIONS Among patients with long-standing controlled systemic hypertension, magnitude of aortic remodelling is influenced by the type of the measure adopted, with physiological consistency only for AscAo and AscAo/HT, but not for AscAo/BSA.
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Affiliation(s)
- Costantino Mancusi
- Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University, Via S. Pansini 5, Naples 80131, Italy
| | - Maria Virginia Manzi
- Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University, Via S. Pansini 5, Naples 80131, Italy
| | - Maria Lembo
- Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University, Via S. Pansini 5, Naples 80131, Italy
| | - Ilaria Fucile
- Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University, Via S. Pansini 5, Naples 80131, Italy
| | - Christian Basile
- Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University, Via S. Pansini 5, Naples 80131, Italy
| | - Luca Bardi
- Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University, Via S. Pansini 5, Naples 80131, Italy
| | - Carmine Morisco
- Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University, Via S. Pansini 5, Naples 80131, Italy
| | - Nicola De Luca
- Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University, Via S. Pansini 5, Naples 80131, Italy
| | - Eduardo Bossone
- Department of Public Health, Federico II University, Naples, Italy
| | - Bruno Trimarco
- Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University, Via S. Pansini 5, Naples 80131, Italy
| | - Raffaele Izzo
- Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University, Via S. Pansini 5, Naples 80131, Italy
| | - Giovanni de Simone
- Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University, Via S. Pansini 5, Naples 80131, Italy
| | - Giovanni Esposito
- Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University, Via S. Pansini 5, Naples 80131, Italy
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Lei Y, Tong J, Su Y, Wang Y, Zhong B, Wang Q, Zhang Y. Risk factors of left ventricular diastolic dysfunction in maintenance hemodialysis patients. BMC Nephrol 2023; 24:166. [PMID: 37308865 DOI: 10.1186/s12882-023-03220-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/29/2023] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVE To investigate the risk factors of left ventricular diastolic dysfunction in maintenance hemodialysis (MHD) patients. METHOD We retrospectively collected data from 363 hemodialysis patients who were on dialysis for at least 3 months at January 1, 2020. According to the echocardiogram results, these patients were divided into left ventricular diastolic dysfunction (LVDD) group and non-LVDD group. The differences in basic data, cardiac structure and functiona between the two groups were analyzed. Logistic regression analysis was used to analyze the risk factors of cardiac diastolic dysfunction in MHD patients. RESULTS Compared with the non-LVDD group, patients in the LVDD group were older, with an increased proportion of coronary heart disease, more prone to chest tightness, shortness of breath. Simultaneously, they had a significantly increased (p < 0.05) proportion of cardiac structural abnormalities such as left ventricular hypertrophy, left heart enlargement and systolic dysfunction. Multivariate logistic regression analysis showed that the risk of LVDD was significantly increased in elderly MHD patients older than 60 years (OR = 3.86, 95%CI 1.429-10.429), and left ventricular hypertrophy was also significantly associated with LVDD (OR = 2.227, 95% CI 1.383-3.586). CONCLUSION According to research, both age and left ventricular hypertrophy are risk factors for LVDD in MHD patients. It is recommended that early intervention for LVDD should be implemented to improve the quality of dialysis and reduce the incidence of cardiovascular events in MHD patients.
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Affiliation(s)
- Ying Lei
- Department of Nephrology, Huadu District People's Hospitalof Guangzhou, Southern Medical University, Guangzhou, 510800, China
| | - JinYan Tong
- Department of Nephrology, Huadu District People's Hospitalof Guangzhou, Southern Medical University, Guangzhou, 510800, China
| | - YanYan Su
- Department of Nephrology, Huadu District People's Hospitalof Guangzhou, Southern Medical University, Guangzhou, 510800, China
| | - YuQuan Wang
- Department of Nephrology, Huadu District People's Hospitalof Guangzhou, Southern Medical University, Guangzhou, 510800, China
| | - BiXian Zhong
- Department of Nephrology, Huadu District People's Hospitalof Guangzhou, Southern Medical University, Guangzhou, 510800, China
| | - Qi Wang
- Department of Nephrology, Huadu District People's Hospitalof Guangzhou, Southern Medical University, Guangzhou, 510800, China
| | - YunFang Zhang
- Department of Nephrology, Huadu District People's Hospitalof Guangzhou, Southern Medical University, Guangzhou, 510800, China
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Huang S, Lan Y, Zhang C, Zhang J, Zhou Z. The Early Effects of Bariatric Surgery on Cardiac Structure and Function: a Systematic Review and Meta-Analysis. Obes Surg 2023; 33:453-468. [PMID: 36508155 DOI: 10.1007/s11695-022-06366-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 10/28/2022] [Accepted: 11/18/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND This meta-analysis was performed to investigate how cardiac structures and functions change in the very early stage after bariatric surgery. MATERIALS AND METHODS We thoroughly searched the PubMed, Embase, Cochrane Library, and Web of Science databases for articles including patients who underwent bariatric surgery and examined the changes of their cardiac indices. Results were pooled by using Review Manager 5.1 and Stata 12.0. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) were obtained. The I-squared (I2) test was used to determine the heterogeneity between studies. To identify publication bias, funnel plots and Egger's test were utilized. The leave-one-out method was used to conduct sensitivity analysis. RESULTS In this meta-analysis, 24 research including 942 patients were considered. According to our findings, most cardiac indices changed 3-6 months following bariatric surgery. An improvement in cardiac geometry was reflected by a reduction in left ventricular mass (LVM) (WMD = - 22.06, 95% CI = (- 27.97, - 16.16)). The left ventricular diastolic function improved, as reflected by the decrease in the E/e' ratio (WMD = - 0.90, 95% CI = (- 1.83, - 0.16)). Left ventricular ejection fraction (LVEF) did not show an obvious change (WMD = 0.94, 95% CI = (- 0.19, 2.07)), while a more sensitive indicator of left ventricular systolic function, left ventricular longitudinal strain (LV LS), increased (WMD = - 2.43, 95% CI = (- 3.96, - 0.89)). CONCLUSION This meta-analysis includes the newest and most comprehensive cardiac indices to prove that cardiac structures and functions are improved early after bariatric surgery, which has not been reported by any other studies.
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Affiliation(s)
- Shanya Huang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.,Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yi Lan
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.,Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Chunlan Zhang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Jingjing Zhang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
| | - Zhiguang Zhou
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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Esparham A, Shoar S, Kheradmand HR, Ahmadyar S, Dalili A, Rezapanah A, Zandbaf T, Khorgami Z. The Impact of Bariatric Surgery on Cardiac Structure, and Systolic and Diastolic Function in Patients with Obesity: A Systematic Review and Meta-analysis. Obes Surg 2023; 33:345-361. [PMID: 36469205 DOI: 10.1007/s11695-022-06396-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/07/2022]
Abstract
The purpose of this study was to provide pooled data from all studies on the impact of bariatric surgery on cardiac structure, and systolic and diastolic function evaluated by either echocardiography or cardiac magnetic resonance. PubMed, Web of Science, Embase, and Scopus databases were searched. Almost all of cardiac left-side structural indices improved significantly after bariatric surgery. However, right-side structural indices did not change significantly. Left ventricular ejection fraction and most of the diastolic function indices improved significantly after the bariatric surgery. The subgroup analysis showed that the left ventricular mass index decreased more in long-term follow-up (≥ 12 months). In addition, subgroup analysis of studies based on surgery type did not reveal any difference in outcomes between gastric bypass and sleeve gastrectomy groups.
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Affiliation(s)
- Ali Esparham
- Student Research Committee, College of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Shoar
- Department of Clinical Research, ScientificWriting Corp, Houston, TX, USA
| | - Hamid Reza Kheradmand
- Student Research Committee, College of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Soheil Ahmadyar
- Student Research Committee, College of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Dalili
- Department of Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Surgical Oncology Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Rezapanah
- Department of Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Surgical Oncology Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Tooraj Zandbaf
- Department of Surgery, School of Medicine, Islamic Azad University, Mashhad, Iran
| | - Zhamak Khorgami
- Department of Surgery, University of Oklahoma College of Community Medicine, Tulsa, OK, USA.
- Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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Saidu H, Mohammed IY, Ishaq NA, Balarabe SA, Tukur J, Adedeji TA, Makinde ON, Adebayo RA, Umar H, Isezuo SA, Karaye KM. Impact of Parity on Cardiac Structure and Function in Apparently Healthy Pregnant Nigerian Women. West Afr J Med 2022; 39:1057-1061. [PMID: 36260810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND There are few and conflicting reports in the literature about the relationship between parity and maternal cardiac function. The study aimed to assess the impact of parity on cardiac structure and function in apparently healthy pregnant women in Nigeria. METHODS This was a cross-sectional study carried out in 3 tertiary centers in Kano, and 1 in Ile-Ife, Nigeria. 112 apparently healthy pregnant women were consecutively recruited between the 28th and 38th weeks of gestation, and their cardiac structure and function assessed using echocardiography. Left ventricular (LV) systolic dysfunction was defined as LV ejection fraction of below 50%, and diastolic dysfunction was graded using mitral filling and tissue Doppler velocities. RESULTS LV systolic dysfunction and diastolic dysfunction were found in 6 (5.4%) subjects and 20 (17.9%) subjects, respectively. Age (p= <0.0001), left atrial (LA) size (P<0.0001), interventricular septal thickness at end diastole (IVSD) (p= 0.005), posterior wall thickness at end diastole (PWTD) (p=0.004) and QRS duration (p= <0.0001) all increased progressively with higher parity, while tricuspid annular systolic excursion (p=0.320) decreased with higher parity. There was significant positive correlation between parity and age (r= 0.475, p= <0.0001), LA size (r=0.332, p= <0.0001), IVSD (r=0.264, p= 0.005) and PWTD (r= 0.343, p= <0.0001). LV systolic function was not significantly associated with parity. CONCLUSION Our findings suggested that parity was significantly associated with myocardial remodeling in apparently healthy pregnant women.
