Abstract P181: Cardiac Structure is Associated with Obesity and Blood Pressure But Not Inflammation

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Robert A Palermo ◽  
Samuel S Gidding ◽  
Stehpanie S DeLoach ◽  
Scott W Keith ◽  
Bonita Falkner
Keyword(s):  
Blood Pressure ◽  
African American ◽  
Left Ventricular Mass Index ◽  
African American Adolescents ◽  
Female Gender ◽  
Left Ventricular ◽  
P Value ◽  
Cardiac Structure ◽  
Z Score ◽  
Pai 1

Purpose: The aim of this study was to identify risk factors associated with cardiac structure in a cohort of African American adolescents oversampled for obesity and high blood pressure (BP). Additional associations of cardiac structure with a pro-inflammatory adipokine profile (low adiponectin, elevated IL6, PAI-1 and CRP) were sought. Methods: A cross-sectional study was conducted using a two-by-two factorial design with four groups of African American adolescents based on BP (prehypertension or stage 1 hypertension=high BP) and body mass index (BMI > 95% =obese) designation. Measurements included: echocardiogram, anthropomorphics, BP (on 3 separate occasions), high sensitivity CRP and plasma adipokines (adiponectin, IL6, PAI-1). Standardized echocardiogram measurements were used to obtain left ventricular mass index (LVMI, g/m 2.7 ) and left atrial diameter index (LADI, mm/m 2 ). Ordinary least-squares regression with model selection by Mallow's Cp was used to determine if pro-inflammatory adipokine profile predicted LV mass and LA diameter in models including age, gender, BMI z-score, and systolic BP. Results: Data on 251 African American adolescents, ages 13-19, were analyzed. BMI-z score was strongly associated with a pro-inflammatory adipokine profile whereas high BP was not. Variation in LADI was significantly associated with BMI (β=0.12, p<0.01) and female gender (β=0.08, p=0.04). LVMI variation was significantly associated with BMI (β=3.53, p<0.01), age (β=0.71, p<0.01), female gender (β=-4.32, p<0.01), and systolic BP (β=0.10, p=0.03). Though significant in univariate models, inflammatory markers were not significantly associated with LADI or LVMI after BMI adjustment. Conclusions: In African American adolescents, BMI is an important determinant of LADI and LVMI. Obesity is associated with a pro-inflammatory adipokine profile but LADI and LVMI are not. Table. Regression modeling results after variable selection by Mallow C p : Left Atrium Diameter Index and Left Ventricular Mass Index (N = 251) LADI LVMI Estimate (95% CL) p-value Estimate (95% CL) p-value Age (yr) 0.00063 (-0.021, 0.023) 0.955 0.71 ( 0.18, 1.24) 0.009 Gender (F) 0.08 ( 0.01, 0.16) 0.036 −4.32 (-6.13,-2.51) <.001 BMI z-score 0.12 ( 0.08, 0.16) <.001 3.53 ( 2.66, 4.40) <.001 Systolic BP 0.0019 (-0.0017, 0.0055) 0.306 0.0952 ( 0.0085, 0.1819) 0.032

Nocturnal Dipping and Left Ventricular Mass Index in the Chronic Kidney Disease in Children Cohort

2021 ◽  
pp. CJN.09810721
Author(s):  
Christine Bakhoum ◽  
Ronit Katz ◽  
Joshua Samuels ◽  
Tala Al-Rousan ◽  
Susan Furth ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
African American ◽  
Kidney Disease ◽  
Left Ventricular Mass Index ◽  
Sodium Intake ◽  
Left Ventricular ◽  
Spline Regression ◽  
African American Race

