scholarly journals High vitamin K status is prospectively associated with decreased left ventricular mass in women: the Hoorn Study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Joline W. J. Beulens ◽  
Elisa Dal Canto ◽  
Coen D. A. Stehouwer ◽  
Roger J. M. W. Rennenberg ◽  
Petra J. M. Elders ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular Mass ◽  
Vitamin K ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Cardiac Structure ◽  
High Vitamin ◽  
Ventricular Mass

Abstract Background Vitamin K is associated with reduced cardiovascular disease risk such as heart failure, possibly by carboxylation of matrix-gla protein (MGP), a potent inhibitor of vascular calcification. The relationship of vitamin K intake or status with cardiac structure and function is largely unknown. Therefore this study aims to investigate the prospective association of vitamin K status and intake with echocardiographic measures. Methods This study included 427 participants from the Hoorn Study, a population-based cohort. Vitamin K status was assessed at baseline by plasma desphospho-uncarboxylated MGP (dp-ucMGP) with higher concentrations reflecting lower vitamin K status. Vitamin K intake was assessed at baseline with a validated food-frequency questionnaire. Echocardiography was performed at baseline and after a mean follow-up time of 7.6, SD=±0.7 years. We used linear regression for the association of vitamin K status and intake with left ventricular ejection fraction (LVEF), left atrial volume index (LAVI) and left ventricular mass index (LVMI), adjusted for potential confounders. Results The mean age was 66.8, SD=±6.1 years (51% were male). A high vitamin K status was prospectively associated with decreased LVMI (change from baseline to follow-up: -5.0, 95% CI: -10.5;0.4 g/m2.7) for the highest quartile compared to the lowest in women (P-interaction sex=0.07). No association was found in men. Vitamin K status was not associated with LVEF or LAVI. Vitamin K intake was not associated with any of the echocardiographic measures. Conclusions This study showed a high vitamin K status being associated with decreased LVMI only in women, while intakes of vitamin K were not associated with any cardiac structure or function measures. These results extend previous findings for a role of vitamin K status to decrease heart failure risk.

scholarly journals High Vitamin K Status is Prospectively Associated with Decreased Left Ventricular Mass in Women: The Hoorn Study

2021 ◽  
Author(s):  
Joline W.J. Beulens ◽  
Elisa Dal Canto ◽  
Coen D.A. Stehouwer ◽  
Roger J.M.W. Rennenberg ◽  
Petra J.M Elders ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular Mass ◽  
Vitamin K ◽  
Left Ventricular ◽  
Matrix Gla Protein ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
High Vitamin ◽  
Ventricular Mass

Abstract Background: Vitamin K is associated with reduced cardiovascular disease risk such as heart failure, possibly by carboxylation of matrix-gla protein (MGP), a potent inhibitor of vascular calcification. The relationship of vitamin K intake or status with cardiac structure and function is largely unknown. Therefore this study aims to investigate the prospective association of vitamin K status and intake with echocardiographic measures. Methods: This study included 427 participants from the Hoorn Study, a population-based cohort. Vitamin K status was assessed at baseline by plasma desphospho-uncarboxylated MGP (dp-ucMGP) with higher concentrations reflecting lower vitamin K status. Vitamin K intake was assessed at baseline with a validated food-frequency questionnaire. Echocardiography was performed at baseline and after 7.6 years follow-up. We used linear regression for the association of vitamin K status and intake with left ventricular ejection fraction (LVEF), left atrial volume index (LAVI) and left ventricular mass index (LVMI), adjusted for potential confounders.Results: The mean age was 66.8±6.1 years (51% were male). A high vitamin K status was prospectively associated with decreased LVMI -5.0 (-10.5;0.4) g/m2.7 for the highest quartile compared to the lowest in women (P-interaction sex=0.07). No association was found in men. Vitamin K status was not associated with LVEF or LAVI. Intakes of vitamin K were not associated with any of the echocardiographic measures.Conclusions: This study indicates that a high vitamin K status is associated with decreased LVMI only in women. These results extend previous findings for a role of vitamin K status to decrease heart failure risk.

