Impact of Mineralocorticoid Receptor Antagonists on Changes in Cardiac Structure and Function of Left Ventricular Dysfunction

AbstractThis study evaluated the effects of mitral regurgitation (MR) on cardiac structure and function in left ventricular noncompaction (LVNC) patients. The clinical and cardiovascular magnetic resonance (CMR) data for 182 patients with noncompaction or hypertrabeculation from three institutes were retrospectively included. We analyzed the difference in left ventricular geometry, cardiac function between LVNC patients with and without MR. The results showed that patients with MR had a worse New York Heart Association (NYHA) class and a higher incidence of arrhythmia (P < 0.05). MR occurred in 48.2% of LVNC patients. Compared to LVNC patients without MR, the two-dimensional sphericity index, maximum/minimum end-diastolic ratio and longitudinal shortening in LVNC patients with MR were lower (P < 0.05), and the peak longitudinal strain (PLS) of the global and segmental myocardium were obviously reduced (P < 0.05). No significant difference was found in strain in LVNC patients with different degree of MR; end diastolic volume, end systolic volume, and global PLS were statistically associated with MR and NYHA class (P < 0.05), but the non-compacted to compacted myocardium ratio had no significant correlation with them. In conclusion, the presence of MR is common in LVNC patients. LVNC patients with MR feature more severe morphological and functional changes. Hypertrabeculation is not an important factor affecting structure and function at the heart failure stage.

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Abstract 6278: Burden of Chronic Renal Insufficiency in the General Population and Added Predictive Power of GFR to BNP and NT-proBNP in Detection of Altered Ventricular Structure and Function

Circulation ◽

10.1161/circ.118.suppl_18.s_1173 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Alessandro Cataliotti ◽

Richard J Rodeheffer ◽

Douglas W Mahoney ◽

Carolyn S Lam ◽

Margaret M Redfield ◽

...

Keyword(s):

General Population ◽

Renal Insufficiency ◽

Chronic Renal Insufficiency ◽

Predictive Power ◽

Left Ventricular ◽

Structure And Function ◽

Cardiac Biomarkers ◽

Cardiac Structure ◽

Cardiac Structure And Function ◽

And Function

Background: Chronic renal insufficiency (CRI) is a strong predictor of increased mortality in the presence of heart failure (HF) and its prevalence has been increasing in the US. In addition, CRI is a major contributing factor to the progression of HF as it is associated with chronic volume overload, accelerated atherosclerosis and hypertension (HTN). The first aim of the current study was to evaluate the prevalence of CRI in an adult general population. The second aim was to address whether calculated glomerular filtration rate (cGFR) adds value to the cardiac biomarkers BNP and NT-proBNP in detecting early cardiac structural and functional impairments in the general population. Methods: From 1997 to 1999 medical history, physical examination, echocardiography, BNP (Biosite) and NT-proBNP (Roche) and serum creatinine (SCr) were obtained in 1,982 randomly selected residents of Olmsted County, MN >= 45 years (range 45 – 96 years). GFR was calculated using the Cockroft Gault equation. CRI was defined as a GFR < 60 ml/min. Cardiac structure and function were evaluated by in-depth echocardiographic examination. Results: The prevalence of cardiovascular co-morbidities was coronary atherosclerosis 12%, HTN 29.5% and diabetes mellitus 7.5%. The prevalence of CRI was 22.8% when cGFR was used for its detection. Importantly, by Chi-Square model, cGFR significantly increased the ability of BNP in detecting left ventricular hypertrophy (LVH) (p=0.004), increased relative wall thickness (p=0.0036), diastolic dysfunction (DDF) (p=0.0001) and HTN (p=0.0002). Similarly, when combined with NT-proBNP, cGFR increased the predictive power of detecting DDF (p=0.0001) and HTN (p=0.0366). Conclusion: This study reports a higher than predicted prevalence of CRI in this general US population equal to 23% and closely associated with the prevalence of HTN (29.5%). Importantly, this study also demonstrates that cGFR has additive predictive power when used in combination with two cardiac biomarkers of cardiac dysfunction and remodeling, BNP and NT-proBNP. These studies underscore the increasing burden of CRI in the general population and the utility of assessing cardiorenal function by combining renal and cardiac biomarkers in assessment of cardiac structure and function.

