scholarly journals Low plasma levels of B-type natriuretic peptide predict the insulin resistance and left ventricular concentric remodeling in subjects without heart diseases: the observational arita cohort study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C Okamoto ◽  
T Hasegawa ◽  
O Tsukamoto ◽  
T Hitsumoto ◽  
K Matsuoka ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cohort Study ◽  
Natriuretic Peptide ◽  
Metabolic Disorders ◽  
Heart Diseases ◽  
Left Ventricular ◽  
Model Assessment ◽  
Funding Sources ◽  
Multivariate Adjustment ◽  
Lv Mass

Abstract Introduction Although natriuretic peptides (NPs) are established as a biomarker of heart failure (HF), NPs have been attracting attention as a mediator in the metabolic sequences recently. On the other hand, metabolic disorders including insulin resistance have been suggested to be involved in left ventricular (LV) concentric remodeling, hinting us to the unexpected relationship among NPs, insulin resistance and LV concentric remodeling. Purpose To investigate whether the basal B-type natriuretic peptide (BNP) level is linked to insulin resistance or LV concentric remodeling in the participants independent of HF in the Japanese Arita-cho cohort study. Methods Among 1632 subjects who participated in annual health checks from 2005 to 2008 in Arita-cho, Saga, Japan as a cohort study, we studied 675 subjects without history of cardiovascular disease with LV ejection fraction≥50% and BNP level<35pg/ml (227 men; median 62 years old). Insulin resistance was assessed by homeostatic model assessment of insulin resistance (HOMA-IR) and LV geometry including LV concentric remodeling was classified based on relative wall thickness (RWT) and LV mass index from echocardiographic findings. Results The tertile levels of BNP were inversely associated with HOMA-IR (the 1st tertile 1.33 (0.76–1.74), the 2nd tertile 1.05 (0.72–1.59), the 3rd tertile 0.95 (0.66–1.58), p=0.005); in the logistic regression analysis, the lower BNP level was related to the prevalence of insulin resistance defined as HOMA-IR≥1.37 after full multivariate adjustment (1 SD increment of BNP: adjusted odds ratio [aOR] 0.740, 95% confidence interval 0.601–0.912, P=0.005. LV concentric remodeling (RWT >0.42 and LV mass index ≤115 g/m2 in men and ≤95 g/m2 in women) was observed in 170 (25%) subjects; both low BNP level and higher insulin resistance were independently linked with LV concentric remodeling after multivariate adjustment (1 SD increment of BNP: aOR 0.714, 95% CI 0.544–0.938, p=0.015, HOMA-IR≥1.37 vs. <1.37: aOR 1.694, 95% CI 1.004–2.857, p=0.048, respectively) (Figure). Conclusions In the cohort without HF, the low BNP level was linked to insulin resistance and LV concentric remodeling independently, suggesting that the subjects with low NPs levels may cause metabolic disorders and LV morphological abnormalities. FUNDunding Acknowledgement Type of funding sources: None.

Abstract 14866: Hyperglycemia is an Independent Predictor of Left Ventricular Hypertrophy

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Mohan Thanikachalam ◽  
Vijaykumar Harivanzan ◽  
Jahnavi Sunderarajan ◽  
Ragavendra Baliga ◽  
Sadagopan Thanikachalam
Keyword(s):  
Insulin Resistance ◽  
Left Ventricular Hypertrophy ◽  
Odds Ratio ◽  
Aortic Stiffness ◽  
Ventricular Hypertrophy ◽  
Blood Lipids ◽  
Independent Predictor ◽  
Left Ventricular ◽  
Model Assessment ◽  
Lv Mass

