scholarly journals Stronger Association of Albuminuria with the Risk of Vascular Complications than Estimated Glomerular Filtration Rate in Type 2 Diabetes

2021 ◽  
pp. 1-13
Author(s):  
Xinyu Hong ◽  
Lingning Huang ◽  
Yongze Zhang ◽  
Ximei Shen ◽  
Suiyan Weng ◽  
...  
Keyword(s):  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Vascular Complications ◽  
Left Ventricular ◽  
Control Group ◽  
Stable Group ◽  
Significant Difference

<b><i>Introduction:</i></b> Albuminuria is a risk factor for macro- and microvascular complications of type 2 diabetes (T2D).With an increasing trend of normoalbuminuria, however, of the 2 predictors – estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) – which one is a better predictor of vascular complications of T2D is not clear. <b><i>Objective:</i></b> This study aimed to compare the impacts of albuminuria and eGFR on patients with T2D associated with micro- and macrovascular complications. <b><i>Methods:</i></b> This retrospective study recruited 4,715 patients with T2D and grouped them based on the values of UACR (high UACR: ≥30 mg/g, low UACR: &#x3c;30 mg/g) and eGFR (mL/[min × 1.73 m<sup>2</sup>]) (G1: eGFR ≥ 90; G2: eGFR = 60–89; G3–5: eGFR &#x3c; 60) from April 2008 to November 2018. Logistic regression analysis was carried out for risk factors in patients with diabetic retinopathy (DR), diabetic peripheral neuropathy (DPN), peripheral arterial disease (PAD), left ventricular remodeling, diastolic disorders, and carotid atherosclerotic plaque in 6 different groups: low UACR + G1 (control group), low UACR + G2, low UACR + G3–5, high UACR + G1, high UACR + G2, and high UACR + G3–5. Patients were grouped according to the change in the UACR value (UACR-decreased group: ≤−30%, UACR-stable group: −30 to 30%, and UACR-increased group ≥30%), eGFR value (eGFR-decreased group: &#x3e;3%, and eGFR-stable group: ≤3%) and followed up. <b><i>Results:</i></b> Compared with the control group, patients with higher albuminuria and lower eGFR had higher adjusted odds ratio (OR) trends of complications, especially in the high UACR + G3–5 group. The OR of 2.010, 3.444, 1.633, 2.742, and 3.014 were obtained for DR, DPN, PAD, left ventricular remodeling, and diastolic disorders, respectively. No statistically significant difference was found in the risk of complications within each one of 2 phenotypes, regardless of the change in the eGFR. After grouping by eGFR, the regression analysis of the urinary protein level in each stage revealed that a majority of complications had a statistically significant difference, except for DR and PAD in the high UACR + G3–5 group. DR in the follow-up study had a higher risk in the UACR-stable/increased group than the UACR-decreased group (UACR stable: OR = 2.568; 95% confidence interval (CI): 1.128–5.849; <i>p</i> = 0.025; UACR increased: OR = 2.489; 95% CI: 1.140–5.433; <i>p</i> = 0.022). <b><i>Conclusion:</i></b> UACR is a more predictive risk factor for diabetic complications compared with a reduced eGFR.

Interaction between bradykinin subtype 2 and angiotensin II type 2 receptors during post-MI left ventricular remodeling

2007 ◽  
Vol 293 (6) ◽  
pp. H3372-H3378 ◽  
Author(s):  
David C. Isbell ◽  
Szilard Voros ◽  
Zequan Yang ◽  
Joseph M. DiMaria ◽  
Stuart S. Berr ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Left Ventricular ◽  
Volume Index ◽  
Anterior Myocardial Infarction ◽  
Systolic Volume ◽  
Beneficial Effects ◽  
End Diastolic Volume

