scholarly journals Complement in Renal Disease as a Potential Contributor to Arterial Hypertension

2021 ◽  
pp. 1-15
Author(s):  
Lisa-Maren Fischer ◽  
Laura A. Fichte ◽  
Maike Büttner-Herold ◽  
Fulvia Ferrazzi ◽  
Kerstin Amann ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Left Ventricular ◽  
Renal Diseases ◽  
Experimental Hypertension ◽  
Hypertensive Nephropathy ◽  
Arterial Blood ◽  
Ckd Stage ◽  
Renal Biopsies ◽  
Complement C1q ◽  
Complement Deposition

<b><i>Objective:</i></b> Complement deposition is prevalent in kidney biopsies of patients with arterial hypertension and hypertensive nephropathy, but an association of hypertension and complement deposition or involvement of complement in the pathogenesis of hypertensive nephropathy has not been shown to date. <b><i>Methods:</i></b> In this study, we analyzed complement C1q and C3c deposition in a rat model of overload and hypertension by subtotal nephrectomy (SNX) and in archival human renal biopsies from 217 patients with known hypertension and 91 control patients with no history of hypertension using semiquantitative scoring of C1q and C3c immunohistochemistry and correlation with parameters of renal function. To address whether complement was only passively deposited or actively expressed by renal cells, C1q and C3 mRNA expression were additionally analyzed. <b><i>Results:</i></b> Glomerular C1q and C3c complement deposition were significantly higher in kidneys of hypertensive SNX rats and hypertensive compared to nonhypertensive patients. Mean arterial blood pressure (BP) in SNX rats correlated well with the amount of glomerular C1q and C3c deposition and with left ventricular weight, as an indirect parameter of high BP. Quantitative mRNA analysis showed that C3 was not only deposited but also actively produced by glomerular cells of hypertensive SNX rats and in human renal biopsies. Of note, in patients CKD-stage correlated significantly with the intensity of glomerular C3c staining, but not with that of C1q. <b><i>Conclusion:</i></b> Renal complement deposition correlated with experimental hypertension as well as the presence of hypertension in a variety of renal diseases. To answer the question, if and how exactly renal complement is causative for the pathogenesis of arterial hypertension in men, further studies are needed.

scholarly journals Left ventricular geometric sportsmen power sports heavyweight with arterial hypertension

2020 ◽  
Vol 11 (1) ◽  
pp. 23-27
Author(s):  
Alexander B. Miroshnikov ◽  
Andrey V. Smolensky
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Risk Groups ◽  
Scientific Basis ◽  
Left Ventricular ◽  
Fat Free Mass ◽  
Preventive Program ◽  
Heavy Weight ◽  
Arterial Blood ◽  
Average Body

Aim.To conduct a comparative analysis of the geometry of the left ventricle (LV) at sportsmen heavyweight power sports with hypertension. Material and methods.We examined 238 representatives of power sports (weightlifting, powerlifting, bodybuilding) with an average body weight of 102.76.4 kg and arterial blood pressure at rest: systolic blood pressure 157.45,6, diastolic blood pressure 91.25.3. Along with the examination, all examined athletes underwent: bioimpedansometry, standard resting electrocardiogram, two-fold measurement of blood pressure, transthoracic echocardiography. Results.A survey of 238 weightlifting athletes of heavy weight categories with arterial hypertension showed an increased fat component in powerlifters (SAT 31.83.3%; BMI 34.41.3 kg/m2; Fat Mass Index 10.91,1 kg/m2; Fat-to-Muscle Ratio 0.50.1) and a sufficiently large muscle component: bodybuilding Fat Free Mass Index (FFMI) 26.92.1 kg/m2; powerlifting FFMI 23.51.6 kg/m2and weightlifting FFMI 23.71.8 kg/m2. The examination also showed a violation of the geometry of the LV. For athlete powerlifters, the following LV parameters were noted: LVMM 270.228.7 g; LVMI 123.77.9 g/m2; RWTLV 0.460.03 sm. For representatives of weightlifting; LVMM 267.832.3 g; LVMI 121.48.6 g/m2; RWTLV 0.450.02 sm. For bodybuilder athletes: LVMM 271.418.9 g; LVMI 120.16.3 g/m2; RWTLV 0.300.01 sm. Conclusion.Thus, the patterns obtained in relation to the geometry of the heart of athletes of power sports, heavy weight categories with arterial hypertension, can serve as a scientific basis for the formation of some aspects of the preventive program of physical rehabilitation with a priority focus on risk groups in such men.