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Affiliation(s)
- H Saidu
- Department of Medicine, Bayero University, Kano, Kano State, Nigeria
- Department of Medicine, Murtala Mohammed Specialist Hospital, Kano, Kano State, Nigeria
| | - I Y Mohammed
- Department of Medicine, Bayero University, Kano, Kano State, Nigeria
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria
| | - N A Ishaq
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria
| | - S A Balarabe
- Department of Medicine, Mohammed Abdullahi Wase Specialist Hospital, Kano, Kano State, Nigeria
| | - J Tukur
- Department of Medicine, Bayero University, Kano, Kano State, Nigeria
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria
| | - T A Adedeji
- Department of Chemical Pathology, Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun State, Nigeria
| | - O N Makinde
- Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun State, Nigeria
| | - R A Adebayo
- Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun State, Nigeria
| | - H Umar
- Department of Medicine, Usman Danfodio University Teaching Hospital, Sokoto, Nigeria. 9
| | - S A Isezuo
- Department of Medicine, Usman Danfodio University Teaching Hospital, Sokoto, Nigeria. 9
| | - K M Karaye
- Department of Medicine, Bayero University, Kano, Kano State, Nigeria
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria
- Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
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10
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Shah AS, Gidding SS, El Ghormli L, Tryggestad JB, Nadeau KJ, Bacha F, Levitt Katz LE, Willi SM, Lima J, Urbina EM. Relationship between Arterial Stiffness and Subsequent Cardiac Structure and Function in Young Adults with Youth-Onset Type 2 Diabetes: Results from the TODAY Study. J Am Soc Echocardiogr 2022; 35:620-628.e4. [PMID: 35149207 PMCID: PMC9177714 DOI: 10.1016/j.echo.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Higher arterial stiffness may contribute to future alterations in left ventricular systolic and diastolic function. We tested this hypothesis in individuals with youth-onset type 2 diabetes from the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study. METHODS Arterial stiffness (pulse wave velocity [carotid-femoral, femoral-foot, and carotid-radial], augmentation index, brachial distensibility) was measured in 388 participants with type 2 diabetes (mean age, 21 years; diabetes duration, 7.7 ± 1.5 years). To reflect overall (composite) vascular stiffness, the five arterial stiffness measures were aggregated. An echocardiogram was performed in the same cohort 2 years later. Linear regression models assessed whether composite arterial stiffness was associated with left ventricular mass index or systolic and diastolic function, independent of age, sex, race/ethnicity, current cigarette smoking, and long-term exposure (time-weighted mean values over 9.1 years) of hemoglobin A1c, blood pressure, and body mass index. Interactions among arterial stiffness and time-weighted mean hemoglobin A1c, blood pressure, and body mass were also examined. RESULTS After adjustment, arterial stiffness remained significantly associated with left ventricular mass index and diastolic function measured by mitral valve E/Em, despite attenuation by time-weighted mean body mass index. A significant interaction revealed a greater adverse effect of composite arterial stiffness on mitral valve E/Em among participants with higher levels of blood pressure over time. Arterial stiffness was unrelated to left ventricular systolic function. CONCLUSIONS The association of higher arterial stiffness with future left ventricular diastolic dysfunction suggests the path to future heart failure may begin early in life in this setting of youth-onset type 2 diabetes. TRIAL REGISTRATION ClinicalTrials.gov NCT00081328.
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Affiliation(s)
- Amy S Shah
- Department of Pediatrics, Cincinnati Children's Hospital and University of Cincinnati, Cincinnati, Ohio
| | | | - Laure El Ghormli
- Biostatistics Center, Milken Institute School of Public Health, George Washington University, Rockville, Maryland.
| | - Jeanie B Tryggestad
- Section of Diabetes and Endocrinology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Kristen J Nadeau
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Fida Bacha
- Children's Nutrition Research Center, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Lorraine E Levitt Katz
- Children's Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Steven M Willi
- Children's Hospital of Philadelphia, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Joao Lima
- Department of Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Elaine M Urbina
- Heart Institute, Cincinnati Children's Hospital and University of Cincinnati, Cincinnati, Ohio
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11
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McKay L, Goss KN, Haraldsdottir K, Beshish AG, Barton GP, Palta M, Chesler NC, François CJ, Wieben O, Macdonald JA, Eldridge MW, Watson AM. Decreased ventricular size and mass mediate the reduced exercise capacity in adolescents and adults born premature. Early Hum Dev 2021; 160:105426. [PMID: 34332186 DOI: 10.1016/j.earlhumdev.2021.105426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 06/18/2021] [Accepted: 07/21/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Premature birth is associated with lower levels of cardiorespiratory fitness (CRF) but the underlying mechanisms responsible remain unclear. This study assessed whether differences in cardiac morphology or function mediate differences in CRF among adolescents and young adults born preterm. METHODS Adolescents and young adults born moderately to extremely premature (gestational age ≤ 32 weeks or birth weight < 1500 g) and age-matched term born participants underwent resting cardiac MRI and maximal exercise testing. Mediation analysis assessed whether individual cardiovascular variables accounted for a significant proportion of the difference in maximal aerobic capacity between groups. RESULTS Individuals born preterm had lower VO2max than those born term (41.7 ± 8.6 v 47.5 ± 8.7, p < 0.01). Several variables differed between term and preterm born subjects, including systolic and diastolic blood pressure, mean pulmonary artery pressure, indexed left ventricular end-diastolic volume (LVEDVi), right ventricular end-diastolic volume (RVEDVi), LV mass (LVMi), LV stroke volume index (LVSVi), and LV strain (p < 0.05 for all). Of these variables, LVEDVi, RVEDVi, LVSVi, LVMi, and LV longitudinal strain were significantly related to VO2max (p < 0.05 for all). Significant portions of the difference in VO2max between term and preterm born subjects were mediated by LVEDVi (74.3%, p = 0.010), RVEDVi (50.6%, p = 0.016), and LVMi (43.0%, p = 0.036). CONCLUSIONS Lower levels of CRF in adolescents and young adults born preterm are mediated by differences in LVEDVi, RVEDVi, and LVMi. This may represent greater risk for long-term cardiac morbidity and mortality in preterm born individuals.
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Affiliation(s)
- Lauren McKay
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States of America.
| | - Kara N Goss
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States of America; Department of Medicine, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Kristin Haraldsdottir
- Department of Pediatrics, Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Arij G Beshish
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Gregory P Barton
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States of America; Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Mari Palta
- Department of Pediatrics, Population Health Sciences and Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Naomi C Chesler
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States of America; Department of Medicine, University of Wisconsin-Madison, Madison, WI, United States of America; Department of Pediatrics, Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Christopher J François
- Department of Pediatrics, Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America; Department of Pediatrics, Radiology, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Oliver Wieben
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States of America; Department of Pediatrics, Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America; Department of Pediatrics, Radiology, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Jacob A Macdonald
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Marlowe W Eldridge
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States of America; Department of Medicine, University of Wisconsin-Madison, Madison, WI, United States of America; Department of Pediatrics, Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Andrew M Watson
- Department of Pediatrics, Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, United States of America
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12
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Shah AS, Isom S, Dabelea D, D'Agostino R, Dolan LM, Wagenknecht L, Imperatore G, Saydah S, Liese AD, Lawrence JM, Pihoker C, Urbina EM. A cross sectional study to compare cardiac structure and diastolic function in adolescents and young adults with youth-onset type 1 and type 2 diabetes: The SEARCH for Diabetes in Youth Study. Cardiovasc Diabetol 2021; 20:136. [PMID: 34233679 PMCID: PMC8265135 DOI: 10.1186/s12933-021-01328-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/29/2021] [Indexed: 01/19/2023] Open
Abstract
AIMS To compare left ventricular structure (LV) and diastolic function in young adults with youth- onset diabetes by type, determine the prevalence of abnormal diastolic function by diabetes type using published values from age similar healthy controls, and examine the risk factors associated with diastolic function. METHODS In a cross sectional analysis we compared LV structure and diastolic function from two dimensional echocardiogram in participants with type 1 (T1D) and type 2 diabetes (T2D) who participated in the SEARCH for Diabetes in Youth Study. Linear models were used to examine the risk factors associated with worse diastolic function. RESULTS Of 479 participants studied, 258 had T1D (mean age 21.2 ± 5.2 years, 60.5% non-Hispanic white, 53.9% female) and 221 had T2D (mean age 24.8 ± 4.3 years, 24.4% non-Hispanic white, 73.8% female). Median diabetes duration was 11.6 years. Participants with T2D had greater LV mass index and worse diastolic function that persisted after adjustment for differences in risk factors compared with participants with T1D (all p < 0.05). Abnormal diastolic function, quantified using healthy controls, was pronounced in both groups but greater in those with T2D than T1D (T2D: 57.7% vs T1D: 47.2%, respectively), p < 0.05. Risk factors associated with worse diastolic function included older age at diabetes diagnosis, female sex, higher BP, heart rate and HbA1c and longer diabetes duration. CONCLUSIONS LV structure and diastolic function is worse in individuals with T2D compared to T1D. However, abnormal diastolic function in seen in both groups compared to published values from age similar healthy controls.