Abstract P221: Combined Low Vitamin D and K Status is Associated With Greater Left Ventricular Mass

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Sharon Remmelzwaal ◽  
Joline Beulens ◽  
Petra J Elders ◽  
Jacqueline M Dekker ◽  
Coen D Stehouwer ◽  
...  
Keyword(s):  
Vitamin D ◽  
Left Ventricle ◽  
Left Ventricular Mass ◽  
Vitamin K ◽  
Reference Group ◽  
Left Ventricular ◽  
Cardiac Structure ◽  
Left Ventricle Mass ◽  
Ventricular Mass

Introduction: Low vitamin D and vitamin K status are both associated with cardiovascular disease risk. New evidence from experimental studies on bone health suggest an interaction between vitamin D and K, however, a joint association with vascular health outcomes is largely unknown. Hypothesis: We assessed the hypothesis that combined low vitamin D and low vitamin K status is prospectively associated with unfavorable measures of cardiac structure and function. Methods: In the Hoorn Study, a population-based cohort study of 598 participants, mean age 70.1±6.6 years, 51% female, had physical examinations in 2000-2001 (baseline for the current analyses), and of these 265 had a follow-up in 2007-2009. In baseline samples, vitamin D and K status were assessed by measuring 25-hydroxyvitamin D [25(OH)D] and dephosphorylated uncarboxylated matrix gla protein (dp-ucMGP). High dp-ucMGP is indicative of a low vitamin K status. We studied the combined association of 25(OH)D and dp-ucMGP with echocardiographic measures of left ventricular mass index, left ventricular ejection fraction and left atrium volume index after 8 years of follow-up using linear regression analyses. The group high 25(OH)D/low dp-ucMGP was the reference group. We adjusted our analyses for potential confounders including follow-up time and baseline echocardiographic measures. Results: Mean 25(OH)D was 57.8 nmol/L and median was dp-ucMGP was 567 pmol/L. The low 25(OH)D/high dp-ucMGP category was associated with a greater left ventricle mass index:4.8 g/m 2.7 (95% CI 0.6, 9.1) at follow-up compared to the reference group, in the fully adjusted model (Table 1). No associations were observed between 25(OH)D and dp-ucMGP categories with systolic and diastolic function after 8 years of follow-up. Conclusion: In conclusion, these results suggest that high levels of 25(OH)D and low levels of dp-ucMGP are associated with a greater left ventricle mass index. Vitamin D and K supplementation trials are the next step to assess a causal relationship with cardiac structure.

scholarly journals Regression of Left Ventricular Mass after Implantation of the Sutureless 3f Enable Aortic Bioprosthesis

2015 ◽  
Vol 42 (2) ◽  
pp. 117-123
Author(s):  
Giovanni Concistrè ◽  
Antonio Miceli ◽  
Federica Marchi ◽  
Francesca Chiaramonti ◽  
Mattia Glauber ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Left Ventricular Mass ◽  
Valve Replacement ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Mass ◽  
The Mean

Left ventricular hypertrophy in aortic stenosis is considered a compensatory response for the maintenance of systolic function but a risk factor for cardiac morbidity and death. We investigated the degree of left ventricular mass regression after implantation of the sutureless Medtronic 3f Enable® Aortic Bioprosthesis. We studied 19 patients who, from May 2010 through July 2011, underwent isolated aortic valve replacement with the 3f Enable bioprosthetic valve, with clinical and echocardiographic follow-up at 6 months. The mean age was 77.1 ± 5.1 years (range, 68–86 yr); 14 patients were women (73.7%); and the mean logistic EuroSCORE was 15.4% ± 11.8%. Echocardiography was performed preoperatively, at discharge, and at 6 months' follow-up. The left ventricular mass was calculated by means of the Devereux formula and indexed to body surface area. The left ventricular mass index decreased from 146.1 ± 47.6 g/m2 at baseline to 118.1 ± 39.8 g/m2 at follow-up (P=0.003). The left ventricular ejection fraction did not change significantly. The mean transaortic gradient decreased from 57.3 ± 14.2 mmHg at baseline to 12.3 ± 4.6 mmHg at discharge and 12.2 ± 5.3 mmHg at follow-up (P <0.001), and these decreases were accompanied by substantial clinical improvement. No moderate or severe paravalvular leakage was present at discharge or at follow-up. In isolated aortic stenosis, aortic valve replacement with the 3f Enable bioprosthesis results in significant regression of left ventricular mass at 6 months' follow-up. However, this regression needs to be verified by long-term echocardiographic follow-up.

