Differences between diabetic and non-diabetic nephropathy patients in cardiac structure and function at the beginning of hemodialysis and their impact on the prediction of mortality

Objectives To characterize differences in cardiac structure and function in hemodialysis (HD) patients with diabetic nephropathy (DN) and in those without using echocardiography and to determine their impact on the prediction of mortality using echocardiographic parameters. Methods Clinical, laboratory, and echocardiographic data were collected from patients commencing HD. Results Compared with those without DN, patients with DN had lower peak velocity of the early diastolic wave (e′), larger left atria, and higher peak early diastolic velocity (E)/e′ and peak velocity of tricuspid regurgitation (TR). In addition, a larger proportion of DN patients had a combination of left ventricular (LV) diastolic dysfunction, cardiac valve calcification, moderate-to-severe cardiac valve regurgitation (CVR), and at least moderate pericardial effusion (PE). After accounting for age, sex, smoking, hypertension, hemoglobin, and albumin, DN was responsible for e′ < 10 cm/s, E/e′ >13 m/s, TR >2.8 m/s, LV diastolic dysfunction, CVR, and PE. LV diastolic dysfunction and E/e′ >13 were the most useful predictors of mortality in patients with DN. Conclusions Patients with DN who undergo HD tend to have worse LV diastolic function and are more likely to have heart valve problems. LV diastolic dysfunction and E/e′ are predictors of death in DN patients.

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Abstract 31: Impact of Acculturation on Cardiac Structure and Function Among Latinos in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL): The ECHO-SOL Ancillary Study

Circulation ◽

10.1161/circ.131.suppl_1.31 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Lenny Lopez ◽

Katrina Sweet ◽

Fátima Rodríguez ◽

Jorge R Kizer ◽

Frank J Penedo ◽

...

Keyword(s):

Diastolic Dysfunction ◽

Left Atrial Volume ◽

Left Ventricular ◽

Structure And Function ◽

Volume Index ◽

Cardiac Structure ◽

Length Of Residence ◽

The Us ◽

Cardiac Structure And Function ◽

And Function

Background: Abnormalities of cardiac structure and function are part of the spectrum of heart failure risk and progression. Acculturation is the process whereby an individual adopts the beliefs and practices of a host culture. Increasing acculturation has been associated with increased psychosocial stress and the adoption of deleterious health behaviors. The extent to which acculturation contributes to cardiovascular disease among Latinos is not well defined, and its association with cardiac structure and function in particular has not been studied among Latinos. Hypothesis: We hypothesized that higher acculturation is associated with worse left ventricular structure and function. Methods: The HCHS/SOL cohort included 16,415 Latino adults age 18-74 years from Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American backgrounds. A random subsample of 1350 also underwent detailed echocardiographic assessment for the following primary outcome measures: left atrial volume index (LAVI), left ventricular mass index (LVMI) and LV ejection fraction (LVEF), LV end diastolic volume (LVEDV) and diastolic dysfunction (Grade 0 vs. Grade 1-3). Acculturation was measured by length of residence in the US categorized as (< 5 years, 5-10 years, >10 years). Chi-square and ANOVA were used to assess differences across acculturation level and dependent variables. Separate linear and logistic regression analyses were used with sequential modeling for age and sex followed by models including diabetes, hypertension, body mass index, tobacco use, and estimated glomerular filtration rate. Results: The mean age of the Echocardiographic Cohort was 56 years (S.D. ±0.5). Length of residence among first generation immigrants (n=1239) was as follows: 9.7% ≤ 5 years; 14.8% 5-10 years; and 75.5% ≥10 years. Fully adjusted models demonstrated abnormal cardiac structure was significantly higher with increasing years of US residence: increasing LAVI (1.6 ml/m 2 higher ≥10 years vs. ≤ 5 years), increasing LVEDV (5.6 ml higher ≥10 years vs. ≤ 5 years), and LVMI (4.9g/m 2 higher ≥10 years vs. ≤ 5 years) (p<0.01 each). Increasing length of residence in the US was also associated with higher prevalence of diastolic dysfunction in models adjusted for age and gender (54.2% ≤ 5 years vs. 63.7% ≥10 years; p=0.04), though this became marginally non-significant in our fully adjustment models (p=0.07). There were no significant differences in systolic cardiac function as measured by LVEF. Conclusions: Among a diverse Latino population, higher acculturation defined as greater length of residence in the US, a proxy measure for acculturation, was associated with larger LA volume, larger LV cavity, higher LV mass and a tendency to higher prevalence of diastolic dysfunction independent of traditional risk factors. Acculturation may be a significant process that impacts cardiac structure and function among Latinos.