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MESH Headings
- Adolescent
- Adult
- Age of Onset
- Case-Control Studies
- Cross-Sectional Studies
- Diabetes Mellitus, Type 1/diagnosis
- Diabetes Mellitus, Type 1/epidemiology
- Diabetes Mellitus, Type 2/diagnosis
- Diabetes Mellitus, Type 2/epidemiology
- Diastole
- Echocardiography
- Female
- Humans
- Hypertrophy, Left Ventricular/diagnostic imaging
- Hypertrophy, Left Ventricular/epidemiology
- Hypertrophy, Left Ventricular/physiopathology
- Male
- Predictive Value of Tests
- Prevalence
- Risk Assessment
- Risk Factors
- United States/epidemiology
- Ventricular Dysfunction, Left/diagnostic imaging
- Ventricular Dysfunction, Left/epidemiology
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Function, Left
- Ventricular Remodeling
- Young Adult
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Affiliation(s)
- Amy S Shah
- Department of Pediatrics, Division of Endocrinology, Cincinnati Children's Hospital Medical Center and The University of Cincinnati, 3333 Burnet Ave ML 7012, Cincinnati, OH, 45229, USA.
| | - Scott Isom
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus (CU-Anschutz), Aurora, USA
| | - Ralph D'Agostino
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, USA
| | - Lawrence M Dolan
- Department of Pediatrics, Division of Endocrinology, Cincinnati Children's Hospital Medical Center and The University of Cincinnati, 3333 Burnet Ave ML 7012, Cincinnati, OH, 45229, USA
| | - Lynne Wagenknecht
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, USA
| | - Giuseppina Imperatore
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, USA
| | - Sharon Saydah
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, USA
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Jean M Lawrence
- Department of Research & Evaluation, Kaiser Permanente Southern California, Los Angeles, USA
| | - Cate Pihoker
- Department of Pediatrics, The University of Washington, Washington, USA
| | - Elaine M Urbina
- Department of Pediatrics, Division of Endocrinology, Cincinnati Children's Hospital Medical Center and The University of Cincinnati, 3333 Burnet Ave ML 7012, Cincinnati, OH, 45229, USA
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13
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Kusy K, Błażejewski J, Gilewski W, Karasek D, Banach J, Bujak R, Zieliński J, Sinkiewicz W, Grześk G. Aging Athlete's Heart: An Echocardiographic Evaluation of Competitive Sprint- versus Endurance-Trained Master Athletes. J Am Soc Echocardiogr 2021; 34:1160-1169. [PMID: 34175421 DOI: 10.1016/j.echo.2021.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 06/17/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Sports training triggers exercise-induced cardiac remodeling (EICR). Sprint- and endurance-trained master athletes are exposed to different hemodynamic stimuli accompanied by aging. The aim of this study was to compare EICR types in light of the Morganroth hypothesis, frequency of abnormalities, and relationships between cardiac traits and age. METHODS In this observational cross-sectional study, echocardiographic examinations were conducted in 143 sprint-trained (age range, 36-83 years) and 114 endurance-trained (age range, 38-85 years) competitive master athletes. Structural and functional characteristics were compared with population reference values, and EICR types were identified. Athletic groups were compared using t tests and χ2 tests. Relationships with age were assessed using linear regression. RESULTS In the sprint group, 51.0% of athletes had normal cardiac geometry (nonhypertrophic heart), 4.2% had eccentric hypertrophy, 36.4% had concentric remodeling, and 8.4% had concentric hypertrophy. In their endurance-trained peers, these proportions were 22.8%, 16.7%, 36.8%, and 23.7%, respectively. Many athletes in both groups had structural abnormalities, as assessed using population norms (up to ~81% for septal thickness) but their resting cardiac function was normal. The relationships of structural and functional cardiac characteristics with age were mostly weak to moderate and did not differ between training modalities. CONCLUSIONS Even though many endurance- and sprint-oriented master athletes exceed population norms for cardiac structure, they do not go beyond the "gray zone" and preserve normal cardiac function. Therefore, physiologic adaptations, rather than pathologic abnormalities, are expected in aging but still active athletes. Inconsistent with the Morganroth hypothesis, EICR is shifted toward normal geometry in sprinters and toward concentric remodeling and hypertrophy in endurance runners. A better understanding of the mechanisms behind cardiac remodeling during aging is needed to adequately predict EICR types in master athletes.
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Affiliation(s)
- Krzysztof Kusy
- Department of Athletics, Strength and Conditioning, Faculty of Sport Sciences, Poznan University of Physical Education, Poznań, Poland.
| | - Jan Błażejewski
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Wojciech Gilewski
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Danuta Karasek
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Joanna Banach
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Robert Bujak
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Jacek Zieliński
- Department of Athletics, Strength and Conditioning, Faculty of Sport Sciences, Poznan University of Physical Education, Poznań, Poland
| | - Władysław Sinkiewicz
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Grzegorz Grześk
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
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14
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Neves JS, Fontes-Carvalho R, Borges-Canha M, Leite AR, Martins S, Oliveira A, Guimarães JT, Carvalho D, Leite-Moreira A, Azevedo A. Thyroid Hormones within the Normal Range and Cardiac Function in the General Population: The EPIPorto Study. Eur Thyroid J 2021; 10:150-160. [PMID: 33981619 PMCID: PMC8077596 DOI: 10.1159/000508407] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 05/04/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Hypothyroidism and hyperthyroidism are associated with marked changes in cardiac structure and function. However, the association of thyroid function within the normal range with cardiac structure and function in the general population remains uncertain. METHODS Eight hundred thirty-five subjects aged ≥45 years from the EPIPorto cohort (evaluation between 2006 and 2008) were cross-sectionally analyzed. We excluded participants with TSH, free T4 (FT4), or free T3 (FT3) outside of the reference range or with self-reported cardiovascular or thyroid disease. Cardiac structure and function were evaluated by echocardiography. We used linear regression models unadjusted and adjusted for sex and age (model 1), and sex, age, BMI, diabetes, hypertension, and smoking (model 2). Nonlinear associations were assessed using restricted cubic splines. RESULTS The mean age was 61.5 years (SD 10.5); 61.1% of the patients were women. In the adjusted model 2, heart rate was positively associated with FT3; diastolic blood pressure was positively associated with TSH; LV end-diastolic and end-systolic volumes were inversely associated with TSH, and ejection fraction was nonlinearly associated with FT3, with higher ejection fractions near the limits of the reference range. Left ventricle (LV) posterior wall thickness was nonlinearly associated with FT4 in the adjusted model 1, with a greater thickness near the limits of the reference range. Regarding diastolic function, no significant associations were observed in adjusted models. CONCLUSIONS Thyroid function within the reference range was associated with heart rate, blood pressure, cardiac structure, and function. Increasing thyroid function (lower TSH, higher FT4, or higher FT3) was associated with a higher heart rate, a lower diastolic blood pressure, and larger LV volumes. LV wall thickness and ejection fraction had a U-shaped association with thyroid hormones.
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Affiliation(s)
- João Sérgio Neves
- Unidade de Investigação Cardiovascular, Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- *João Sérgio Neves, Unidade de Investigação Cardiovascular, Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, PT–4200-319 Porto (Portugal),
| | - Ricardo Fontes-Carvalho
- Unidade de Investigação Cardiovascular, Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Department of Cardiology, Centro Hospitalar Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Marta Borges-Canha
- Unidade de Investigação Cardiovascular, Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Ana Rita Leite
- Unidade de Investigação Cardiovascular, Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Sandra Martins
- Department of Clinical Pathology, Centro Hospitalar Universitário de São João, Porto, Portugal
- EPIUnit − Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Ana Oliveira
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - João Tiago Guimarães
- Department of Clinical Pathology, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Biomedicine, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- EPIUnit − Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Davide Carvalho
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal
| | - Adelino Leite-Moreira
- Unidade de Investigação Cardiovascular, Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Ana Azevedo
- EPIUnit − Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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15
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Abstract
BACKGROUND It is still unclear whether growth hormone (GH) replacement is able to improve cardiovascular parameters in adults with GH deficiency (AGHD) from the updated clinical trials reported to date. METHODS AND RESULTS We systematically reviewed clinical trials of GH treatment on AGHD patients in recent decade, and evaluated the effects of GH on cardiovascular parameters assessed by echocardiography. 11 clinical trials were identified in 3 bibliographic databases. We conducted a combined analysis of effects on four aspects: General indicators: baseline heart rate (BHR), peak heart rate (PHR), systolic blood pressure (SBP), diastolic blood pressure (DBP); Cardiac structure: left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular interventricular septum (LVIS), left ventricular mass (LVM), left ventricular posterior wall (LVPW); Cardiovascular function: deceleration time of E wave (DT), E/A ratio (E/A), ejection fraction (EF), NT-BNP; Life quality: peak VO2, VE/VCO2 slope. Overall effect size was used to evaluate significance, and weighted mean difference after GH treatment was given to appreciate size of the effect. GH treatment was associated with a significant increase in BHR (3.03[2.00, 4.06]), LVIS (0.50[0.43, 0.57]), LVPW (0.50[0.43, 0.57]), and EF (2.12[1.34, 2.90]). Overall effect sizes were negative significant for DBP (- 1.19[- 2.33, - 0.05]), LVEDV (- 9.84[- 16.53, - 3.15]), NT-BNP (- 206.34[- 308.95, - 103.72]), and VE/VCO2 slope (- 2.31[- 2.92, - 1.71]). CONCLUSIONS As assessed by echocardiography, GH administration may improve the general vital signs and life quality of AGHD patients, based on the positive effect on BHR and negative effects on DBP and VE/VCO2 slope. Also, GH treatment would influence the structure of heart with positive effects on LVIS, LVPW and negative effect on LVEDV, which together with the increase of EF and decrease of NT-BNP, then resulting in improving the systolic function of AGHD patients.