Angiotensin II type 2 receptor (AT2R) overexpression (AT2TG) attenuates left ventricular remodeling in a mouse model of anterior myocardial infarction (MI). We hypothesized that the beneficial effects of cardiac AT2TG are mediated via the bradykinin subtype 2 receptor (B2R). Fourteen transgenic mice overexpressing the AT2R (AT2TG mice), 10 mice with a B2R deletion (B2KO mice), 13 AT2TG mice with B2R deletion (AT2TG/B2KO mice), and 11 wild-type (WT) mice were studied. All mice were on a C57BL/6 background. Mice were studied by cardiac magnetic resonance imaging at baseline and days 1, 7, and 28 after MI induced by 1 h of occlusion of the left anterior descending artery followed by reperfusion. Short-axis images from apex to base were used to compare ventricular volumes and ejection fraction (EF). At baseline, end-diastolic volume index (EDVI) and end-systolic volume index (ESVI) were lower and EF higher in AT2TG mice compared with the other three strains. Infarct size was similar between groups. No differences were observed in global remodeling parameters at day 28 between AT2TG and AT2TG/B2KO mice; however, EDVI and ESVI were lower and EF higher in both transgenic groups than in WT or B2KO mice. Both strains lacking B2R demonstrated increased collagen content and less hypertrophy in adjacent noninfarcted regions at day 28. Attenuation of postinfarct remodeling by overexpression of AT2R is not directly mediated via a B2R pathway. However, B2R does appear to have a role in the smaller cavity size and hyperdynamic function observed at baseline in AT2TG mice and in limiting collagen deposition during postinfarct remodeling.

scholarly journals A Nonpeptide Angiotensin II Type 2 Receptor Agonist Does Not Attenuate Postmyocardial Infarction Left Ventricular Remodeling in Mice

2012 ◽  
Vol 59 (4) ◽  
pp. 363-368 ◽  
Author(s):  
Alexander B. Jehle ◽  
Yaqin Xu ◽  
Joseph M. DiMaria ◽  
Brent A. French ◽  
Frederick H. Epstein ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Receptor Agonist ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Left Ventricular ◽  
Postmyocardial Infarction

scholarly journals Dynamic Tracking of Injected Mesenchymal Stem Cells after Myocardial Infarction in Rats: A Serial 7T MRI Study

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Xiuyu Chen ◽  
Minjie Lu ◽  
Ning Ma ◽  
Gang Yin ◽  
Chen Cui ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Capillary Density ◽  
Left Ventricular ◽  
Cine Mri ◽  
Control Group

Purpose.To track the fate of micron-sized particles of iron oxide (MPIO) labeled mesenchymal stem cells (MSCs) in vivo in a rat myocardial infarction model using 7T magnetic resonance imaging (MRI) scanner.Materials and Methods.Male MSCs (2 × 106/50 μL) dual-labeled with MPIO and CM-DiI were injected into the infarct periphery 7 days after myocardial infarction (MI). The control group received cell-free media injection. The temporal stem cell location, signal intensity, and cardiac function were dynamically assessed using a 7T MRI at 24 h before transplantation (baseline), 3 days, 2 weeks, and 4 weeks after transplantation, respectively.Results.MR hypointensities caused by MPIOs were observed on T2⁎-weighted images at all time points after MSCs injection. Cine-MRI showed that MSCs moderated progressive left ventricular remodeling. Double staining for iron and CD68 revealed that most of the iron-positive cells were CD68-positive macrophages. Real-time PCR for rat SRY gene showed the number of survival MSCs considerably decreased after transplantation. MSC-treated hearts had significantly increased capillary density in peri-infarct region and lower cardiomyocytes apoptosis and fibrosis formation.Conclusions.Iron particles are not a reliable marker for in vivo tracking the long-term fate of MSCs engraftment. Despite of poor cell retention, MSCs moderate left ventricular remodeling after MI.

scholarly journals Does a selective non-peptide angiotensin II type 2 receptor agonist reduce post-infarction left ventricular remodeling?