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Childhood and adult exposure to secondhand tobacco smoke and cardiac structure and function: results from Echo-SOL

Open Heart ◽

10.1136/openhrt-2018-000831 ◽

2018 ◽

Vol 5 (2) ◽

pp. e000831 ◽

Cited By ~ 2

Author(s):

Melissa Suzanne Burroughs Peña ◽

Katrina Swett ◽

Robert C Kaplan ◽

Krista Perreira ◽

Martha Daviglus ◽

...

Keyword(s):

Left Ventricular ◽

Structure And Function ◽

Cardiac Structure ◽

Isovolumic Relaxation Time ◽

Shs Exposure ◽

Cardiac Structure And Function ◽

And Function ◽

Relationship Of ◽

The Relationship ◽

Isovolumic Relaxation

ObjectiveTo describe the relationship of household secondhand smoke (SHS) exposure and cardiac structure and function.MethodsParticipants (n=1069; 68 % female; age 45–74 years) without history of tobacco use, coronary artery disease or severe valvular disease were included. Past childhood (starting at age <13 years), adolescent/adult and current exposure to household SHS was assessed. Survey linear regression analyses were used to model the relationship of SHS exposure and echocardiographic measures of cardiac structure and function, adjusting for covariates (age, sex, study site, alcohol use, physical activity and education).ResultsSHS exposure in childhood only was associated with reduced E/A velocity ratio (β=−0.06 (SE 0.02), p=0.008). SHS exposure in adolescence/adult only was associated with increased left ventricular ejection fraction (LVEF) (1.2 (0.6), p=0.04), left atrial volume index (1.7 (0.8), p=0.04) and decreased isovolumic relaxation time (−0.003 (0.002), p=0.03). SHS exposure in childhood and adolescence/adult was associated with worse left ventricular global longitudinal strain (LVGLS) (two-chamber) (0.8 (0.4), p= 0.049). Compared with individuals who do not live with a tobacco smoker, individuals who currently live with at least one tobacco smoker had reduced LVEF (−1.4 (0.6), p=0.02), LVGLS (average) (0.9 (0.40), p=0.03), medial E′ velocity (−0.5 (0.2), p=0.01), E/A ratio (−0.09 (0.03), p=0.003) and right ventricular fractional area change (−0.02 (0.01), p=0.01) with increased isovolumic relaxation time (0.006 (0.003), p=0.04).ConclusionsPast and current household exposure to SHS was associated with abnormalities in cardiac systolic and diastolic function. Reducing household SHS exposure may be an opportunity for cardiac dysfunction prevention to reduce the risk of future clinical heart failure.

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Association between Reduced estimated Glomerular Filtration Rate and Cardiac Structure and Function in Patients with Essential Hypertension

10.22541/au.163428484.43885905/v1 ◽

2021 ◽

Author(s):

Liying Mu ◽

Lu Chen ◽

juan du ◽

Hua Jiang ◽

Caixia Guo ◽

...

Keyword(s):

Essential Hypertension ◽

Left Atrial ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Left Ventricular ◽