Background: Diabetes mellitus (DM) is a risk factor for cardiovascular morbidity and mortality. In the current study we examine the association of hyperglycemic with left ventricular hypertrophy (LVH) independent of major correlates of LVH, such as, age, body size, blood pressure (BP) and aortic stiffness. Methods: We conducted a population-based, cross-sectional survey in 8,080 South Indians over the age of 20 years. The study included anthropometric, socioeconomic, psychosocial, BP, blood lipids, insulin, HbA1C, glucose tolerance test and carotid-femoral pulse wave velocity (PWV) assessments. Insulin resistance (IR) was defined as the 25% of the population with the highest values for homeostasis model assessment of insulin resistance (HOMA-IR). LV mass and relative wall thickness (RWT) were determined using echocardiography. LVH was defined as LV mass index (LVMI) >109 g/m 2 for men and >89 g/m 2 for women. Results: After the exclusion of people with hypertension, 5,841 subjects (mean age 41 years, 59% women) constituted the study sample. The mean LVMI in subjects with normoglycemia (n=3585), pre-DM (impaired fasting and/or post prandial blood sugar; n=1315) and DM (n=888) was 78.5 ± 17.5, 80.7 ± 19.4 and 87.2 ± 20.3, while mean RWT was 0.46 ± 0.09, 0.48 ± 0.09 and 0.51 ± 0.1, respectively (p<0.01). After adjustments for age, sex, BMI, BP, PWV, blood lipids, history of coronary artery disease, socioeconomic and smoking status, and physical activity, when compared to persons with normoglycemia, the odds ratio (95% CI) for LVH in pre-DM and DM men was 1.12 (0.89, 1.42) and 1.37 (1.04, 1.8), respectively; the odds ratio in pre-DM and DM women was 1.07 (0.89, 1.28) and 1.4 (1.08, 1.82), respectively. Among the persons with normoglycemia those with IR the odds ratio for LVH was 1.23 (0.85, 1.78) in men and 1.01 (0.79, 1.30) in women. In the multi-linear regression models HbA1c was independently correlated with LVMI. The correlation coefficients were higher in men (β= 0.07, p <0.001) compared to women (β= 0.037, p = 0.032). Conclusion: Hyperglycemia is an independent predictor of LVH in South Asian population. These findings indicate potential adverse myocardial effects of DM independent of associated risk factors, such as obesity, BP and aortic stiffness.

scholarly journals Association of Myocardial Energetic Efficiency with Circumferential and Longitudinal Left Ventricular Myocardial Function in Subjects with Increased Body Mass Index (the FATCOR Study)

2021 ◽  
Vol 10 (8) ◽  
pp. 1581
Author(s):  
Costantino Mancusi ◽  
Helga Midtbø ◽  
Nicola De De Luca ◽  
Hilde Halland ◽  
Giovanni de de Simone ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Body Mass ◽  
Myocardial Function ◽  
Left Ventricular ◽  
Energetic Efficiency ◽  
Model Assessment ◽  
Cardiometabolic Disorders ◽  
Lv Mass

Lower myocardial mechanic-energetic efficiency (MEEi), expressed as stroke volume/heart rate ratio (SV/HR) in mL/s/g of the left ventricular (LV) mass, is associated with the incidence of heart failure in subjects with cardiometabolic disorders. We explored the association of MEEi with LV systolic circumferential and longitudinal myocardial function in 480 subjects with increased body mass index (BMI) without known cardiovascular disease (mean age 47 ± 9 years, 61% women, 63% obese, 74% with hypertension) participating in the fat-associated cardiovascular dysfunction (FATCOR) study. Insulin resistance was assessed by the homeostasis model assessment insulin-resistance index (HOMA-IR). SV was calculated by Doppler echocardiography. The LV systolic circumferential myocardial function was evaluated by midwall fractional shortening (MFS) and longitudinal function by global longitudinal strain (GLS). Patients were grouped into MEEi quartiles. The lowest MEEi quartile (< 0.41 mL/s per g) was considered low MEEi. The association of MEEi with MFS and GLS were tested in multivariable linear regression analyses. Patients with low MEEi were more frequently men, with obesity and hypertension, dyslipidemia and higher HOMA-IR index (all p for trend < 0.05). In multivariable analyses, lower MEEi was associated with lower LV myocardial function by MFS and GLS independent of higher LV mass and clinical variables, including older age, male sex, presence of hypertension and a higher triglycerides level (all p < 0.05). In conclusion, in subjects with increased BMI without known cardiovascular disease participating in the FATCOR study, reduced MEEi was associated with lower LV myocardial function both in the circumferential and longitudinal direction, independent of cardiometabolic factors.