2009 ◽  
Vol 11 (S1) ◽  
Author(s):  
Alexander B Jehle ◽  
Yaqin Xu ◽  
Joseph D DiMaria ◽  
Frederick H Epstein ◽  
Brent A French ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Receptor Agonist ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Left Ventricular

scholarly journals Indicators of hemodynamic and structural heart parameters in patients with comorbid pathology

2021 ◽  
Vol 90 (1) ◽  
pp. 44-51
Author(s):  
I.I. Topchii ◽  
P.S. Semenovykh ◽  
O.M. Kirienko ◽  
D.O. Kirienko ◽  
O.I. Tsygankov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Left Ventricular ◽  
Control Group

Currently, diabetes mellitus is a complex global problem, which is increasing every year. So in 2019, diabetes in the world was detected in 463 million adults (from 20 to 79 years old). And the main cause of death in patients with diabetes mellitus is cardiovascular complications. The features of functional and structural changes in the heart were studied in patients with type 2 diabetes mellitus and nephropathy. A total of 75 patients with type 2 diabetes mellitus were examined, of which 50 patients had diabetic nephropathy of varying severity. The control group consisted of 20 healthy individuals. The control group consisted of 20 practically healthy patients. After a clinical examination, depending on the state of renal function, all patients were divided into the following groups: group I consisted of 25 patients with type 2 diabetes mellitus without signs of nephropathy; group II consisted of 26 patients with type 2 diabetes mellitus with normal glomerular filtration rate and albuminuria; group III consisted of 24 patients with type 2 diabetes mellitus with decreased glomerular filtration rate and albuminuria. To study changes in hemodynamics and structural parameters of the heart, patients underwent transthoracic echocardiography on an ULTIMA PA ultrasound machine (Radmir, Ukraine) using a sectoral phased transducer with a frequency range of 2–3 MHz according to the standard technique according to the recommendations of the American Echocardiographic Society. Indicators the patients underwent anthropometric measurements. Patients with diabetic nephropathy and albuminuria and decreased glomerular filtration rate showed an increase in the linear dimensions of the heart in comparison with controls and patients without signs of nephropathy. With diabetic nephropathy patients have a significant increase in left ventricular myocardial mass and a significant increase in the detection rate of left ventricular hypertrophy up to 91.3 % in patients with albuminuria and preserved renal function and up to 100.0 % with a decrease in glomerular filtration rate. Keywords: diabetes mellitus, hypertonic disease, diabetic nephropathy, heart remodeling, chronic kidney disease.

Abstract 11460: Chronic Intermittent Low Level Transcutaneous Electrical Stimulation of the Auricular Branch of the Vagus Nerve Improves Left Ventricular Remodeling in Conscious Dogs With Healed Myocardial Infarction

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Zhuo Wang ◽  
Lilei Yu ◽  
Songyun Wang ◽  
Bing Huang ◽  
Kai Liao ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Vagus Nerve ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Left Ventricular ◽  
Conscious Dogs ◽  
Control Group ◽  
Low Level ◽  
Auricular Branch

Introduction: Vagus nerve stimulation (VNS) attenuates left ventricular remodeling after myocardial infarction (MI) by improving the imbalance of autonomic nervous system. Our previous study found Low-level tragus stimulation (LL-TS) had the same antiarrhythmic effects as VNS by regulation of the autonomic nervous system. Hypothesis: Chronic intermittent LL-TS could attenuate left ventricular remodeling in conscious dogs with healed myocardial infarction. Methods: Thirty beagle dogs were randomly divided into three groups. LL-TS group (n=10) and MI group (n=10) underwent left anterior descending coronary artery and all major diagonal branches ligation to introduce MI under general anesthesia. Control group (n=10) underwent sham surgery. Auricular vagus nerve stimulation (frequency 20Hz, pulse width 1ms) with duty cycle of 5s on and 5s off was delivered to the bilateral tragus in external auditory canal with ear-clips connected to a custom-made stimulator. The voltage slowing sinus rate was used as the threshold for setting LL-TS at 80% below that. The actual voltage of stimulation was in the range of 16 to 24V that did not cause any heart rate changes. LL-TS group was given four hours of LL-TS at 7-9AM and 4-6PM on conscious dogs from the day of MI introduction to the end of 90-day follow-up, MI group and control group were given no stimulations. Results: At the end of 90-days follow-up LL-TS group significantly reduced left ventricular dilatation, improve left ventricular contractile and diastolic function, reduced mean infarct size by about 50% compared with MI group. Also LL-TS treatment alleviated cardiac fibrosis around infarction border and significantly decreased protein level of collagen I, collagen III, TGF-β1, MMP-9 in noninfarcted left ventricular free wall tissue after MI. Moreover, the plasma level of hs-CRP, NE and NT-proBNP in LL-TS group was significantly lower than MI group from the 7th day to the end of follow-up. Conclusions: Chronic intermittent low-level transcutaneous electrical stimulation of the auricular branch of the vagus nerve can attenuate left ventricular remodeling and improve cardiac function in conscious dogs with healed myocardial infarction.