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Affiliation(s)
- Siwen Zhang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China
| | - Zhuo Li
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China
| | - You Lv
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China
| | - Lin Sun
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China
| | - Xianchao Xiao
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China
| | - Xiaokun Gang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China.
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China.
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Larsen MN, Madsen M, Nielsen CM, Manniche V, Hansen L, Bangsbo J, Krustrup P, Hansen PR. Cardiovascular adaptations after 10 months of daily 12-min bouts of intense school-based physical training for 8-10-year-old children. Prog Cardiovasc Dis 2020; 63:813-817. [PMID: 32497586 DOI: 10.1016/j.pcad.2020.05.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The present study examined cardiovascular adaptations in 8-10-year-old schoolchildren after a full school year (10 months) of 5 × 12 min/wk. of intense physical training, including small-sided ball games (soccer, basketball and floorball) or interval running. The study involved 8-10-year-old healthy Danish schoolchildren (n = 232), who were cluster-randomized to a small-sided games group (SSG, n = 60), an interval running group (IR, n = 57) or a control group (CON, n = 115). Comprehensive transthoracic echocardiography, resting heart rate and blood pressure measurements were performed at baseline and post intervention. For interval running, analysis of baseline-to-10-months changes showed significant (P < 0.05) between-group differences in delta scores for diastolic blood pressure (BP) and mean arterial BP (IR -3.2 ± 5.7 and - 2.2 ± 6.5 mmHg vs. CON 0.2 ± 5.3 and 0.4 ± 6.4 mmHg, respectively). Delta scores also showed a trend for reduction of mean arterial BP in SSG compared to CON (-2.1 ± 6.0 vs. 0.2 ± 5.3 mmHg, P = 0.067). Moreover, there were between-group differences in delta scores (P < 0.05) for selected echocardiographic parameters, i.e. in SSG vs. CON for interventricular septum thickness and peak transmitral flow velocity in early diastole, and in IR vs. CON for left ventricular systolic diameter. In conclusion, 10 months of 5 × 12 min/wk. of IR in 8-10-year-old children decreased diastolic BP, while both IR and SSG elicited cardiac adaptations. The results suggest that frequent low volume, intense physical training can have effects on the cardiovascular health profile in healthy children.
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Affiliation(s)
- Malte Nejst Larsen
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark.
| | - Mads Madsen
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Claus Malta Nielsen
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Jens Bangsbo
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Peter Riis Hansen
- Department of Cardiology, Herlev-Gentofte University Hospital, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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Mehdipoor G, Chen S, Chatterjee S, Torkian P, Ben-Yehuda O, Leon MB, Stone GW, Prince MR. Cardiac structural changes after transcatheter aortic valve replacement: systematic review and meta-analysis of cardiovascular magnetic resonance studies. J Cardiovasc Magn Reson 2020; 22:41. [PMID: 32475350 PMCID: PMC7262773 DOI: 10.1186/s12968-020-00629-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 04/21/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Transcatheter aortic valve replacement (TAVR) is increasingly used to treat patients with severe aortic stenosis (AS). Cardiovascular magnetic resonance imaging (CMR) provides reliable and reproducible estimates for assessment of cardiac structure and function after TAVR. The goal of this study was to conduct a systematic review and meta-analysis of the literature to assess left ventricular (LV) volumes, mass and function by CMR after TAVR. METHODS Using Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines, we searched PubMed and Embase for studies reporting CMR findings before and at least 1 month after TAVR. Main factors of interest were LV end-diastolic volume index (LVEDVi), LV end-systolic volume index (LVESVi), LV mass index (LVMi), and left ventricular ejection fraction (LVEF). Standardized mean differences (SMD) were pooled by random effects meta-analytic techniques. RESULTS Of 453 screened publications, 10 studies (published between 2012 and 2018) were included. A total of 305 patients completed pre- and post-TAVR follow-up CMR (mean age range 78.6-85.0 years, follow-up range 6-15 months). Random effects analysis showed TAVR resulted in reduced LVEDVi (SMD: -0.25, 95% CI: - 0.43 to - 0.07, P = 0.006), LVESVi (SMD: -0.24, 95% CI: - 0.44 to - 0.05, P = 0.01), LVMi (SMD: -0.82, 95% CI: - 1.0 to - 0.63, P < 0.001) and increased LVEF (SMD: 22, 95% CI: 6 to 38%, P = 0.006). Heterogeneity across studies was low (I2: 0%, Pheterogeneity > 0.05 for all). The median reduction was 4 ml/m2 (IQR: 3.1 to 8.2) for LVEDVi, 5 ml/m2 (IQR: 3.0 to 6.0) for LVESVi, and 15.1 g/m2 (IQR: 11.8 to 18.3) for LVMi. The median increase for LVEF was 3.4% (IQR 1.0 to 4.6%). CONCLUSIONS CMR demonstrates reverse LV remodeling occurrs within 6-15 months after TAVR, with reductions in LVEDVi, LVESVi and LVMi, and increased LVEF.
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Affiliation(s)
| | - Shmuel Chen
- Cardiovascular Research Foundation, New York, NY USA
- Department of Cardiology, Columbia University College of Physicians and Surgeons, New York, NY USA
| | - Saurav Chatterjee
- Hoffman Heart Institute, Saint Francis Hospital of the University of Connecticut, Hartford, CT USA
| | - Pooya Torkian
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ori Ben-Yehuda
- Cardiovascular Research Foundation, New York, NY USA
- Department of Cardiology, Columbia University College of Physicians and Surgeons, New York, NY USA
| | - Martin B. Leon
- Cardiovascular Research Foundation, New York, NY USA
- Department of Cardiology, Columbia University College of Physicians and Surgeons, New York, NY USA
| | - Gregg W. Stone
- Cardiovascular Research Foundation, New York, NY USA
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Martin R. Prince
- Department of Radiology, Weill Cornell Medical College& New York Presbyterian Hospital, 416 East 55th Street, New York, NY 10022 USA
- Department of Radiology, Columbia University College of Physicians and Surgeons, New York, NY USA
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18
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Díaz A, Bia D, Zócalo Y. Impact of Methodological and Calibration Approach on the Association of Central and Peripheral Systolic Blood Pressure with Cardiac Structure and Function in Children, Adolescents and Adults. High Blood Press Cardiovasc Prev 2019; 26:509-34. [PMID: 31667753 DOI: 10.1007/s40292-019-00346-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 10/17/2019] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Peripheral and aortic systolic blood pressure (pSBP and aoSBP) were measured using different methodological and calibration approaches to analyze the association and agreement between pSBP and/or aoSBP, and the association of pSBP and aoSBP with left ventricle (LV) and atrium (LA) structural-functional characteristics. METHODS In healthy subjects (n = 269, age: 9-85 years; n = 147, age < 24 years) LV and LA parameters were echocardiography-derived. pSBP and aoSBP were obtained by brachial sub-diastolic (Mobil-O-Graph®) and supra-systolic oscillometry (Arteriograph®) and aortic diameter waveform re-calibration (RCD; ultrasonography), using three calibration schemes: systo-diastolic (SD), calculated mean (CM), and oscillometric mean (OscM). RESULTS Always pSBP and aoSBP were positively associated; aoSBP obtained with the Mobil-O-Graph® and calibrated to CM or OscM were the ones that showed the lowest levels of association with the remaining forms of aoSBP and pSBP. Bland-Altman related mean errors varied noticeably (e.g. - 27, - 23, - 17, - 12 or 8 mmHg when aoSBP obtained with MOG (OscM) was compared with data from other methodological and calibration schemes). The aoSBP data obtained with Mobil-O-Graph® (calibration: CM and OscM) showed the highest levels of association with cardiac structural characteristics. aoSBP values obtained calibrating to OscM were higher than those obtained calibrating to SD or CM. CONCLUSIONS aoSBP obtained with Mobil-O-Graph® and calibrated to CM or OscM showed (1) lower association with other forms of aoSBP and pSBP determination and (2) higher levels of association with LV and LA structural characteristics. Differences in aoSBP data between approaches were more sensitive to the calibration method than to the device used.
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Shintani Y, Takahama H, Hamatani Y, Nishimura K, Kanzaki H, Kusano K, Noguchi T, Toyoda K, Yasuda S, Izumi C. Ischemic stroke risk during post-discharge phases of heart failure: association of left ventricular concentric geometry. Heart Vessels 2019; 35:564-575. [PMID: 31641888 DOI: 10.1007/s00380-019-01522-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/02/2019] [Indexed: 01/20/2023]
Abstract
Despite a higher risk of ischemic stroke in hospitalized patients with acute heart failure (HF), little is known about the risk of ischemic stroke during the post-discharge phases of HF. Here we investigated (1) the ischemic stroke incidence rate during the post-discharge phases among HF patients receiving standard treatments; (2) the association between ischemic stroke incidence and clinical background, including cardiac structure and function. Among 950 patients who required hospitalization for HF (median duration: 19 days) at our institution, where they received standard treatments, we investigated stroke occurrences during the 2-year period following their discharge and retrospectively evaluated their clinical data. Relative wall thickness (RWT) and left ventricular (LV) mass were determined based on echocardiographic measurements and then used to determine LV geometric patterns. During the follow-up period, ischemic stroke occurred in 25 patients (2.6%) after hospital discharge (1.4 per 100 patient-years). The incidence rate of IS tended to be higher in patients with AF than those without AF (1.8 vs. 1.0 per 100 patient-years, respectively). Notably, multivariate analysis revealed a significant association between RWT and ischemic stroke risk (p < 0.05). RWT was associated with ischemic stroke risk in patients with AF or left atrial enlargement, but not in patients without them. These findings suggest that even with standard HF treatments, the risk of ischemic stroke is high in patients with HF. Moreover, LV concentric geometry is a significant risk factor for ischemic stroke in patients with HF, especially in those with left atrial remodeling and/or AF.