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Abstract 539: Buthionine Sulfoximine (BSO) Prevents Reductive Stress-induced Pathological Hypertrophic Cardiomyopathy

Circulation Research ◽

10.1161/res.127.suppl_1.539 ◽

2020 ◽

Vol 127 (Suppl_1) ◽

Author(s):

Gobinath Shanmugam ◽

Silvio Litovsky ◽

Steven M Pogwizd ◽

Namakkal S. Rajasekaran

Keyword(s):

Diastolic Dysfunction ◽

Weight Ratio ◽

Buthionine Sulfoximine ◽

Structure And Function ◽

Heart Weight ◽

Cardiac Structure ◽

Ros Signaling ◽

Reductive Stress ◽

Cardiac Structure And Function ◽

And Function

Background: Chronic reductive stress (RS) induces pathological cardiac remodeling and diastolic dysfunction. Here, we hypothesized that preventing RS via glutathione (GSH) depletion, through selective inhibition of γ-glutamyl cysteine ligase (γGCL), mitigates cardiac pathology in cRS mice. Methods: Cardiac-specific constitutively active Nrf2 TG-mice (α-MHc-caNrf2-TG), at 6 weeks of age, were administered with buthionine sulfoximine (BSO; 5.0 mM/Kg; daily for 16-weeks). At the end of 22 weeks, cardiac structure and function (systole & diastole using echocardiography), myocardial redox state, levels of ROS (using dihydroethidium (DHE) fluorescence), and antioxidant proteome were assessed in TG mice treated with PBS or BSO and compared with the age matched NTG littermates (n=6/group). Results: While the TG mice experiencing RS (GSH; 426.3±22.55 vs. 141.8±3.9 & GSH/GSSG; 61.04±5.4 vs. 23.27±1.3 in TG vs. NTG), this was significantly curtailed in BSO-treated TG mice (GSH 161.8±12.6 & GSH/GSSG; 25.1±4.3). This was coupled with the normal cardiac functions (EF; ~53% & MV E/A; 1.57) in the BSO-treated TG when compared to TG mice experiencing a hyper systolic function (>80% ejection fraction) with decreased cardiac volume and diastolic dysfunction with restricted filling (MV E/A ratio; >3.0), Of note, BSO treatment did not alter the protein levels of antioxidants (i.e. GCLC, GCLM, NQO1 and CAT), but only depleted the GSH pool (via inhibiting GCL activity) and restored the basal ROS signaling in the myocardium. Moreover, the BSO-treated TG mice did not develop cardiac hypertrophy, which was assessed by heart weight/body weight ratio, qPCR-based gene expression for hypertrophy ( Anf, Bnf, α-MHc and β-Mhc ). Conclusion: Our results suggest that pharmacological manipulation of myocardial redox and repletion of basal ROS signaling prevented RS-mediated pathological processes and rescued the cardiac structure and function.