scholarly journals Natural history and disease progression of early cardiac amyloidosis evaluated by echocardiography

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
O Itzhaki Ben Zadok ◽  
A Eisen ◽  
Y Shapira ◽  
D Monakier ◽  
Z Iakobishvili ◽  
...  
Keyword(s):  
Disease Progression ◽  
Wall Thickness ◽  
Cardiac Amyloidosis ◽  
Time Course ◽  
Right Ventricular Dysfunction ◽  
Disease Diagnosis ◽  
Left Ventricular ◽  
Funding Sources ◽  
Lv Mass ◽  
Echocardiographic Findings

Abstract Funding Acknowledgements Type of funding sources: None. Background Since the diagnosis of cardiac amyloidosis (CA) is often delayed, echocardiographic findings are frequently indicative of already advanced cardiomyopathy. Aims to describe early echocardiographic features in patients subsequently diagnosed with CA and to delineate disease progression. Methods Pre-amyloid diagnosis echocardiographic studies were screened for structural and functional parameters and stratified according to the pathogenetic amyloid subtype (immunoglobulin light-chain (AL) or amyloid transthyretin (ATTR)). Abnormalities were defined based on published guidelines. Results Our cohort included 75 CA patients of whom 42 (56%) were diagnosed with AL and 33 (44%) with ATTR. Forty-two patients had an earlier echocardiography exam available for review. Patients presented with increased wall thickness (1.3 (IQR 1.0, 1.5)cm) ≥3 years before the diagnosis of CA and relative wall thickness (RWT) was increased (0.47 (IQR 0.41, 0.50)) ≥7 years pre-diagnosis. Between 1 to 3 years before CA diagnosis restrictive left ventricular (LV) filling pattern was present in 19% of patients and LV ejection fraction (LVEF)≤50% was present in 21% of patients. Right ventricular dysfunction was detected concomitantly with disease diagnosis. The echocardiographic phenotype of ATTR versus AL-CA showed increased RWT (0.74 (IQR 0.62, 0.92) vs. 0.62 (IQR 0.54, 0.76), p = 0.004) and LV mass index (144 (IQR 129, 191) vs. 115 (IQR 105, 146)g/m2,p = 0.020) and reduced LVEF (50 (IQR 44, 58) vs. (60 (IQR 53, 60)%, p = 0.009) throughout the time course of CA progression, albeit survival time was similar. Conclusions Increased wall thickness and diastolic dysfunction in CA develop over a time course of several years and can be diagnosed in their earlier stages by standard echocardiography Abstract Figure. Schematic proposed timeline of CA

scholarly journals Morphofunctional cardiac changes in pregnant women: associations with biomarkers

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000850 ◽  
Author(s):  
Takeshi Umazume ◽  
Takahiro Yamada ◽  
Satoshi Yamada ◽  
Satoshi Ishikawa ◽  
Itsuko Furuta ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Natriuretic Peptide ◽  
Troponin I ◽  
Vena Cava ◽  
Left Ventricular ◽  
Volume Index ◽  
Blood Levels ◽  
Lv Mass ◽  
Creatine Kinase Mb ◽  
In Pregnancy

