scholarly journals Cardiac remodeling induced by exercise in male master athletes

2021 ◽  
Author(s):  
Helder Dores ◽  
Pedro de Araújo Gonçalves ◽  
José Monge ◽  
Nuno Cardim
Keyword(s):  
Cardiac Remodeling ◽  
High Intensity ◽  
Global Longitudinal Strain ◽  
High Volume ◽  
Left Ventricular ◽  
Master Athletes ◽  
Endurance Sports ◽  
Concentric Hypertrophy ◽  
Eccentric Hypertrophy ◽  
Structural Adaptations

Abstract Aims: To describe cardiac remodeling in a population of male master athletes evaluated by transthoracic echocardiography and to analyse its relationship with several exercise-related characteristics.Methods and results: A total of 105 male master athletes aged ≥40 years old, mostly involved in endurance sports (81.0%) with a median training-volume of 66 [44; 103] METs/h/week, were studied. Left ventricular end-diastolic and end-systolic volumes were above the references in 84.8% and 75.8% athletes, decreasing in frequency when adjusted for BSA (26.3% and 23.2%). LV geometry was changed in more than half of the athletes (eccentric hypertrophy 28.3%, concentric remodelling 15.2% and concentric hypertrophy 8.1%) and several right ventricular (RV) dimensions were increased. Left atrium was dilated in 53.5% and right atrium in 37.4% athletes; only one athlete had a dilated aorta. Mean LV ejection fraction was 61±7% and global longitudinal strain -18.3±2.0%. Changes in LV geometry were more common in high intensity sports; LV dilation in athletes exercising >10 hours/week and in high intensity sports; RV dilation in athletes exercising >66 MET-hour/week and in endurance sports. In multivariate analysis high intensity sports remained an independent predictor of changes in LV geometry. There was a significant correlation between volume of exercise and cardiac structural adaptations.Conclusions: Cardiac structural adaptations were frequent in male master athletes, more pronounced in those involved in endurance sports, with high intensity and high volume of exercise. This data reinforces the concept that the characteristics of exercise are major determinants of cardiac remodeling and should be considered during athletes’ evaluation.

scholarly journals Echocardiographic Assessment of Left Ventricular Geometric Patterns in Hypertensive Patients in Nigeria

2013 ◽  
Vol 7 ◽  
pp. CMC.S12727 ◽  
Author(s):  
Rasaaq A. Adebayo ◽  
Olaniyi J. Bamikole ◽  
Michael O. Balogun ◽  
Anthony O. Akintomide ◽  
Victor O. Adeyeye ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Left Ventricular ◽  
Geometric Pattern ◽  
Color Flow ◽  
Hypertensive Patients ◽  
Geometric Patterns ◽  
Concentric Hypertrophy ◽  
Eccentric Hypertrophy ◽  
Lv Systolic Function

Left ventricular (LV) hypertrophy is an important predictor of morbidity and mortality in hypertensive patients, and its geometric pattern is a useful determinant of severity and prognosis of heart disease. Studies on LV geometric pattern involving large number of Nigerian hypertensive patients are limited. We examined the LV geometric pattern in hypertensive patients seen in our echocardiographic laboratory. A two-dimensional, pulsed, continuous and color flow Doppler echocardiographic evaluation of 1020 consecutive hypertensive patients aged between 18 and 91 years was conducted over an 8-year period. LV geometric patterns were determined using the relationship between the relative wall thickness and LV mass index. Four patterns of LV geometry were found: 237 (23.2%) patients had concentric hypertrophy, 109 (10.7%) had eccentric hypertrophy, 488 (47.8%) had concentric remodeling, and 186 (18.2%) had normal geometry. Patients with concentric hypertrophy were significantly older in age, and had significantly higher systolic blood pressure (BP), diastolic BP, and pulse pressure than those with normal geometry. Systolic function index in patients with eccentric hypertrophy was significantly lower than in other geometric patterns. Doppler echocardiographic parameters showed some diastolic dysfunction in hypertensive patients with abnormal LV geometry. Concentric remodeling was the most common LV geometric pattern observed in our hypertensive patients, followed by concentric hypertrophy and eccentric hypertrophy. Patients with concentric hypertrophy were older than those with other geometric patterns. LV systolic function was significantly lower in patients with eccentric hypertrophy and some degree of diastolic dysfunction were present in patients with abnormal LV geometry.