scholarly journals Polymorphism A1166C of AGTR1 Gene and the State of Intrarenal Blood Flow in Patients with Essential Arterial Hypertension 1–2 Degrees

Kardiologiia ◽  
2019 ◽  
Vol 59 (3) ◽  
pp. 5-10 ◽  
Author(s):  
L. V. Melnikova ◽  
E. V. Osipova ◽  
O. A. Levashova
Keyword(s):  
Blood Flow ◽  
Arterial Hypertension ◽  
Renal Arteries ◽  
Hypertensive Nephropathy ◽  
Acceleration Time ◽  
Ckd Stage ◽  
Essential Arterial Hypertension ◽  
Intrarenal Blood Flow ◽  
Group 2 ◽  
Group 1

Aim: to study relationship between genetic disorders and features of intrarenal blood flow in patients with essential arterial hypertension (AH) of 1–2 degree. Materials and methods. We examined 100 patients (60 women, 40 men) aged 35 to 58 years with 1–2‑degree essential arterial hypertension (AH) and chronic kidney disease (CKD) stages I–III. Examination included triplex scanning of renal arteries on the ultrasound scanner Vivid-7 Dimension, genotyping of single-nucleotide polymorphism А1166С of the AGTR1 gene by real time polymerase chain reaction (PCR), estimation of glomerular filtration rate (GFR) using CKD-EPI formula. Patients were divided into 2 groups: group 1 included persons with I and II stage CKD (n=65, 25 men and 40 women), group 2 included patients with stages IIIA and IIIB CKD (n=35, 15 men and 20 women). Results. Among patients of group 1 prevailed genotype AA, while among group 2 patients prevailed genotype AC. Speed of blood flow in interlobar renal arteries was higher in the group 1 compared with group 2, while in the group 2 time of acceleration of blood flow was higher than in the group 1. Discussion. The data obtained are indicative of the decrease of systolic, diastolic, and averaged maximal blood flow velocity and the lengthening of acceleration time in patients with higher CKD stage. Conclusions. The presence in the genotype of patients with 1–2‑degree AH of AGTR1 1166С allele may be considered a risk factor of early development of CKD. Lowering of speed characteristics of blood flow and lengthening of the acceleration time in patients with AH can be a criterion of hypertensive nephropathy development.

scholarly journals The Capabilities of Amlodipine/Lisinopril Single-Pill Combination in the Treatment of Newly Diagnosed Arterial Hypertension in a Middle-Aged Patient (Case Report)

2020 ◽  
Vol 16 (2) ◽  
pp. 221-230
Author(s):  
A. I. Kochetkov ◽  
M. V. Lopukhina ◽  
E. A. Kotaeva ◽  
A. A. Kirichenko ◽  
O. D. Ostroumova
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Left Ventricular ◽  
Favorable Effect ◽  
Newly Diagnosed ◽  
Functional Changes ◽  
Collagen Formation ◽  
Cardiovascular Morbidity And Mortality ◽  
Single Pill ◽  
Left Atrial Stiffness

Arterial hypertension (AH) is one of the most significant modifiable risk factors that increase cardiovascular morbidity and mortality worldwide, including Russia. The complex of structural and functional changes in the heart that occurs during AH consists not only in the formation of left ventricular (LV) myocardial hypertrophy, but also in the myocardial stiffness increasing due to collagen formation and cardiomyocytes apoptosis. These abnormalities are substrate for diastolic function disturbances, electrical myocardial instability and ischemia. The article provides a clinical case of amlodipine/lisinopril single-pill combination (A/L SPC) use in real clinical practice in a patient with stage II grade 2 newly diagnosed AH and its effect on blood pressure and echocardiographic myocardial fibrosis markers, including speckle tracking parameters The high antihypertensive efficacy of A/L SPC, a favorable effect on blood pressure circadian rhythm, as well as pronounced target-organ protective properties, in particular the ability to reduce LV and left atrial stiffness, were demonstrated. So, we conclude that A/L SPC improve the elastic properties of the left heart.