Background and objectives: The physiological nocturnal blood pressure decline is often blunted in patients with chronic kidney disease (CKD); however, the consequences of blood pressure non-dipping in children are largely unknown. Our objective was to determine risk factors for non-dipping and to investigate if non-dipping is associated with higher left ventricular mass index (LVMI) in children with CKD. Design, setting, participants, and measurements: We conducted a cross-sectional analysis of ambulatory blood pressure monitoring and echocardiographic data in participants of the Chronic Kidney Disease in Children study. Multivariable linear and spline regression analyses were used to evaluate the relationship of risk factors with dipping, and of dipping with LVMI. Results: Within 552 participants, mean age was 11 (± 4) years, mean eGFR was 53 (± 20) ml/min/1.73m2, and 41% were classified as non-dippers. In subjects with non-glomerular CKD, female sex and higher sodium intake were significantly associated with less systolic and diastolic dipping (p≤ 0.05). In those with glomerular CKD, African American race and greater proteinuria were significantly associated with less systolic and diastolic dipping (p≤ 0.05). Systolic and diastolic dipping were not significantly associated with LVMI; however, in spline regression plots, diastolic dipping appeared to have a non-linear relationship with LVMI. As compared to diastolic dipping of 20-25%, dipping of < 20% was associated with 1.41 g/m2.7 higher LVMI (95% CI -0.47, 3.29), and dipping of > 25% was associated with 1.98 g/m2.7 higher LVMI (95% CI -0.77, 4.73), though these relationships did not achieve statistical significance. Conclusion: African American race, female sex, and greater proteinuria and sodium intake were significantly associated with blunted dipping in children with CKD. We did not find a statistically significant association between dipping and LVMI.

scholarly journals Associations of Cardiac Structure with Obesity, Blood Pressure, Inflammation, and Insulin Resistance in African-American Adolescents

2013 ◽  
Vol 35 (2) ◽  
pp. 307-314 ◽  
Author(s):  
Samuel S. Gidding ◽  
Robert A. Palermo ◽  
Stephanie S. DeLoach ◽  
Scott W. Keith ◽  
Bonita Falkner
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
African American ◽  
African American Adolescents ◽  
Cardiac Structure

scholarly journals Interatrial block is related to atrial dysfunction in hypertensive subjects

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
L Tirapu Sola ◽  
F Loncaric ◽  
M Mimbrero ◽  
LG Mendieta ◽  
L Nunno ◽  
...  
Keyword(s):  
Global Longitudinal Strain ◽  
Female Gender ◽  
Left Ventricular ◽  
P Wave ◽  
P Value ◽  
Atrial Remodeling ◽  
Maximal Volume ◽  
Surface Ecg ◽  
Interatrial Block ◽  
And Function

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): La Marató TV3 Background Interatrial block (IAB), a delay of conduction of the sinus stimulus from right to left atria (LA), is defined as surface ECG P-wave duration ≥120 ms. Arterial hypertension (AH) and IAB have been related to development of atrial fibrillation. Aim To investigate the IAB prevalence in a cohort of AH patients and relate it to LA function. Methods 162 patients with well-regulated AT were included. 12-lead ECG were performed and analysed with a digital caliper. 2D and 3D echocardiography were performed, and LA function assessed with speckle-tracking deformation imaging.  Results The median age was 56 ± 6 years, 54% were males. Average duration of AH was 10 ± 6 years. IAB was seen in 25% of AH patients.  The comparison between groups is shown in Table 1. There were no differences in demographic characteristics,  QRS complex duration (p = 0.179) or left ventricular (LV) size and function between subgroups. LA was enlarged in IAB patients, which was coupled with impairment of the LA reservoir strain.  Conclusion Our results show considerable prevalence of IAB in AH patients. The demonstrated LA enlargement and function impairment is not associated with LV dysfunction, therefore suggesting an independent role of IAB in atrial remodeling. Table 1 Interatrial block P value Yes (n= 40) No (n= 142) Age 59 (54-62) 57 (53-61) 0.157 Female gender 16 (40%) 58 (48%) 0.467 Duration of Hypertension (years) 10 (6-12) 8 (5-15) 0.421 Systolic blood pressure (mmHg) 136 (125-150) 136 (127-147) 0.799 Diabetes 3 (8%) 16 (13%) 0.410 LVEDV (mL) 73 (63-91) 71 (57-87) 0.424 E/A 0.98 (0.84-1.25) 0.94 (0.79-1.11) 0.230 E/e’ 7.0 (4.9-8.9) 6.6 (5.2-8.4) 0.779 LVEF (%) 63 ± 7 64 ± 6 0.864 LV global longitudinal strain (%) 21.22 ± 2.63 21.19 ± 2.30 0.932 3D LA maximal volume (mL/m2) 36 (30-39) 30 (26-37) 0.028 3D LA minimal volume (mL/m2) 16 (12-18) 14 (11-17) 0.050 LA reservoir strain (%) 27.64 (24.90-31.23) 29.55 (26.17-32.81) 0.032 LA conduit strain (%) 13.91 (10.71-15.47) 14.37 (11.75-16.72) 0.192 LA contractile strain (%) 14.46 (11.86-16.59) 15.52 (13.66-16.96) 0.079 LVEDV Left Ventricular End Dyastolic Volume