ObjectiveThis longitudinal study was performed to determine changes in echocardiography parameters in association with various biomarker levels in pregnancy/postpartum.MethodsFifty-one healthy pregnant women underwent echocardiography with simultaneous determination of blood levels of five biomarkers at each of the first, second and third trimesters of pregnancy, immediately postpartum within 1 week after childbirth and approximately 1 month postpartum. Data on 255 echocardiography scans (five times per woman) and biomarkers were analysed.ResultsLeft ventricular end-diastolic dimension, left atrial (LA) volume index and left ventricular (LV) mass index increased with advancing gestation and reached the maximum immediately postpartum concomitant with the highest brain natriuretic peptide (BNP), N-terminal pro B-type natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hs-TnI) and creatine kinase MB levels. The inferior vena cava diameter was significantly reduced in the third trimester compared with that in the first trimester and the peak occurred immediately after childbirth. In 255 paired measurements, hs-TnI level was significantly positively correlated with LA volume index and LV mass index; BNP and NT-proBNP were significantly positively correlated with LA volume index and estimated glomerular filtration rate (eGFR) was significantly positively correlated with the average of early diastolic septal and lateral mitral annular velocity (e′).ConclusionsMaximal cardiac changes in morphology occurred postpartum within 1 week after childbirth, not during pregnancy. BNP/NT-proBNP, hs-TnI and eGFR reflected cardiac changes in pregnancy.

Abstract P372: Trajectories in Fasting Glucose and Insulin Resistance During Young Adulthood and Measures of Cardiac Function and Structure in Middle Adulthood: the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Michael P Bancks ◽  
Mercedes Carnethon ◽  
Lisa S Chow ◽  
David R Jacobs ◽  
Satoru Kishi ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cardiac Function ◽  
Young Adulthood ◽  
Left Atrial ◽  
Fasting Glucose ◽  
Left Ventricular ◽  
Middle Adulthood ◽  
End Diastolic Volume ◽  
Lv Mass ◽  
Stable Trajectory

Introduction: Whether trajectories in fasting glucose (FG) and insulin resistance (HOMA-IR) during young adulthood, before the onset of diabetes, are associated with cardiac function and structure in middle adulthood is unclear. Hypothesis: We tested the hypothesis that as compared to low-stable trajectory of FG and HOMA-IR, an increasing trajectory for each would be associated with worse cardiac structure and function in middle adulthood. Methods: We determined FG and HOMA-IR for 2,198 CARDIA participants, age 18-30 years, at baseline (1985-1986) and 7, 10, 15, 20, and 25 year follow-up exams who fasted for >8 hours and were not pregnant and were free from diabetes at all exams. At year 30 (2016), Doppler echocardiography and 2D-guided M-mode echocardiography was performed, measuring left atrial dimension, relative wall thickness, left ventricular (LV) mass, LV mass indexed to height, LV ejection fraction percentage, LV end-diastolic and systolic volume, and LV mass to volume ratio. Trajectories were determined using latent class analysis (SAS Proc Traj). We used multivariable linear regression to estimate adjusted means for echo measures according to FG and HOMA-IR trajectory group after adjustment for potential confounding factors. Results: For individuals free from diabetes in midlife, we identified three trajectory groups for both FG and HOMA-IR, low-stable to increasing, moderate-increasing, and high-increasing. Compared to low-stable trajectory for FG, increasing trajectory was associated with greater LV end-diastolic volume, whereas for HOMA-IR increasing trajectory was associated with lower LV end-diastolic volume ( Table ). Increasing FG trajectory was also associated with greater left atrial dimension, while HOMA-IR was not. Conclusion: Trajectory of both FG and HOMA-IR during young adulthood, in the absence of diabetes, was most prominently and differentially associated with LV end-diastolic volume. Future research should elaborate on differential associations of FG and HOMA-IR trajectory.

scholarly journals Association between Serum Mg2+ Concentrations and Cardiovascular Organ Damage in a Cohort of Adult Subjects

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1264 ◽  
Author(s):  
Elettra Mancuso ◽  
Maria Perticone ◽  
Rosangela Spiga ◽  
Carolina Averta ◽  
Mariangela Rubino ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Intima Media Thickness ◽  
Multivariate Regression Analysis ◽  
Organ Damage ◽  
Tolerance Test ◽  
Cardiovascular Complications ◽  
Left Ventricular ◽  
Oral Glucose ◽  
Model Assessment ◽  
Increased Risk

