Effect of 24-Week Treatment with Telmisartan on Myocardial Structure and Function: Relationship to Insertion/Deletion Polymorphism of the Angiotensin-Converting Enzyme Gene

2005 ◽  
Vol 33 (1_suppl) ◽  
pp. 30A-38A ◽  
Author(s):  
AO Conrady ◽  
IO Kiselev ◽  
NI Usachev ◽  
AN Krutikov ◽  
OI Yakovleva ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Angiotensin Converting Enzyme ◽  
Diastolic Function ◽  
Left Ventricular Mass ◽  
Left Ventricular ◽  
Structure And Function ◽  
Converting Enzyme ◽  
Ace Gene ◽  
Myocardial Structure ◽  
And Function

The aim of the present study was to assess the effect of treatment with the angiotensin II receptor blocker telmisartan for 24 weeks on myocardial structure and function in patients with essential hypertension, and the relationship between this effect and the structural polymorphism of the angiotensin-converting enzyme (ACE) gene. Thirty-five patients with essential hypertension and left ventricular hypertrophy (LVH) without other associated morbidity were included in an open-label, non-comparative study. The patients were treated with telmisartan 40-80 mg once daily. In the final analysis, there were 29 patients who received the full course of treatment and were evaluated echocardiographically before and after treatment by the same blinded investigator, and myocardial structure and function were analysed. The myocardial mass of the left ventricle was determined in M-mode. Assessment of diastolic function of transmitral blood flow was performed using pulsed Doppler echocardiography. All patients were genotyped for insertion/deletion (I/D) polymorphism of the ACE gene. Telmisartan produced a significant reduction in left ventricular mass index from 140.4 ± 48.6 to 128.7 ± 40.6 g/m2 that was accompanied by an improvement in characteristics of diastolic function. The decrease in LVH was more significant in the ID genotype group than in the II and DD groups. Thus, prolonged treatment with telmisartan is accompanied by an improvement in myocardial structure, expressed as a reduction in left ventricular mass and function that is more marked in patients with ID genotype of the ACE gene.

Left ventricular size, mass, and function in relation to angiotensin-converting enzyme gene polymorphism in humans

1994 ◽  
Vol 267 (3) ◽  
pp. H1107-H1111 ◽  
Author(s):  
M. Kupari ◽  
M. Perola ◽  
P. Koskinen ◽  
J. Virolainen ◽  
P. J. Karhunen
Keyword(s):  
Heart Disease ◽  
Gene Polymorphism ◽  
Angiotensin Converting Enzyme ◽  
Body Height ◽  
Left Ventricular ◽  
Major Influence ◽  
Converting Enzyme ◽  
Ace Gene ◽  
Lv Mass ◽  
And Function

Angiotensin-converting enzyme (ACE) exhibits genetic variation related to insertion/deletion (I/D) polymorphism in intron 16 of the ACE gene. The DD genotype results in high ACE activity and is overrepresented in diseases characterized by left ventricular (LV) hypertrophy and dysfunction. We studied whether the ACE gene polymorphism predicts LV mass or function in the absence of heart disease. Polymerase chain reaction of leukocyte DNA was used to determine the I/D genotype, and M-mode and Doppler echocardiography were used to quantify LV mass and function in 86 human subjects, 36-37 yr of age. All were free of clinical heart disease. The LV mass-to-body height ratio averaged 99 +/- 19 (SD) g/m in subjects with the II genotype (n = 25), 99 +/- 30 g/m in those with the ID genotype (n = 35), and 94 +/- 24 g/m in those with the DD genotype (n = 26; P = 0.790). The indexes of LV systolic and diastolic function were also unrelated to the ACE genotype. We conclude that in the absence of heart disease the ACE gene variation has no major influence on LV mass or function that is detectable at echocardiography.