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Affiliation(s)
- Yasuhiro Shintani
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, 564-8565, Japan
| | - Hiroyuki Takahama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, 564-8565, Japan.
| | - Yasuhiro Hamatani
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, 564-8565, Japan
| | - Kunihiro Nishimura
- Department of Statics and Data Analysis, National Cerebral and Cardiovascular Center, Suita, Osaka, 564-8565, Japan
| | - Hideaki Kanzaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, 564-8565, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, 564-8565, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, 564-8565, Japan
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, 564-8565, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, 564-8565, Japan
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, 564-8565, Japan
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20
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Han J, Wang X, Fan JY, Nie SP, Wei YX. [Effect of moderate or severe obstructive sleep apnea on cardiac structure and function in patients with acute coronary syndrome]. Zhonghua Yi Xue Za Zhi 2019; 99:1782-1786. [PMID: 31207687 DOI: 10.3760/cma.j.issn.0376-2491.2019.23.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effect of obstructive sleep apnea (OSA) on cardiac structure and function in patients with acute coronary syndrome (ACS). Methods: A total of 767 patients with ACS consecutively hospitalized at the Emergency & Critical Care Center of Beijing Anzhen Hospital from June 2015 to May 2017 were enrolled in this study. There were 637 males and 130 females. Patients who met the inclusion criteria according to the sleep apnea hypopnea index (AHI) were examined with portable sleep respiration monitoring. Patients were divided into moderate or severe OSA group (AHI≥15,n=389) and non or mild OSA group (AHI<15, n=78). The general information and echocar diographic results were analyzed. The data fitted normal distribution were compared between the groups with independent sample t test. Results: The body mass index [(27.8±3.6) vs (25.8±3.4) kg/m(2), t=-7.854, P<0.01], neck circumference [(41.1±4.2) vs (39.3±3.2) cm, t=-6.717, P<0.01] and waist-to-hip ratio (0.99±0.54 vs 0.97±0.53, t=-4.735, P<0.01) at admission were significantly higher in moderate or severe OSA group than those in non or mild OSA group. The left ventricular end-diastolic diameter, inter-ventricular septum thickness, left atrial diameter,right atrial diameter were all significantly higher, and the E/A peak ratio was remarkably lower in the moderate or severe OSA group (t=-2.130, 0.278, -3.045, -2.241, 2.260, all P<0.05). Conclusion: Moderate or severe OSA may aggravate cardiac remodeling and diastolic function in ACS patients.
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Affiliation(s)
- J Han
- Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - X Wang
- Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - J Y Fan
- Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - S P Nie
- Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Y X Wei
- Otalaryngology-Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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21
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Tang X, Zhong J, Zhang H, Luo Y, Liu X, Peng L, Zhang Y, Qian X, Jiang B, Liu J, Li S, Chen Y. Visit-to-visit fasting plasma glucose variability is an important risk factor for long-term changes in left cardiac structure and function in patients with type 2 diabetes. Cardiovasc Diabetol 2019; 18:50. [PMID: 30992008 PMCID: PMC6469221 DOI: 10.1186/s12933-019-0854-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 04/05/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To investigate the effect of visit-to-visit fasting plasma glucose (FPG) variability on the left cardiac structure and function in patients with type 2 diabetes mellitus (T2DM). METHODS In this prospective cohort study, 455 T2DM patients were included and follow-up for a median of 4.7 years. FPG measured on every hospital visit was collected. FPG variability was calculated by its coefficient of variation (CV-FPG). Left cardiac structure and function were assessed using echocardiography at baseline and after follow-up. Multivariable linear regression analyses were used to estimate the effect of FPG variability on the annualized changes in left cardiac structure and function. Subgroup analysis stratified by mean HbA1c levels (< 7% and ≥ 7%) were also performed. RESULT In multivariable regression analyses, CV-FPG was independently associated with the annualized changes in left ventricle (β = 0.137; P = 0.031), interventricular septum (β = 0.215; P = 0.001), left ventricular posterior wall thickness (β = 0.129; P = 0.048), left ventricular mass index (β = 0.227; P < 0.001), and left ventricular ejection fraction (β = - 0.132; P = 0.030). After additionally stratified by mean HbA1c levels, CV-FPG was still independently associated with the annualized changes in the above parameters in patients with HbA1c ≥ 7%, while not in patients with HbA1c < 7%. CONCLUSIONS Visit-to-visit variability in FPG could be a novel risk factor for the long-term adverse changes in left cardiac structure and systolic function in patients with type 2 diabetes. Trial registration ClinicalTrials.gov (NCT02587741), October 27, 2015, retrospectively registered.
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Affiliation(s)
- Xixiang Tang
- Department of Endocrinology & Metabosim, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China.,Advanced Medical Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
| | - Junlin Zhong
- Department of Ultrasonography, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
| | - Hui Zhang
- Department of Ultrasonography, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
| | - Yanting Luo
- Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
| | - Xing Liu
- Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
| | - Long Peng
- Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
| | - Yanling Zhang
- Department of Ultrasonography, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
| | - Xiaoxian Qian
- Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
| | - Boxiong Jiang
- Advanced Medical Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
| | - Jinlai Liu
- Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
| | - Suhua Li
- Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China.
| | - Yanming Chen
- Department of Endocrinology & Metabosim, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China.
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Zhu Y, Xu C, Zhang Y, Xie Z, Shu Y, Lu C, Mo X. Associations of trace elements in blood with the risk of isolated ventricular septum defects and abnormal cardiac structure in children. Environ Sci Pollut Res Int 2019; 26:10037-10043. [PMID: 30746621 DOI: 10.1007/s11356-019-04312-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 01/22/2019] [Indexed: 06/09/2023]
Abstract
This study sought to determine correlations between the presence of isolated ventricular septum defects (VSDs) and blood levels of trace elements. A total of 144 patients with VSDs and 144 controls were recruited for cross-sectional assessment of trace elements and examination of cardiac structures in the Jiangsu and Anhui provinces between 2016 and 2018. Logistic regression was performed to explore the relationships between VSDs and trace elements. Additionally, general linear regression models were used to investigate relationships between trace elements and echocardiography indicators. Relative to the lowest zinc (Zn) concentrations, the highest Zn concentrations may be associated with lower odds of VSD development (OR = 0.03, 95% confidence interval [CI] = 0.01-0.29, P < 0.001). However, no significant relationships between the concentrations of other trace elements and the risk of VSD were identified. Aorta (AO) diameters were markedly smaller in the VSD group, whereas no significant between-group differences were observed for other echocardiography indicators. After adjusting for age and gender, linear regression indicated a significant association between Zn level and mean AO diameter (beta coefficient = 0.247, 95% CI = 0.126-0.367). Zn deficiency was observed in patients with isolated VSDs. Further work to explore the mechanisms by which Zn deficiency leads to VSDs is warranted.
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Affiliation(s)
- Yu Zhu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Cheng Xu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Yuxi Zhang
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Zongyun Xie
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Yaqin Shu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Changgui Lu
- Department of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xuming Mo
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China.
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Shih JY, Chen ZC, Chang HY, Liu YW, Ho CH, Chang WT. Risks of age and sex on clinical outcomes post myocardial infarction. Int J Cardiol Heart Vasc 2019; 23:100350. [PMID: 30976655 PMCID: PMC6441739 DOI: 10.1016/j.ijcha.2019.100350] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 03/17/2019] [Accepted: 03/18/2019] [Indexed: 11/29/2022]
Abstract
Background How sex and age influence post-myocardial infarction (post-MI) outcomes remains unclear. This study evaluated the influence of sex and age on drug therapy, echocardiographic parameters, and outcomes in post-MI patients undergoing percutaneous coronary intervention (PCI). Methods We retrospectively enrolled 643 patients with first acute MI who underwent successful PCI and two echocardiographic examinations within 1 year after MI. Clinical characteristics and 4-year follow-up outcomes were compared between sexes and age groups. Primary endpoints were cardiovascular mortality and hospitalization for heart failure (HF). Results Compared with males, female patients with MI, particularly older females, had more systemic diseases. Younger females received fewer guideline-directed therapies. Older patients presented with higher left ventricular volume and mass index but no significant differences in left ventricular ejection fraction. The Kaplan–Meier analysis revealed increased mortality in both younger and older females. Elderly patients, particularly older females, exhibited significantly higher post-MI HF incidence but no difference in recurrent MI, ventricular arrhythmia, or revascularization. Conclusions In MI patients receiving PCI, outcome differences between sexes are age-dependent. Age influences outcome more heavily in females than in males. Females are likely to exhibit worse overall survival, and older females are at higher risk of post-MI HF.