Structure And Function ◽

Right Atrial ◽

Cardiac Structure ◽

Cardiac Structure And Function ◽

And Function

Objectives To investigate the relationship between small reductions in estimated glomerular filtration rate (eGFR) and cardiac structure and function in patients with essential hypertension. Methods The study group included 565 patients with essential hypertensive. eGFR was calculated by EPI equation and cardiac structure and function were assessed using echocardiography. The participants were divided into three groups: eGFR ≥90 mL/min /1.73 m2, 60-89 mL/min/1.73 m2, and 30-59 mL/min /1.73 m2. Pearson correlation analysis and multiple stepwise linear regression analysis were performed to evaluate associations between eGFR and echocardiogram parameters. Results Compared with patients with eGFR ≥ 90 mL/min/ 1.73 m2, those with eGFR 60-89 mL/min/ 1.73 m2 and 30-59 mL/min/ 1.73 m2 had higher left ventricular end-diastolic diameter (LVEDD) (p=0.019), mitral valve E wave (p=0.004), left atrial diameter (LAD) (p=0.001), right atrial diameter (RAD) (p=0.001), right ventricular diameter (RVD) (p=0.001) and lower left ventricular ejection fraction (LVEF) (p=0.01). After further adjustment for traditional cardiovascular risk factors including systolic and diastolic blood pressure, BMI, diabetes, dyslipidemia and smoking, eGFR was still associated with LVEF (p＜0.001), LAD (p＜0.001) and RAD (p=0.003). Conclusion Among patients with essential hypertension, even mildly reduced renal function is independently associated with greater cardiac remodeling, indicated by left atrial and right atrial enlargement, and worse left ventricular systolic function.

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Abstract MP57: The Association Between Anthropometrics and Different Measures of Cardiac Structure and Function - The Echo-SOL Study

Circulation ◽

10.1161/circ.131.suppl_1.mp57 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Matthew A Allison ◽

Jianwen Cai ◽

Ankit Desai ◽

Barry Hurwitz ◽

Ai Ni ◽

...

Keyword(s):

Ejection Fraction ◽

Left Ventricular ◽

Structure And Function ◽

Health Study ◽

Cardiac Structure ◽

Physical Measurements ◽

Lv Mass ◽

The Mean ◽

Cardiac Structure And Function ◽

And Function

Background: The purpose of this study was to determine the magnitudes and significances of the associations between adiposity and echocardiographically determined measures of left ventricular (LV) structure and function in a diverse cohort of Hispanic/Latino adults. Methods: Subjects were 1,350 adult men and women participants of the Hispanic Communities Health Study - Study of Latinos (HCHS-SOL) who enrolled in an ancillary study to determine cardiac structure and function by echocardiography. In addition to echocardiography, subjects were evaluated by extensive survey information, relevant physical measurements (to include bioelectrical impedance) and fasting blood assays. Results: The mean age was 56.1 years and 57% were female. Twenty-six percent were Mexican American, 25% Cuban American, 18% Dominican American, 17% Puerto Rican American, 8% Central American and 7% South American. Overall, the mean ejection fraction was 60.5%, while the mean stroke volume was 70 ml, end diastolic volume 83 ml, fractional shortening 31% and cardiac output 4.5 L/min. Results of multivariable linear regression adjusted for age, gender, hypertension, diabetes, dyslipidemia, cigarette smoking, family history of coronary heart disease, C-reactive protein and chronic kidney disease revealed that each 1-unit increment in body mass index (BMI) and fat mass (FM) by impedance was associated with 0.64 and 0.25 (p < 0.01 for both) higher LV mass index (to height), while a 0.1 unit increment in the waist to hip ratio (WHR) was associated with 3.2 higher LV mass index. Concomitantly, each 1-unit increment in BMI and FM was associated with 7 and 3% (p < 0.01 for each) higher odds of LV hypertrophy, while a 0.1 unit increment in WHR was associated with 78% higher odds for LV hypertrophy (p < 0.01). On the other hand, none of these variables were significantly associated with ejection fraction. There were no significant interactions between the anthropometric variables and the different Hispanic groups for LV mass index or hypertrophy. Conclusions: Among Hispanics/Latinos from different cultural backgrounds, and by three measures of body composition (BMI, FM and WHR), higher levels of adiposity are significantly associated with higher LV mass indexed for height and the odds for hypertrophy, while not being associated with better or worse ejection fraction.

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