scholarly journals Nicotine-modified postinfarction left ventricular remodeling

1999 ◽  
Vol 276 (3) ◽  
pp. H1103-H1106 ◽  
Author(s):  
Francisco J. Villarreal ◽  
Derrick Hong ◽  
Jeffrey Omens
Keyword(s):  
Wound Healing ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Day Treatment ◽  
Nicotine Patch ◽  
Strain Analysis ◽  
Anterior Wall ◽  
Mechanical Tests ◽  
Left Ventricular ◽  
Control Group

Cigarette smoking has been noted to impair wound healing in tissues such as skin, bone, and gut. This study was designed to examine whether nicotine adversely affects postinfarction cardiac wound healing and remodeling in an experimental model of myocardial infarction. For this purpose, two groups of rats were studied. The control group received a simple bandage, and the nicotine group had a section (1.75 mg/day) of a nicotine patch attached on their backs. After a 7-day treatment period, an anterior wall infarction was induced. A bandage-free 7-day healing period followed, after which hearts were isolated for mechanical tests. Nicotine-treated rats developed significantly enlarged left ventricles with thin, infarcted walls and a rightward shift in the passive pressure-volume relationship. Pressure-strain analysis also indicated possible changes in the material properties of the wound for nicotine-treated rats. In conclusion, nicotine has significant adverse effects on postinfarction healing and left ventricular remodeling. These observations have important clinical implications because of the enhanced risk for development of heart failure.

Effects of Tribuli Saponins on Ventricular Remodeling after Myocardial Infarction in Hyperlipidemic Rats

2007 ◽  
Vol 35 (02) ◽  
pp. 309-316 ◽  
Author(s):  
Yan Guo ◽  
Da-Zhuo Shi ◽  
Hui-Jun Yin ◽  
Ke-Ji Chen
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Remodeling ◽  
Early Stage ◽  
Left Ventricular Remodeling ◽  
Posterior Wall ◽  
Left Ventricular ◽  
High Dose ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
Significant Difference

This experiment was designed to determine whether Tribuli saponins (TS) relieve left ventricular remodeling (VR) after myocardial infarction (MI) in a murine hyperlipemia (HL) model. MI and HL models were induced and high and low doses of TS and simvastatin were administrated to the rats. Four weeks later, echocardiographic observation was performed and the left and right ventricular weight index (LVWI, RVWI) was calculated. Echocardiographic results showed that both high dose of TS and simvastatin had a beneficial effect on increasing fractional shortening (FS) and ejection fraction (EF), reducing left ventricular end diastolic volume (LVEDV), systolic volume (LVESV), left ventricular dimension end diastole (LVDd) and systole (LVDs), and decreasing LVWI, as compared to those in the HL-MI model group ( p < 0.05, 0.01). Both medicines had little impact on thickness of the anterior and posterior wall. No significant difference was observed between each treatment group ( p > 0.05). In conclusion, TS not only lowered serum lipidemia, but also relieved left ventricular remodeling, and improved cardiac function in the early stage after MI.

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