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Affiliation(s)
- Jhih-Yuan Shih
- Department of Cardiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Zhih-Cherng Chen
- Department of Cardiology, Chi Mei Medical Center, Tainan, Taiwan.,Department of Pharmacy, Chia Nan University of Pharmacy & Science, Tainan, Taiwan
| | - Hsien-Yuan Chang
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Yun-Lin, Taiwan.,Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan
| | - Yen-Wen Liu
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.,Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan City, Taiwan
| | - Wei-Ting Chang
- Department of Cardiology, Chi Mei Medical Center, Tainan, Taiwan.,Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan
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Abstract
Objective Cardiac structure and function are important predictors for cardiovascular disease in adults. Not much is known about tracking of cardiac measures, other than left ventricular mass, from early life onwards. We examined whether and to what extent cardiac measures track from infancy into school-age. Methods We performed a population-based prospective cohort study among 1072 children. Aortic root diameter, left atrial diameter, left ventricular mass, relative wall thickness and fractional shortening were measured repeatedly by echocardiography. We explored tracking between infancy (1.5, six and 24 months) and school-age (six and 10 years). Results Of all cardiac measures, aortic root diameter, left atrial diameter and left ventricular mass were significantly correlated between infancy and school-age ( r = 0.10-0.42, all p-values < 0.01), with the strongest correlations between 24 months and 10 years. Of the different structures, aortic root diameter showed the strongest correlations. Approximately 30% of children who were in the lowest or highest quartile of a measure at the age of 1.5 months remained in that quartile at the age of 10 years. When analysing the effects of the infant cardiac measures on the same outcomes at 10 years in conditional regression models, we observed effect estimates of the same size for the different age windows. Conclusion Our results suggest moderate tracking of structural cardiac measures from early infancy until school-age, which become stronger at older ages, but not of relative wall thickness or fractional shortening. Moderate tracking of cardiac structures suggests that cardiac structures are at least partly determined in early life.
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Affiliation(s)
- Liza Toemen
- 1 Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,2 Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,3 Department of Pediatrics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Romy Gaillard
- 1 Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,2 Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,3 Department of Pediatrics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Lennie van Osch-Gevers
- 3 Department of Pediatrics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Willem A Helbing
- 3 Department of Pediatrics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Albert Hofman
- 2 Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,4 Department of Epidemiology, Harvard TH Chan of Public Health, Boston, USA
| | - Vincent Wv Jaddoe
- 1 Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,2 Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,3 Department of Pediatrics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
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Grace F, Herbert P, Elliott AD, Richards J, Beaumont A, Sculthorpe NF. High intensity interval training (HIIT) improves resting blood pressure, metabolic (MET) capacity and heart rate reserve without compromising cardiac function in sedentary aging men. Exp Gerontol 2017; 109:75-81. [PMID: 28511954 DOI: 10.1016/j.exger.2017.05.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/13/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study examined a programme of pre-conditioning exercise with subsequent high intensity interval training (HIIT) on blood pressure, echocardiography, cardiac strain mechanics and maximal metabolic (MET) capacity in sedentary (SED) aging men compared with age matched masters athletes (LEX). METHODS Using a STROBE compliant observational design, 39 aging male participants (SED; n=22, aged 62.7±5.2yrs) (LEX; n=17, aged=61.1±5.4yrs) were recruited to a study that necessitated three distinct assessment phases; enrolment (Phase A), following pre-conditioning exercise in SED (Phase B), then following 6weeks of HIIT performed once every five days by both groups before reassessment (Phase C). Hemodynamic, echocardiographic and cardiac strain mechanics were obtained at rest and maximal cardiorespiratory and chronotropic responses were obtained at each measurement phase. RESULTS The training intervention improved systolic, mean arterial blood pressure, rate pressure product and heart rate reserve (each P<0.05) in SED and increased MET capacity in both SED and LEX (P<0.01) which was amplified by HIIT. Echocardiography and cardiac strain measures were unremarkable apart from trivial increase to intra-ventricular septum diastole (IVSd) (P<0.05) and decrease to left ventricular internal dimension diastole (LVId) (P<0.05) in LEX following HIIT. CONCLUSIONS A programme of preconditioning exercise with HIIT induces clinically relevant improvements in blood pressure, rate pressure product and encourages recovery of heart rate reserve in SED, while improving maximal MET capacity in both SED and LEX without inducing any pathological cardiovascular remodeling. These data add to the emerging repute of HIIT as a safe and promising exercise prescription to improve cardiovascular function and metabolic capacity in sedentary aging.
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Affiliation(s)
- Fergal Grace
- School of Health Sciences & Psychology, Faculty of Health, Federation University, Mt Helen, Victoria, Australia.
| | - Peter Herbert
- University of Wales Trinity Saint David, Camarthen Campus, Camarthen, Wales SA31 3EP, United Kingdom
| | - Adrian D Elliott
- Centre for Heart Rhythm Disorders, University of Adelaide, South Australian Health & Medical Research Institute, Adelaide, Australia
| | - Jo Richards
- Faculty of Education & Sport, University of Bedfordshire, Polihill campus, Bedford MK4 9EA, United Kingdom
| | - Alexander Beaumont
- Institute of Clinical Exercise & Health Sciences, School of Science and Sport, University of the West of Scotland, Hamilton, South Lanarkshire, Scotland ML3 0JB, United Kingdom
| | - Nicholas F Sculthorpe
- Institute of Clinical Exercise & Health Sciences, School of Science and Sport, University of the West of Scotland, Hamilton, South Lanarkshire, Scotland ML3 0JB, United Kingdom
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Zhang H, Li J, Chen X, Wu N, Xie W, Tang H, Li C, Wu L, Xiang Y, Zhong L, Li Y. Association of Systemic Inflammation Score With Atrial Fibrillation: A Case-Control Study With Propensity Score Matching. Heart Lung Circ 2017; 27:489-496. [PMID: 28579228 DOI: 10.1016/j.hlc.2017.04.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 04/04/2017] [Accepted: 04/14/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Inflammation plays a key role in the initiation and progression of atrial fibrillation (AF). We developed a novel systemic inflammation score (SIS) based on integration of biomarkers used routinely in clinical settings. We aim to explore the association between SIS and AF. METHODS A matched case-control study with 376 pairs of AF cases and controls was performed using a propensity score matching system. The SIS was developed by integrating albumin (ALB), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocytes to monocytes ratio (LMR). Univariate and multivariate analyses were performed to examine the association of each marker and SIS with AF. RESULTS The conditional multivariate logistic regression analysis showed that elevated levels of ALB and LMR were significantly associated with decreased risk of AF with an OR of 0.74 (95% CI: 0.65, 0.85) and 0.73 (95% CI: 0.64, 0.83), respectively. Patients with elevated SIS had a significantly higher risk of AF. Compared to the patients with SIS equal to 1, the patients with SIS equal to 3 and 4 had an OR of 2.16 (95% CI: 1.40 3.32), and 2.55 (95% CI: 1.66, 3.92), respectively. The SIS was positively correlated with left atrial diameter and right atrial diameter in patients with AF. CONCLUSIONS In conclusion, this study provides further clinical epidemiological evidence that systemic inflammatory status was correlated with AF. The SIS, as an index to evaluate the intensity of systemic inflammatory status, could be useful for early prediction of AF development and understanding of AF mechanism.
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Affiliation(s)
- Huan Zhang
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, People's Republic of China; Evidence-based Medicine and Clinical Epidemiology Center, Third Military Medical University, Chongqing 400038, People's Republic of China
| | - Jun Li
- Department of Thoracic and Cardiac Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, People's Republic of China
| | - Xinghua Chen
- Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, People's Republic of China
| | - Na Wu
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, People's Republic of China; Evidence-based Medicine and Clinical Epidemiology Center, Third Military Medical University, Chongqing 400038, People's Republic of China
| | - Weijia Xie
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, People's Republic of China; Evidence-based Medicine and Clinical Epidemiology Center, Third Military Medical University, Chongqing 400038, People's Republic of China
| | - He Tang
- Institute of Toxicology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, People's Republic of China
| | - Chengying Li
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, People's Republic of China; Evidence-based Medicine and Clinical Epidemiology Center, Third Military Medical University, Chongqing 400038, People's Republic of China
| | - Long Wu
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, People's Republic of China; Evidence-based Medicine and Clinical Epidemiology Center, Third Military Medical University, Chongqing 400038, People's Republic of China
| | - Ying Xiang
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, People's Republic of China; Evidence-based Medicine and Clinical Epidemiology Center, Third Military Medical University, Chongqing 400038, People's Republic of China
| | - Li Zhong
- Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, People's Republic of China
| | - Yafei Li
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, People's Republic of China; Evidence-based Medicine and Clinical Epidemiology Center, Third Military Medical University, Chongqing 400038, People's Republic of China.
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Weaver AM, Wellenius GA, Wu WC, Hickson DA, Kamalesh M, Wang Y. Residential distance to major roadways and cardiac structure in African Americans: cross-sectional results from the Jackson Heart Study. Environ Health 2017; 16:21. [PMID: 28270143 PMCID: PMC5341411 DOI: 10.1186/s12940-017-0226-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 02/28/2017] [Indexed: 05/03/2023]
Abstract
BACKGROUND Heart failure (HF) is a significant source of morbidity and mortality among African Americans. Ambient air pollution, including from traffic, is associated with HF, but the mechanisms remain unknown. The objectives of this study were to estimate the cross-sectional associations between residential distance to major roadways with markers of cardiac structure: left ventricular (LV) mass index, LV end-diastolic diameter, LV end-systolic diameter, and LV hypertrophy among African Americans. METHODS We studied baseline participants of the Jackson Heart Study (recruited 2000-2004), a prospective cohort of cardiovascular disease (CVD) among African Americans living in Jackson, Mississippi, USA. All cardiac measures were assessed from echocardiograms. We assessed the associations between residential distance to roads and cardiac structure indicators using multivariable linear regression or multivariable logistic regression, adjusting for potential confounders. RESULTS Among 4826 participants, residential distance to road was <150 m for 103 participants, 150-299 m for 158, 300-999 for 1156, and ≥1000 m for 3409. Those who lived <150 m from a major road had mean 1.2 mm (95% CI 0.2, 2.1) greater LV diameter at end-systole compared to those who lived ≥1000 m. We did not observe statistically significant associations between distance to roads and LV mass index, LV end-diastolic diameter, or LV hypertrophy. Results did not materially change after additional adjustment for hypertension and diabetes or exclusion of those with CVD at baseline; results strengthened when modeling distance to A1 roads (such as interstate highways) as the exposure of interest. CONCLUSIONS We found that residential distance to roads may be associated with LV end-systolic diameter, a marker of systolic dysfunction, in this cohort of African Americans, suggesting a potential mechanism by which exposure to traffic pollution increases the risk of HF.