Abstract P044: Intensity Of Hypertensive Exposure In Young Adulthood And Myocardial Structure And Function In Middle Age

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Zhenyu Xiong ◽  
Jiaying Li ◽  
Xiaodong Zhuang ◽  
Xinxue Liao
Keyword(s):  
Diastolic Function ◽  
Young Adulthood ◽  
Longitudinal Strain ◽  
Middle Age ◽  
Early Adulthood ◽  
Left Ventricular ◽  
Structure And Function ◽  
Lv Mass ◽  
Myocardial Structure ◽  
And Function

Background and aims: To measure the association between intensity of hypertensive exposure and myocardial structure and function during a 25-year period in young adulthood. Methods: The Coronary Artery Risk Development in Young Adults (CARDIA) Study enrolled 5,115 healthy black and white American aged 18-30 years at baseline (March 1985 to May 2011). Intensity of hypertensive exposure was estimated based on their durations of hypertension over 25 years. Myocardial structure and function was identified by echocardiogram at year 25. Results: Of 2027 participants, 1315 were women (64.9%) and 906 were black (44.7%); mean (SD) age was 24.9 (3.6) at baseline. Duration of stage 1 hypertension was associated with higher left ventricular (LV) structure: LV mass (β [SE], 3.69 [1.80], P < 0.001), relative wall thickness (β [SE], 0.009 [0.003], P = 0.001), worse longitudinal strain (β [SE], 0.27 [0.008], P < 0.001), worse diastolic function: e’ (β [SE], -0.25 [0.07], P < 0.001), E/e’ (β [SE], 0.23 [0.007], P < 0.001). Duration of stage 2 hypertension was associated with higher left ventricular (LV) structure: LV mass (β [SE], 7.30 [2.23], P = 0.001), worse longitudinal strain (β [SE], 0.44 [0.13], P = 0.001), worse diastolic function: e’ (β [SE], -0.77 [0.12], P < 0.001), E/e’ (β [SE], 0.48 [0.13], P < 0.001). Conclusions: In early adulthood, more severe intensity of hypertensive exposure is associated with myocardial structure and diastolic dysfunction in middle age. Key Words: cardiac structure, cardiac dysfunction, hypertension, young adult

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

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.

Effect of chronic ANG I-converting enzyme inhibition on aging processes. II. Large arteries

1994 ◽  
Vol 267 (1) ◽  
pp. R124-R135 ◽  
Author(s):  
J. B. Michel ◽  
D. Heudes ◽  
O. Michel ◽  
P. Poitevin ◽  
M. Philippe ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Smooth Muscle ◽  
Arterial Wall ◽  
Left Ventricular ◽  
Structure And Function ◽  
Wall Structure ◽  
Large Artery ◽  
Converting Enzyme ◽  
Wall Stiffness ◽  
And Function

The consequences of hypertension and aging on cardiovascular structure and function are reputed to be similar, suggesting that blood pressure plays a role in the aging process. However, the exact relationship between aging, blood pressure, and the arterial structure-function relationship has not been demonstrated. To test the effects of aging, renin-angiotensin system, and pressure on the arterial wall, 20 normotensive male WAG/Rij rats were killed at 6, 12, 24, and 30 mo of age and compared with similar groups treated with an angiotensin (ANG)-converting enzyme inhibitor (ACEI), perindopril. Arterial function was determined by a systemic hemodynamic study and by in situ measurement of carotid compliance. Arterial wall structure was determined by histomorphometric and biochemical methods. Aging did not significantly modify blood pressure, but ACE inhibition decreased blood pressure significantly from 6 to 30 mo. Plasma renin activity decreased with age and increased with ACEI. Plasma atrial natriuretic factor increased with age and was significantly decreased with ACEI. Absolute and relative left ventricular weight increased with age, and ACEI delayed these increases. Arterial wall stiffness increased with age, as shown by a significant decrease in systemic and local arterial compliance and by an increase in aortic characteristic impedance. The increase in carotid wall compliance after poisoning of smooth muscle contractile function (KCN) was greater in young (6- and 12-mo old) than in old (24- and 30-mo old) rats. Chronic ACEI treatment increased basal carotid compliance values slightly and did not change KCN carotid compliance. The aortic and carotid luminal size increased regularly with age. Aging was associated without any change in absolute elastin content. In contrast, collagen content increased with aging. Aging was also associated with an increase in medial thickness. Medial thickening was mainly due to smooth muscle hypertrophy. Aging was associated with intimal proliferation, which became progressively thicker and collagen rich. ACEI treatment did not prevent aortic lumen enlargement but significantly postponed the increase in medial and intimal thickening. Biochemical determinations of the aortic wall components confirmed the morphometric data. In conclusion, the age-dependent large artery enlargement and stiffening were observed both in normotensive rats and in those rats whose blood pressure was lowered by ACEI. This suggests that aging and blood pressure affect arterial wall structure and function by different mechanisms.

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