Impact of left atrial appendage closure on left atrial hemodynamics: a prospective single center study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Mertens ◽  
N Bouziri ◽  
P Guedeney ◽  
G Duthoit ◽  
A Redheuil ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Atrial ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Clinical Issue ◽  
Ventricular Ejection Fraction ◽  
Mean Pressure ◽  
The Impact

Abstract Background Percutaneous left atrial (LA) appendage closure is increasingly used to prevent strokes in patients with atrial fibrillation (AF). While LA appendage plays a key role in LA physiology, data regarding the impact of LA appendage occlusion on LA hemodynamics are lacking. The alteration of LA compliance by LA appendage occlusion may represent a clinical issue in AF patients which are at high risk of heart failure. Purpose To describe the impact of LA appendage occlusion on LA hemodynamics. Material and methods From july 2015 to january 2020, all patients undergoing LA occlusion procedure at Pitié-Salpêtrière Hospital (Paris, France) in whom LA pressure curves were recorded, before and immediately after device implantation, were included. The LA mean pressure was measured at baseline and after LA appendage occlusion during the same procedure. Abnormal LA mean pressure was defined as >15mmHg. We also recorded cardiovascular death and hospitalization for congestive heart failure at longest follow-up. Results We enrolled 85 patients (78±8 years, 46 men), the CHA2DS2-VASc score was 5±1 and the HAS-BLED score was 4±1. The mean LA volume index was 51±15mL/m2, the left ventricular ejection fraction was 60±7%. The LA mean pressure increased significatively after LA appendage closure from 12.6±3.9mmHg to 15.5±5.2mmHg (p<0.0001, Figure). The prevalence of abnormal LA pressure was 20% (17/85) at baseline and 45% (38/85) after LA appendage closure (p=0.005). Post procedural LA pressure elevation was not related to procedure duration nor to fluid expansion volume. During a median follow-up of 364 [124–726] days, 3 (3.5%) patients died from a cardiovascular cause. Hospitalization for heart failure occurred in 6 (16%) of the 38 patients with abnormal postprocedural LA pressure, whereas no congestive episode was observed in the rest of the study population (p=0.006). Conclusion Catheter-based LA appendage occlusion induces an acute alteration of LA hemodynamics. Post procedural abnormal LA pressure may be linked to heart failure episodes in some patients. Further studies are warranted to investigate heart failure as a potential late complication of LA appendage closure. Variations of mean LA pressure Funding Acknowledgement Type of funding source: None

scholarly journals Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Antonio Leon-Justel ◽  
Jose I. Morgado Garcia-Polavieja ◽  
Ana Isabel Alvarez-Rios ◽  
Francisco Jose Caro Fernandez ◽  
Pedro Agustin Pajaro Merino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Secondary Outcome ◽  
Ventricular Ejection Fraction ◽  
Number Of Patients ◽  
Ed Visits ◽  
The Impact

Abstract Background Heart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF with a reduced left ventricular ejection fraction (HFrEF). Methods This is a before and after interventional study, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before the intervention and again after the intervention. The primary objective was the rate of readmissions, due to a HF. Secondary outcome compared the rate of ED visits and quality of life improvement assessed by the number of patients who had reduced NYHA score. A cost-analysis was also performed on these data. Results Admission rates significantly decreased by 19.8% after the intervention (from 30.2 to 10.4), the total hospital admissions were reduced by 32 (from 78 to 46) and the total length of stay was reduced by 7 days (from 15 to 9 days). The rate of ED visits was reduced by 44% (from 64 to 20). Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was € 72,769 per patient (from € 201,189 to € 128,420) and €139,717.65 for the whole group over 1 year. Conclusions A personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care-associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.

scholarly journals Impact of Transcendental Meditation on Left Ventricular Mass in African American Adolescents

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Vernon A. Barnes ◽  
Gaston K. Kapuku ◽  
Frank A. Treiber
Keyword(s):  
African American ◽  
Left Ventricular Mass ◽  
Ventricular Remodeling ◽  
Transcendental Meditation ◽  
African American Adolescents ◽  
Left Ventricular ◽  
Ventricular Mass ◽  
Cardiovascular Morbidity And Mortality ◽  
Before And After

Background. An early sign of ventricular remodeling is increased left ventricular mass (LVM) which over time may lead to left ventricular hypertrophy, the strongest predictor of cardiovascular morbidity and mortality, other than advancing age.Methods. 62 (30 TM; 32 CTL) African American adolescents (age16.2±1.3years) with high normal systolic BP were randomly assigned to either 4-month Transcendental Meditation (TM) or health education control groups. The echocardiographic-derived measure of LVM index (LVMI = LVM/ht2.7) was measured before and after the 4-month TM study and at 4-month followup. 2D-guided M-mode echocardiography using a Hewlett Packard 5500 echosonograph was used to determine LVMI.Results. The TM group exhibited a greater decrease in LVMI at 4-month followup compared to the CTL group (−2.6 versus +0.3 gm/ht2.7,P<0.04). The TM group exhibited a lesser increase in BMI at 4-month follow-up compared to the CTL group (0.2±1.6versus1.1±1.4,P<0.03).Conclusion. These findings indicate that among a group of prehypertensive African American adolescents, 4 months of TM compared to heath education resulted in a significant decrease in LVMI, and these changes were maintained at 4-month follow-up.

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