scholarly journals Impact of Stress Reduction Interventions on Hostility and Ambulatory Systolic Blood Pressure in African American Adolescents

2010 ◽  
Vol 37 (2) ◽  
pp. 210-233 ◽  
Author(s):  
Lynda Brown Wright ◽  
Mathew J. Gregoski ◽  
Martha S. Tingen ◽  
Vernon A. Barnes ◽  
Frank A. Treiber
Keyword(s):  
Blood Pressure ◽  
African American ◽  
Systolic Blood Pressure ◽  
Stress Reduction ◽  
African American Adolescents

Abstract 15706: Association of Blood Pressure Level With Left Atrial Size and Function in Adolescents (SHIP AHOY)

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Edem Binka ◽  
Cedric Manlhiot ◽  
Elaine M Urbina ◽  
Tarek ALSAIED ◽  
Tammy M Brady
Keyword(s):  
Blood Pressure ◽  
Left Atrial ◽  
Global Longitudinal Strain ◽  
Blood Pressure Level ◽  
Left Ventricular ◽  
Z Score ◽  
Linear Regression Models ◽  
Cvd Risk ◽  
Strain And Strain Rate ◽  
And Function

Introduction: Left atrial (LA) enlargement and dysfunction are risk factors for stroke, atrial fibrillation and death in adults, and are associated with hypertension (HTN). In children, left ventricular hypertrophy is the most common manifestation of cardiac-specific organ damage in those with HTN, but gaps in knowledge remain regarding the association of HTN with LA size and function. Hypothesis: Increasing blood pressure (BP) is associated with increased LA volume and abnormal LA strain in children. Methods: Echocardiographic images of youth, aged 11 to 18 yrs from 5 clinical sites were obtained. LA strain and strain rate were analyzed using 2-D speckle tracking imaging with R-R gating in the apical 4 and 2-chamber views and averages of both views were used. Subjects were grouped by SBP as low-risk (L; <80th %ile), mid-risk (M; 80-<90th %ile), or high-risk, (H;≥90th %ile). Linear regression models were used to determine the association between BP z-score and LA size and function adjusting for age, sex, race and ethnicity. Results: N=347 youth (median age 15.7 yrs) 60% (n=208) male and 40% (n=139) non-white were included. BP groups differed by age (L&H<M) and BMI (L<M&H). BP groups did not differ by LA size and strain but differed by left ventricular mass index (H>L), stroke volume (M&H<L), peak global longitudinal strain (L>H), mitral E/e’ (H>L) and pulse wave velocity (H>L), each indicating worse CVD risk in the H vs. L group (Table). Multivariable analyses revealed DBP z-score to be independently associated with LA conduit strain (beta 0.73, 95% CI 0.01, 1.45, p<0.05). No other LA size or function variables were associated with BP. Conclusions: Greater BP is associated with increased CVD risk among youth as assessed by non-invasive measurements of CV structure and function. DBP is independently associated with LA conduit strain, a finding associated with CV events in adults. Future studies to determine the long-term association of abnormal DBP with LA strain are needed.

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