scholarly journals Interventional and Surgical Treatments for Pulmonary Arterial Hypertension

2021 ◽  
Vol 10 (15) ◽  
pp. 3326
Author(s):  
Tomasz Stącel ◽  
Magdalena Latos ◽  
Maciej Urlik ◽  
Mirosław Nęcki ◽  
Remigiusz Antończyk ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Interdisciplinary Approach ◽  
Left Ventricular ◽  
Free Survival ◽  
Atrial Septostomy ◽  
Surgical Options ◽  
Pulmonary Arterial ◽  
Va Ecmo ◽  
Surgical Treatments

Despite significant advancements in pharmacological treatment, interventional and surgical options are still viable treatments for patients with pulmonary arterial hypertension (PAH), particularly idiopathic PAH. Herein, we review the interventional and surgical treatments for PAH. Atrial septostomy and the Potts shunt can be useful bridging tools for lung transplantation (Ltx), which remains the final surgical treatment among patients who are refractory to any other kind of therapy. Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) remains the ultimate bridging therapy for patients with severe PAH. More importantly, VA-ECMO plays a crucial role during Ltx and provides necessary left ventricular conditioning during the initial postoperative period. Pulmonary denervation may potentially be a new way to ensure better transplant-free survival among patients with the aforementioned disease. However, high-quality randomized controlled trials are needed. As established, obtaining the Eisenmenger physiology among patients with severe pulmonary hypertension by creating artificial defects is associated with improved survival. However, right-to-left shunting may be harmful after Ltx. Closure of the artificially created defects may carry some risk associated with cardiac surgery, especially among patients with Potts shunts. In conclusion, PAH requires an interdisciplinary approach using pharmacological, interventional, and surgical modalities.

scholarly journals More than ancillary records: clinical implications of renal pathology examination in tumor nephrectomy specimens

2021 ◽  
Author(s):  
Johannes Philipp Kläger ◽  
Ahmad Al-Taleb ◽  
Mladen Pavlovic ◽  
Andrea Haitel ◽  
Eva Comperat ◽  
...  
Keyword(s):  
Interstitial Fibrosis ◽  
Renal Pathology ◽  
Vascular Lesions ◽  
Renal Tumors ◽  
Renal Diseases ◽  
Tumor Type ◽  
Neoplastic Tissue ◽  
Cell Renal Cell Carcinoma ◽  
Hypertensive Nephropathy ◽  
Tumor Nephrectomy

Abstract Background Nephrectomy is the management of choice for the treatment of renal tumors. Surgical pathologists primarily focus on tumor diagnosis and investigations relating to prognosis or therapy. Pathological changes in non-neoplastic tissue may, however, be relevant for further management and should be thoroughly assessed. Methods Here, we examined the non-neoplastic renal parenchyma in 206 tumor nephrectomy specimens for the presence of glomerular, tubulo-interstitial, or vascular lesions, and correlated them with clinical parameters and outcome of renal function. Results We analyzed 188 malignant and 18 benign or pseudo-tumorous lesions. The most common tumor type was clear cell renal cell carcinoma (CCRCC, n = 106) followed by papillary or urothelial carcinomas (n = 25). Renal pathology examination revealed the presence of kidney disease in 39 cases (18.9%). Glomerulonephritis was found in 15 cases (7.3%), and the most frequent was IgA nephropathy (n = 6; 2.9%). Vasculitis was found in two cases (0.9%). In 15 cases we found tubulo-interstitial nephritis, and in 9 severe diabetic or hypertensive nephropathy. Partial nephrectomy was not linked to better eGFR at follow-up. Age, vascular nephropathy, glomerular scarring and interstitial fibrosis were the leading independent negative factors influencing eGFR at time of surgery, whereas proteinuria was associated with reduced eGFR at 1 year. Conclusion Our large study population indicates a high incidence of renal diseases potentially relevant for the postoperative management of patients with renal neoplasia. Consistent and systematic reporting of non-neoplastic renal pathology in tumor nephrectomy specimens should therefore be mandatory.

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