Magnesium (Mg2+) levels are associated with insulin resistance, hypertension, atherosclerosis, and type 2 diabetes (T2DM). We evaluated the clinical utility of physiological Mg2+ in assessing subclinical cardiovascular organ damage including increased carotid artery intima- media thickness (c-IMT) and left ventricular mass index (LVMI) in a cohort of well-characterized adult non-diabetic individuals. Age- and gender-adjusted correlations between Mg2+ and metabolic parameters showed that Mg2+ circulating levels were correlated negatively with body mass index (BMI), fasting glucose, and 2h-oral glucose tolerance test (OGTT) glucose. Similarly, Mg2+ levels were significantly and negatively related to c-IMT and LVMI. A multivariate regression analysis revealed that age (β = 0.440; p < 0.0001), BMI (β = 0.225; p < 0.0001), and Mg2+ concentration (β = −0.122; p < 0.01) were independently associated with c-IMT. Age (β = 0.244; p = 0.012), Mg2+ (β = −0.177; p = 0.019), and diastolic blood pressure (β = 0.184; p = 0.038) were significantly associated with LVMI in women, while age (β = 0.211; p = 0.019), Mg2+ (β = −0.171; p = 0.038) and the homeostasis model assessment index of insulin resistance (HOMA-IR) (β = −0.211; p = 0.041) were the sole variables associated with LVMI in men. In conclusion, our data support the hypothesis that the assessment of Mg2+ as part of the initial work-up might help unravel the presence of subclinical organ damage in subjects at increased risk of cardiovascular complications.

scholarly journals Association of vitamin D insufficiency with adiposity and metabolic disorders in Brazilian adolescents

2013 ◽  
Vol 17 (4) ◽  
pp. 787-794 ◽  
Author(s):  
Renata MS Oliveira ◽  
Juliana F Novaes ◽  
Lorena M Azeredo ◽  
Ana Paula C Cândido ◽  
Isabel CG Leite
Keyword(s):  
Insulin Resistance ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Metabolic Disorders ◽  
Central City ◽  
Vitamin D Insufficiency ◽  
Model Assessment ◽  
Cross Sectional ◽  
Vitamin D Intake ◽  
Dietary Record

AbstractObjectiveThe present study aimed to evaluate the frequency of deficiency/insufficiency of vitamin D in adolescents and its relationship to overweight and metabolic disorders.DesignCross-sectional study. Nutritional status was assessed by BMI according to WHO recommendations. Dietary intake was evaluated using a 3 d dietary record. The biochemical evaluation comprised measurements of serum lipids, lipoproteins, glucose, insulin, calcidiol (25(OH)D) and parathyroid hormone. Insulin resistance was calculated using the homeostasis model assessment. Body composition and blood pressure were assessed.SettingFifteen schools (eight public and seven private) in the central city of Juiz de Fora, Brazil.SubjectsThe analysis included a study population of 160 adolescents (seventy-seven eutrophic and eighty-three overweight) aged 15 to 17 years.ResultsVitamin D deficiency and insufficiency was observed in 1·25 and 70·6 % of adolescents, respectively. Serum 25(OH)D levels were statistically lower in adolescents with weight excess, abdominal obesity, hypercholesterolaemia, higher levels of parathyroid hormone, insulin resistance, hyperinsulinaemia and hypertension (P < 0·05). Lower BMI and waist circumference were observed in the third (highest) tertile of vitamin D intake for all adolescents. The high prevalence of vitamin D insufficiency is primarily nutritional and reflects a low vitamin D intake.ConclusionsOur results support the negative association among serum 25(OH)D levels and vitamin D intake with non-skeletal outcomes in Brazilian adolescents. Vitamin D fortification of foods and/or the use of vitamin D supplements need to be considered to raise vitamin D intake in the adolescent population, even in a sunny country like Brazil.

scholarly journals Fatty Liver is Associated with Low N-terminal pro-B-type Natriuretic Peptide in a Healthy Population: From the Kangbuk Samsung Health Study