Abstract 11808: Association Between Left Ventricular Properties in Patients With Hypertension and the Incidence of Paroxysmal Atrial Fibrillation: Three-Dimensional Speckle Tracking Echocardiographic Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Masafumi Kawade ◽  
Masanori Kawasaki ◽  
Shingo Minatoguchi ◽  
Ryuhei Tanaka ◽  
Maya Ishiguro ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Three Dimensional ◽  
High Volume ◽  
Left Ventricular ◽  
Myocardial Stiffness ◽  
3 Dimensional ◽  
Concentric Hypertrophy ◽  
Pulmonary Capillary ◽  
Echocardiographic Study ◽  
Heat Failure

Background: Hypertension (HTN) is one of the major causes of atrial fibrillation (AF), since it is usually accompanied by left atrial (LA) remodeling due to pressure and/or volume (LAV) overload. We examined the relationship between ventricular (LV) geometry or LV properties in HTN and the incidence of paroxysmal AF (PAF) using novel, one-beat, automated, 3-dimensional speckle tacking echocardiography (3D-STE) with high volume rates. Methods: Patients with HTN (n=107, age 69±7) and controls (n=60, age 69±9) were prospectively enrolled. HTN patients were divided into 5 groups according to LV geometry and the presence of hypertensive heat failure (HHF) {normal geometry (n=25), concentric remodeling (n=20), concentric hypertrophy (LVH) (n=24), eccentric LVH (n=21) and HHF (n=17)}. Isovolumic relaxation time (IVRT) was measured by Doppler echo. We evaluated LV ejection fraction (EF), E/e’, pulmonary capillary wedge pressure (PCWP), Tau, LV diastolic stress, LV strain and LV myocardial stiffness in sinus rhythm. PCWP was estimated as 10.7- 12.4 x log (LA active emptying function / minimum LAV) as we reported. Tau was calculated as IVRT / (ln 0.9 x systolic blood pressure - ln PCWP). LV diastolic stress was calculated as LV radius at end diastole x PCWP / thickness. LV strain rate (SR) during IVR, as an index of relaxation, and LV strain were measured by the 3D-STE with volume rates of 50-80vps. LV myocardial stiffness was estimated as LV stress / LV strain. Results: LVEF was reduced only in HHF compared with controls (56±7 vs. 67±6%). Conclusion: LVEF in HHF was decreased but still remained within the normal range, whereas diastolic properties in eccentric LVH and HHF were reduced compared with control. The incidence of PAF significantly increased in eccentric LVH and HHF associated with the impairment of LV relaxation and stiffness and increased LV stress. This suggests that the target of treatment to reduce the incidence of PAF in HTN must be diastolic function.

Abstract P092: Longitudinal Impact Of Blood Pressure On Left Ventricular Geometry In The Hispanic Community Health Study/Study Of Latinos: Echocardiographic Study Of Latinos (Echo-SOL) Ancillary Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Jennifer McLeod ◽  
Barry E Hurwitz ◽  
Daniela Sotres-Alvarez ◽  
Mayank M Kansal ◽  
Katrina Swett ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Left Ventricular ◽  
Health Study ◽  
Left Ventricular Geometry ◽  
Longitudinal Impact ◽  
Ventricular Geometry ◽  
Concentric Hypertrophy ◽  
Echocardiographic Study ◽  
Eccentric Hypertrophy ◽  
Latino Adults