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Grants
- HHSN268201300049C National Heart, Lung, and Blood Institute
- HHSN268201300047C National Heart, Lung, and Blood Institute
- R01 ES020871 NIEHS NIH HHS
- HHSN268201300050C National Heart, Lung, and Blood Institute
- HHSN268201300048C National Heart, Lung, and Blood Institute
- R21 NR013231 National Institute of Nursing Research
- HHSN268201300046C National Heart, Lung, and Blood Institute
- National Heart, Lung, and Blood Institute (US); National Institute on Minority Health and Health Disparities (US)
- National Institute of Nursing Research (US); National Institute on Minority Health and Health Disparities (US)
- National Institute of Environmental Health Sciences
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Affiliation(s)
- Anne M. Weaver
- Richard M. Fairbanks School of Public Health, Indiana University, 1050 Wishard Blvd., RG 6082, Indianapolis, IN 46202 USA
| | - Gregory A. Wellenius
- The School of Public Health at Brown University, 121 South Main Street, Providence, RI 02903 USA
| | - Wen-Chih Wu
- The School of Public Health at Brown University, 121 South Main Street, Providence, RI 02903 USA
| | - DeMarc A. Hickson
- Jackson State University School of Public Health Initiative, 350 West Woodrow Wilson Drive, Jackson Medical Mall, Suite 320, Jackson, MS 39213 USA
| | - Masoor Kamalesh
- Department of Cardiology, Richard L. Roudebush VA Medical Center, 1481 W 10th St., Indianapolis, IN 46202 USA
| | - Yi Wang
- Richard M. Fairbanks School of Public Health, Indiana University, 1050 Wishard Blvd., RG 6082, Indianapolis, IN 46202 USA
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Auriemma RS, Grasso LFS, Galdiero M, Galderisi M, Pivonello C, Simeoli C, De Martino MC, Ferrigno R, Negri M, de Angelis C, Pivonello R, Colao A. Effects of long-term combined treatment with somatostatin analogues and pegvisomant on cardiac structure and performance in acromegaly. Endocrine 2017; 55:872-884. [PMID: 27295183 DOI: 10.1007/s12020-016-0995-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 05/19/2016] [Indexed: 01/22/2023]
Abstract
To date, no data are available on the effects of long-term combined treatment with somatostatin analogues (SA) and pegvisomant (PEG) on cardiovascular complications in acromegaly. The current study aimed at investigating the effects of long-term SA + PEG on cardiac structure and performance. Thirty-six patients (14 M, 22 F, aged 52.3 ± 10.2 years) entered this study. Weight, BMI, systolic (SBP) and diastolic (DBP) blood pressure, IGF-I, fasting glucose (FG), fasting insulin (FI), HOMA-IR, HbA1c, and lipids were evaluated at baseline (T0), after long-term (median 36 months) SA (T1), after 12 (T12) and 60 (T60) months of SA + PEG, and at last follow-up (LFU, median 78 months). At each time point, all patients underwent echocardiography. At T1, induced a slight but not significant decrease in IGF-I (p = 0.077), whereas FI (p = 0.004), HOMA-IR (p = 0.013), ejection fraction (EF, p = 0.013), early (E) to late (A) ventricular filling velocities (E/A, p = 0.001), and isovolumetric relaxation time (IVRT, p = 0.000) significantly improved. At T12, IGF-I (p = 0.000) significantly reduced compared to T0, and FI (p = 0.001), HOMA-IR (p = 0.000), LVMI (p = 0.000), and E/A (p = 0.006) further improved compared to T1. At T60, FI (p = 0.027), HOMA-IR (p = 0.049), and E/A (p = 0.005) significantly improved as compared to T1. At LFU IGF-I normalized in 83.3 %, FI (p = 0.000), HOMA-IR (p = 0.000), LVMi (p = 0.000), and E/A (p = 0.005) further improved as compared to T1. PEG dose significantly correlated with LVMi at T12 (r = 0.575, p = 0.000) and T60 (r = 0.403, p = 0.037). Long-term PEG addition to SA improves cardiac structure and performance, particularly diastolic dysfunction, in acromegalic patients resistant to SA.
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Affiliation(s)
- Renata S Auriemma
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II, via S. Pansini 5, 80131, Naples, Italy
| | - Ludovica F S Grasso
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II, via S. Pansini 5, 80131, Naples, Italy
| | - Mariano Galdiero
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II, via S. Pansini 5, 80131, Naples, Italy
| | - Maurizio Galderisi
- Department of Clinical and Experimental Medicine, University Federico II, Naples, Italy
| | - Claudia Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II, via S. Pansini 5, 80131, Naples, Italy
| | - Chiara Simeoli
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II, via S. Pansini 5, 80131, Naples, Italy
| | - Maria Cristina De Martino
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II, via S. Pansini 5, 80131, Naples, Italy
| | - Rosario Ferrigno
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II, via S. Pansini 5, 80131, Naples, Italy
| | - Mariarosaria Negri
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II, via S. Pansini 5, 80131, Naples, Italy
| | - Cristina de Angelis
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II, via S. Pansini 5, 80131, Naples, Italy
| | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II, via S. Pansini 5, 80131, Naples, Italy.
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II, via S. Pansini 5, 80131, Naples, Italy
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Abstract
Childhood obesity has been linked to cardiovascular disease (CVD) risk in adulthood. Of great concern is the expected increase in the population's CVD burden in relation to childhood obesity. This is compounded by the risk related to chronic hyperglycemia exposure in youth with type 2 diabetes. We herein provide an overview of the spectrum of early cardiovascular disease manifestation in youth with obesity and type 2 diabetes, in particular abnormalities in cardiac structure and function. Cardiac remodeling and adverse target organ damage is already evident in the pediatric age group in children with obesity and type 2 diabetes. This supports the importance of intensifying obesity prevention efforts and early intervention to treat comorbidities of obesity in the pediatric age group to prevent cardiac events in early adulthood.
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Affiliation(s)
- Fida Bacha
- USDA/ARS Children's Nutrition Research Center, Texas Children's Hospital, Baylor College of Medicine, 1100 Bates Street, Houston, TX, USA.
- Division of Pediatric Endocrinology and Diabetes, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
| | - Samuel S Gidding
- Nemours Cardiac Center, A.I. DuPont Hospital for Children, Wilmington, DE, USA
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30
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Lee BA, Oh DJ. The effects of long-term aerobic exercise on cardiac structure, stroke volume of the left ventricle, and cardiac output. J Exerc Rehabil 2016; 12:37-41. [PMID: 26933658 PMCID: PMC4771151 DOI: 10.12965/jer.150261] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 02/02/2016] [Indexed: 12/02/2022] Open
Abstract
The purpose of this study is to investigate the effect of the long-term aerobic exercises on cardiac structure, left ventricular stroke volume, and cardiac output. To achieve the purpose of the study, a total of 22 volunteers—including 10 people who have continued regular exercises and 12 people as the control group—were selected as subjects. With regard to data processing, the IBM SPSS Statistics ver. 21.0 was used to calculate the mean and standard deviation, and the difference of the means between the groups was verified through an independent t-test. As a result, there were significant differences between groups in the left ventricular end-diastolic internal dimension, left ventricular end-systolic internal dimension, left ventricular end-diastolic septum thickness. There were significant differences between groups in left ventricular end-diastolic volume, left ventricular mass, and left ventricular mass index per body surface area. However, in cardiac function, only left ventricular stroke volume showed a significant difference between groups.
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Affiliation(s)
- Bo-Ae Lee
- Department of Physical Education, College of Education, Pusan National University, Busan, Korea
| | - Deuk-Ja Oh
- Department of Physical Education, College of Education, Pusan National University, Busan, Korea
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Qi L, Yu Y, Chi X, Xu W, Lu D, Song Y, Zhang Y, Zhang H. Kindlin-2 interacts with α-actinin-2 and β1 integrin to maintain the integrity of the Z-disc in cardiac muscles. FEBS Lett 2015; 589:2155-62. [PMID: 26143257 DOI: 10.1016/j.febslet.2015.06.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 06/18/2015] [Accepted: 06/21/2015] [Indexed: 01/06/2023]
Abstract
Kindlin-2, as an integrin-interacting protein, was known to be required for the maintenance of cardiac structure and function in zebrafish. However, the mechanism remains unclear. We found that Kindlin-2 interacts and colocalizes with α-actinin-2 at the Z-disc of mouse cardiac muscles and there Kindlin-2 also interacts with β1 integrin. Knockdown of Kindlin-2 influences the association of β1 integrin with α-actinin-2 and disrupts the structure of the Z-disc and leads to cardiac dysfunction. Our data indicated that Kindlin-2 is a novel α-actinin-2-interacting protein and plays an important role in the regulation of cardiac structure and function.