2021 ◽  
Author(s):  
Hyo-In Choi ◽  
Mi Yeon Lee ◽  
Byeong Kil Oh ◽  
Seung Jae Lee ◽  
Jeong Gyu Kang ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Regression Model ◽  
Natriuretic Peptide ◽  
Abdominal Ultrasound ◽  
Health Study ◽  
Large Set ◽  
Model Assessment ◽  
Multivariable Regression Model ◽  
Multivariable Regression ◽  
The Impact

Abstract BackgroundFatty liver (FL), insulin resistance (IR), and obesity often coexist, but data on the independent impacts of these factors on N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in healthy populations are scarce. We therefore examined the impact of FL, IR and obesity on NT-proBNP levels using a large set of cross-sectional data.MethodsThe associations of FL, IR and obesity with NT-proBNP were analyzed in 39,923 healthy adult participants using Kangbuk Samsung Health Study data. IR was estimated using homeostasis model assessment-estimated insulin resistance (HOMA-IR) index. A multivariable regression model that adjusted for factors that influence NT-proBNP was conducted to identify associations between NT-proBNP and FL on abdominal ultrasound. ResultsA total of 11,704 (29.3%) individuals had FL on abdominal ultrasound. FL, IR and obesity showed independent inverse associations with NT-proBNP after multiple adjustments for baseline characteristics. In a multivariable regression model adjusting for IR and obesity, FL was independently associated with lower levels of NT-proBNP (odds ratio 0.864, 0.849 - 0.880). The combination of FL and IR was a powerful dual predictor, lowering NT-proBNP levels approximately 25% in the generally healthy study population.ConclusionIn this large sample of healthy individuals, FL was independently associated with lower NT-proBNP levels. FL and a high HOMA-IR index are a powerful predictor combination for lower NT-proBNP levels. Further research is needed to elucidate the mechanism underlying the association between FL and NT-proBNP.

scholarly journals Left Ventricular Remodeling and Myocardial Work: Results From the Population-Based STAAB Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Floran Sahiti ◽  
Caroline Morbach ◽  
Vladimir Cejka ◽  
Judith Albert ◽  
Felizitas A. Eichner ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
General Population ◽  
Myocardial Function ◽  
Myocardial Dysfunction ◽  
Blood Pressure Level ◽  
Hypertensive Heart Disease ◽  
Left Ventricular ◽  
Work Efficiency ◽  
Lv Mass

Introduction: Left ventricular (LV) dilatation and LV hypertrophy are acknowledged precursors of myocardial dysfunction and ultimately of heart failure, but the implications of abnormal LV geometry on myocardial function are not well-understood. Non-invasive LV myocardial work (MyW) assessment based on echocardiography-derived pressure-strain loops offers the opportunity to study detailed myocardial function in larger cohorts. We aimed to assess the relationship of LV geometry with MyW indices in general population free from heart failure.Methods and Results: We report cross-sectional baseline data from the Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) cohort study investigating a representative sample of the general population of Würzburg, Germany, aged 30–79 years. MyW analysis was performed in 1,926 individuals who were in sinus rhythm and free from valvular disease (49.3% female, 54 ± 12 years). In multivariable regression, higher LV volume was associated with higher global wasted work (GWW) (+0.5 mmHg% per mL/m2, p &lt; 0.001) and lower global work efficiency (GWE) (−0.02% per mL/m2, p &lt; 0.01), while higher LV mass was associated with higher GWW (+0.45 mmHg% per g/m2, p &lt; 0.001) and global constructive work (GCW) (+2.05 mmHg% per g/m2, p &lt; 0.01) and lower GWE (−0.015% per g/m2, p &lt; 0.001). This was dominated by the blood pressure level and also observed in participants with normal LV geometry and concomitant hypertension.Conclusion: Abnormal LV geometric profiles were associated with a higher amount of wasted work, which translated into reduced work efficiency. The pattern of a disproportionate increase in GWW with higher LV mass might be an early sign of hypertensive heart disease.

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