Introduction: Abnormal left ventricular geometry (LVG) is an independent predictor of cardiovascular mortality. We assessed the longitudinal transitions of LVG among Hispanic/Latino adults. Methods: Echo-SOL provided serial 2D echocardiograms of Hispanic adults. Each subject was identified as hypertensive or normotensive and categorized into four LVG patterns: normal, concentric remodeling (CR), concentric hypertrophy (CH), or eccentric hypertrophy (EH). Hypertensive adults were stratified on whether they maintained blood pressure (BP) control (<140/90mmHg) by visit 2. The normotensive adults were stratified on whether they developed incident hypertension (HTN) by visit 2. Logistic regression was used to evaluate the outcome of normal vs. abnormal LVG at visit 2 adjusting for age, sex, and follow-up time. Results: There were 1818 adults at visit 1 (mean age 56 years; 42.6% male, 44.7% hypertensive), with 1643 obtaining serial echocardiograms an average of 4.3 years later. At visit 1, LVG was distributed as follows: normal, 65.3%; CR, 30.6%, CH 3.1%, and EH 1.1%. Among hypertensive adults at visit 1, 59.7% had normal LVG and 34.1% had CR. By visit 2, there was a progression from normal LVG to CR among those with and without BP control; CR prevalence increased to 58.5% and 55.2%, respectively (Fig. 1). For visit 1 hypertensive adults, the incidence of abnormal LVG did not differ with regards to BP control (adjusted OR 1.1, 95% CI: 0.7-1.7). Among normotensive adults at visit 1, 69.8% had normal LVG. If they remained normotensive by visit 2, this prevalence decreased to 52.2%. If they developed HTN, there was an associated progression toward abnormal geometry (adjusted OR 2.5, 95% CI: 1.4-4.2), with the majority (59.2%) demonstrating a CR phenotype. Conclusion: Our findings suggest that BP control to 140mmHg is not adequate to prevent progressive LV remodeling among Hispanic/Latino adults. Further study is needed to understand this maladaptive process and how it contributes to cardiovascular disease in this population.

Co-morbidity (HFrEF and HFpEF): hypertension

ESC CardioMed ◽  
2018 ◽  
pp. 1808-1812
Author(s):  
Francesco Paneni ◽  
Massimo Volpe
Keyword(s):  
Blood Pressure ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Ventricular Dilation ◽  
Hypertensive Patients ◽  
Reduced Ejection Fraction ◽  
Concentric Hypertrophy ◽  
Drug Classes ◽  
Left Ventricular Dilation ◽  
Eccentric Hypertrophy

Hypertensive heart disease is a major cause of heart failure (HF) and mortality. Hypertension precedes HF occurrence in 75% of cases, and carries a sixfold increase in HF risk as compared to non-hypertensive individuals. Most importantly, a minority of patients survive 5 years after the onset of hypertensive HF. In hypertensive patients, the heart may present different patterns of adaptive remodelling: concentric remodelling, concentric hypertrophy, and eccentric hypertrophy. Although most hypertensive patients are at high risk of developing concentric hypertrophy, a growing proportion of subjects display a concentric-to-eccentric progression eventually leading to left ventricular dilation and systolic dysfunction. Several factors including myocardial ischaemia, ethnicity, genetic background, history of diabetes, and blood pressure pattern may significantly influence the pathway from hypertension to left ventricular dilation. Patients with a concentric hypertrophy usually develop HF with preserved ejection fraction (HFpEF), whereas those with an eccentric (dilated) phenotype develop HF with reduced ejection fraction (HFrEF). Lowering blood pressure has a striking effect in reducing the risk of HF. Although available antihypertensive drugs are all successful in lowering blood pressure, angiotensin-converting enzyme inhibitors, angiotensin receptor blocker (ARBs), and diuretics are more effective than other drug classes in preventing HF. The combination of the neprilysin inhibitor sacubitril with the ARB valsartan (LCZ696) has recently been shown to be highly effective in reducing HF-related outcomes in hypertensive subjects. An individualized treatment scheme taking into account blood pressure levels, type of HF (HFpEF or HFrEF), and relevant co-morbidities (i.e. renal disease, diabetes) is currently the best approach to improve morbidity and mortality in hypertensive patients with HF.