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Affiliation(s)
- Lihua Qi
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, and State Key Laboratory of Natural and Biomimetic Drugs, Peking University Health Science Center, Beijing 100191, China; Department of Anatomy, Histology and Embryology, Peking University Health Science Center, Beijing 100191, China
| | - Yu Yu
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, and State Key Laboratory of Natural and Biomimetic Drugs, Peking University Health Science Center, Beijing 100191, China; Department of Anatomy, Histology and Embryology, Peking University Health Science Center, Beijing 100191, China
| | - Xiaochun Chi
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, and State Key Laboratory of Natural and Biomimetic Drugs, Peking University Health Science Center, Beijing 100191, China; Department of Anatomy, Histology and Embryology, Peking University Health Science Center, Beijing 100191, China
| | - Weizhi Xu
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, and State Key Laboratory of Natural and Biomimetic Drugs, Peking University Health Science Center, Beijing 100191, China; Department of Anatomy, Histology and Embryology, Peking University Health Science Center, Beijing 100191, China
| | - Danyu Lu
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, and State Key Laboratory of Natural and Biomimetic Drugs, Peking University Health Science Center, Beijing 100191, China; Department of Anatomy, Histology and Embryology, Peking University Health Science Center, Beijing 100191, China
| | - Yao Song
- Institute for Cardiovascular Research, Peking University Health Science Center, Beijing 100191, China
| | - Youyi Zhang
- Institute for Cardiovascular Research, Peking University Health Science Center, Beijing 100191, China
| | - Hongquan Zhang
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, and State Key Laboratory of Natural and Biomimetic Drugs, Peking University Health Science Center, Beijing 100191, China; Department of Anatomy, Histology and Embryology, Peking University Health Science Center, Beijing 100191, China.
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32
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Sharma S, Colangelo LA, Allison MA, Lima JAC, Ambale-Venkatesh B, Kishi S, Liu K, Greenland P. Association of serum leptin with future left ventricular structure and function: The Multi-Ethnic Study of Atherosclerosis (MESA). Int J Cardiol 2015; 193:64-8. [PMID: 26005181 DOI: 10.1016/j.ijcard.2015.05.068] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 05/11/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND/OBJECTIVES Earlier studies differ on whether serum leptin is associated with adverse or beneficial cardiac structure. We determined the association between serum leptin with subsequent cardiac structure and function. METHODS MESA is a multicenter longitudinal study of Black, White, Hispanic and Asian-American men and women. Cardiac MRI (CMR) was completed 6 to 8 years after leptin was measured. Left ventricular (LV) mass and volumes were indexed to body surface area. Multivariable linear regression models were constructed to assess the associations between leptin and risk factor adjusted (age, race, gender, systolic blood pressure, anti-hypertensive usage, LDL, HDL, hyperlipidemia medication usage, diabetes, diabetic medication usage, chronic kidney disease, alcohol and tobacco use, adiponectin and BMI) CMR variables. RESULTS Relative to participants in the lowest quintile of leptin concentration, participants in the highest quintile had a lower risk factor adjusted LV mass (-14 g), LV mass index (-9 g/m(2)), LV end diastolic volume index (LVEDVi) (-7 ml/m(2)), LV end systolic volume index (LVESVi) (-3 ml/m(2)) and stroke volume (-5 ml) (all p≤0.05). On regression analysis, a doubling of leptin concentration was associated with lower LV mass (-2.5 g ± 0.7 g), LV mass index (-1.7 ± 0.3g/m(2)), LVEDVi (-1.5 ± 0.4 ml/m(2)), LVESVi (-0.7 ± 0.2 ml/m(2)) and stroke volume (-1.0 ± 0.5 ml) (all p ≤ 0.05). CONCLUSIONS Higher leptin was associated with more favorable subsequent cardiac structure. Further study is needed to assess the prognostic and therapeutic implications of these observations.
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Affiliation(s)
- Shishir Sharma
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Laura A Colangelo
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | | | - Joao A C Lima
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - Satoru Kishi
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kiang Liu
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Philip Greenland
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
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Pacifico L, Chiesa C, Anania C, Merulis AD, Osborn JF, Romaggioli S, Gaudio E. Nonalcoholic fatty liver disease and the heart in children and adolescents. World J Gastroenterol 2014; 20:9055-9071. [PMID: 25083079 PMCID: PMC4112863 DOI: 10.3748/wjg.v20.i27.9055] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 02/07/2014] [Accepted: 05/14/2014] [Indexed: 02/06/2023] Open
Abstract
Over the last two decades, the rise in the prevalence rates of overweight and obesity explains the emergence of nonalcoholic fatty liver disease (NAFLD) as the leading cause of chronic liver disease worldwide. As described in adults, children and adolescents with fatty liver display insulin resistance, glucose intolerance, and dyslipidemia. Thus NAFLD has emerged as the hepatic component of the metabolic syndrome (MetS) and a strong cardiovascular risk factor even at a very early age. Several studies, including pediatric populations, have reported independent associations between NAFLD and markers of subclinical atherosclerosis including impaired flow-mediated vasodilation, increased carotid artery intima-media thickness, and arterial stiffness, after adjusting for cardiovascular risk factors and MetS. Also, it has been shown that NAFLD is associated with cardiac alterations, including abnormal left ventricular structure and impaired diastolic function. The duration of these subclinical abnormalities may be important, because treatment to reverse the process is most likely to be effective earlier in the disease. In the present review, we examine the current evidence on the association between NAFLD and atherosclerosis as well as between NAFLD and cardiac dysfunction in the pediatric population, and discuss briefly the possible biological mechanisms linking NAFLD and cardiovascular changes. We also address the approach to treatment for this increasingly prevalent disease, which is likely to have an important future global impact on the burden of ill health, to prevent not only end-stage liver disease but also cardiovascular disease.
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Carnevali L, Trombini M, Graiani G, Madeddu D, Quaini F, Landgraf R, Neumann ID, Nalivaiko E, Sgoifo A. Low vagally-mediated heart rate variability and increased susceptibility to ventricular arrhythmias in rats bred for high anxiety. Physiol Behav 2014; 128:16-25. [PMID: 24518868 DOI: 10.1016/j.physbeh.2014.01.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 01/15/2014] [Accepted: 01/26/2014] [Indexed: 10/25/2022]
Abstract
In humans, there is a documented association between anxiety disorders and cardiovascular disease. Putative underlying mechanisms may include an impairment of the autonomic nervous system control of cardiac function. The primary objective of the present study was to characterize cardiac autonomic modulation and susceptibility to arrhythmias in genetic lines of rats that differ largely in their anxiety level. To reach this goal, electrocardiographic recordings were performed in high-anxiety behavior (HAB, n=10) and low-anxiety behavior (LAB, n=10) rats at rest, during stressful stimuli and under autonomic pharmacological manipulations, and analyzed by means of time- and frequency-domain indexes of heart rate variability. During resting conditions, HAB rats displayed a reduced heart rate variability, mostly in terms of lower parasympathetic (vagal) modulation compared to LAB rats. In HAB rats, this relatively low cardiac vagal control was associated with smaller heart rate responsiveness to acute stressors compared to LAB counterparts. In addition, beta-adrenergic pharmacological stimulation induced a larger incidence of ventricular tachyarrhythmias in HABs compared to LABs. At sacrifice, a moderate increase in heart-body weight ratio was observed in HAB rats. We conclude that high levels of anxiety-related behavior in rats are associated with signs of i) impaired autonomic modulation of heart rate (low vagally-mediated heart rate variability), ii) poor adaptive heart rate responsiveness to stressful stimuli, iii) increased arrhythmia susceptibility, and iv) cardiac hypertrophy. These results highlight the utility of the HAB/LAB model for investigating the mechanistic basis of the comorbidity between anxiety disorders and cardiovascular disease.
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Affiliation(s)
| | | | - Gallia Graiani
- Department of Clinical and Experimental Medicine, University of Parma, Italy
| | - Denise Madeddu
- Department of Clinical and Experimental Medicine, University of Parma, Italy
| | - Federico Quaini
- Department of Clinical and Experimental Medicine, University of Parma, Italy
| | | | - Inga D Neumann
- Department of Behavioural and Molecular Neurobiology, University of Regensburg, Germany
| | - Eugene Nalivaiko
- School of Biomedical Sciences and Pharmacy, University of Newcastle, New South Wales, Australia
| | - Andrea Sgoifo
- Department of Neuroscience, University of Parma, Italy
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Abstract
The right ventricular apex (RVA) is a potential hot spot for development of cardiac rhythm anomalies. Many conditions, including arrhythmogenic right ventricular cardiomyopathy and Brugada's syndrome affect the RVA, and further, the RVA remains an incompletely characterized pacing region. Whether there are structural reasons underlying these conduction properties remains unsettled. In the current study, we characterize the mechanical strains and structural attributes of the right ventricular wall, and test the hypothesis that the right ventricular apex experiences heterogeneous strain distributions and altered fiber organization, and is thus susceptible to conduction alterations. Electromechanical wave imaging (EWI), or elastography, of hearts was used to quantify mechanical strains occurring through a cardiac cycle. Histological and immunofluorescence imaging techniques were used to examine cardiac wall structure and arrangement of junctional proteins. Right ventricular mechanical strains were elevated and sustained throughout systole, compared to the left ventricle and septum. Heterogeneous strain distributions, myocardial fiber disarray, and altered junctional protein localization occured at the RVA. Disarray and altered strain distributions suggest decreased structural strength at the right ventricular apex in particular and increased mechanical impositions in the right ventricle, respectively. Thus, these data demonstrate why the right ventricular apex may be particularly vulnerable to conduction abnormalities.
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