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Relation of Impaired Glucose Tolerance to Cardiac Structure and Function: The Strong Heart Study

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(97)88289-7 ◽

1998 ◽

Vol 31 (2) ◽

pp. 525A-526A

Author(s):

A Ilercil

Keyword(s):

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Structure And Function ◽

Cardiac Structure ◽

Strong Heart Study ◽

Heart Study ◽

Cardiac Structure And Function ◽

And Function

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Faculty Opinions recommendation of Cardiac structure and function in heart failure with preserved ejection fraction: baseline findings from the echocardiographic study of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718180959.793489610 ◽

2014 ◽

Author(s):

Chim Lang

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Cardiac Function ◽

Structure And Function ◽

Cardiac Structure ◽

Preserved Ejection Fraction ◽

Aldosterone Antagonist ◽

Echocardiographic Study ◽

Cardiac Structure And Function ◽

And Function

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Impact of the severity of end-stage liver disease in cardiac structure and function

Annals of Hepatology ◽

10.1016/s1665-2681(19)31389-4 ◽

2013 ◽

Vol 12 (1) ◽

pp. 85-91 ◽

Cited By ~ 18

Author(s):

Odilson Marcos Silvestre ◽

Fernando Bacal ◽

Danusa de Souza Ramos ◽

Jose L. Andrade ◽

Meive Furtado ◽

...

Keyword(s):

Liver Disease ◽

Structure And Function ◽

Cardiac Structure ◽

End Stage Liver Disease ◽

Cardiac Structure And Function ◽

End Stage ◽

And Function

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Development of a semi-automated segmentation tool for high frequency ultrasound image analysis of mouse echocardiograms

Scientific Reports ◽

10.1038/s41598-021-85971-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kristi Powers ◽

Raymond Chang ◽

Justin Torello ◽

Rhonda Silva ◽

Yannick Cadoret ◽

...

Keyword(s):

Image Analysis ◽

Automated Analysis ◽

Structure And Function ◽

Ultrasound Images ◽

Cardiac Structure ◽

Short Axis ◽

Pixel Intensity ◽

Cardiac Structure And Function ◽

And Function

AbstractEchocardiography is a widely used and clinically translatable imaging modality for the evaluation of cardiac structure and function in preclinical drug discovery and development. Echocardiograms are among the first in vivo diagnostic tools utilized to evaluate the heart due to its relatively low cost, high throughput acquisition, and non-invasive nature; however lengthy manual image analysis, intra- and inter-operator variability, and subjective image analysis presents a challenge for reproducible data generation in preclinical research. To combat the image-processing bottleneck and address both variability and reproducibly challenges, we developed a semi-automated analysis algorithm workflow to analyze long- and short-axis murine left ventricle (LV) ultrasound images. The long-axis B-mode algorithm executes a script protocol that is trained using a reference library of 322 manually segmented LV ultrasound images. The short-axis script was engineered to analyze M-mode ultrasound images in a semi-automated fashion using a pixel intensity evaluation approach, allowing analysts to place two seed-points to triangulate the local maxima of LV wall boundary annotations. Blinded operator evaluation of the semi-automated analysis tool was performed and compared to the current manual segmentation methodology for testing inter- and intra-operator reproducibility at baseline and after a pharmacologic challenge. Comparisons between manual and semi-automatic derivation of LV ejection fraction resulted in a relative difference of 1% for long-axis (B-mode) images and 2.7% for short-axis (M-mode) images. Our semi-automatic workflow approach reduces image analysis time and subjective bias, as well as decreases inter- and intra-operator variability, thereby enhancing throughput and improving data quality for pre-clinical in vivo studies that incorporate cardiac structure and function endpoints.

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The mitral regurgitation effects of cardiac structure and function in left ventricular noncompaction

Scientific Reports ◽

10.1038/s41598-021-84233-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Qing Zou ◽

Rong Xu ◽

Xiao Li ◽

Hua-yan Xu ◽

Zhi-gang Yang ◽

...

Keyword(s):

Mitral Regurgitation ◽

Nyha Class ◽

Left Ventricular ◽

Structure And Function ◽

Left Ventricular Geometry ◽

Cardiac Structure ◽

Left Ventricular Noncompaction ◽

Ventricular Noncompaction ◽

Cardiac Structure And Function ◽

And Function

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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