Cardiac response to pressure overload in 129S1/SvImJ and C57BL/6J mice: temporal- and background-dependent development of concentric left ventricular hypertrophy

2007 ◽  
Vol 292 (5) ◽  
pp. H2119-H2130 ◽  
Author(s):  
Cordelia J. Barrick ◽  
Mauricio Rojas ◽  
Robert Schoonhoven ◽  
Susan S. Smyth ◽  
David W. Threadgill
Keyword(s):  
Heart Failure ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Pressure Overload ◽  
Left Ventricular ◽  
Cardiac Response ◽  
Dependent Manner ◽  
Geometric Patterns ◽  
Concentric Hypertrophy ◽  
Eccentric Hypertrophy

Left ventricular hypertrophy (LVH), a risk factor for cardiovascular morbidity and mortality, is commonly caused by essential hypertension. Three geometric patterns of LVH can be induced by hypertension: concentric remodeling, concentric hypertrophy, and eccentric hypertrophy. Clinical studies suggest that different underlying etiologies, genetic modifiers, and risk of mortality are associated with LVH geometric patterns. Since pressure overload-induced LVH can be modeled experimentally using transverse aortic constriction (TAC) and since C57BL/6J (B6) and 129S1/SvImJ (129S1) strains, which have different baseline cardiovascular phenotypes, are commonly used, we conducted serial echocardiographic studies to assess cardiac function up to 8 wk of post-TAC in male B6, 129S1, and B6129F1 (F1) mice. B6 mice had an earlier onset and more pronounced impairment in contractile function, with corresponding left and right ventricular dilatation, fibrosis, change in expression of hypertrophy marker, and increased liver weights at 5 wk of post-TAC. These observations suggest that B6 mice had eccentric hypertrophy with systolic dysfunction and right-sided heart failure. In contrast, we found that 129S1 and F1 mice delayed transition to decompensated heart failure, with 129S1 mice exhibiting preserved systolic function until 8 wk of post-TAC and relatively mild alterations in histology and markers of hypertrophy at 5 wk post-TAC. Consistent with concentric hypertrophy, our results show that these strains manifest different cardiac responses to pressure overload in a time-dependent manner and that genetic susceptibility to initial concentric hypertrophy is dominant to eccentric hypertrophy. These results also imply that genetic background differences can complicate interpretation of TAC studies when using mixed genetic backgrounds.

scholarly journals ASSOCIATION OF LEFT ATRIAL FIBROSIS EXTENT WITH LEFT VENTRICULAR STRUCTURAL AND FUNCTIONAL REMODELLING IN PATIENTS WITH ATRIAL FIBRILLATION

2019 ◽  
Vol 34 (2) ◽  
pp. 39-46
Author(s):  
T. P. Gizatulina ◽  
A. V. Pavlov ◽  
L. U. Martyanova ◽  
I. V. Shorokhova ◽  
G. V. Kolunin
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Low Voltage ◽  
Negative Relationship ◽  
Left Ventricular ◽  
Lv Function ◽  
Nonvalvular Atrial Fibrillation ◽  
Concentric Hypertrophy ◽  
Eccentric Hypertrophy ◽  
Left Atrial Fibrosis

Aim.To investigate the relationships between left atrial (LA) fibrosis extent and left ventricular (LV) structural and functional status in patients (pts) with nonvalvular atrial fibrillation (AF).Material and Methods.The study enrolled 56 pts (mean age 57.1±8.4 years, 25 females), admitted to hospital for primary catheter ablation (CA), including 47 pts with paroxysmal AF and 9 pts with persistent AF. All pts had scheduled transthoracic echocardiography to measure size and volume of cardiac chambers and systolic and diastolic functions of the left ventricle. Based on the calculation of the LV mass index (LVMI) and relative wall thickness (RWT), we categorized all pts into 4 groups: (1) normal geometry (n=27); (2) concentric remodeling (normal LVMI and high RWT, n=13); (3) concentric hypertrophy (high LVMI and high RWT, n=6); and (4) eccentric remodeling (high LVMI and normal RWT, n=10). The assessment of LA fibrosis sizes was based on the allocation of low voltage zones (<0.5 mV) in the process of voltage electroanatomic mapping (VEM) as the first stage of CA. Following indicators were calculated: total square of fibrosis (Sf), % of fibrosis from the total LA square (Sf%), the degree of LA fibrosis (an analog of the UTAH score), and number of LA fibrosis zones. Level of NT-proBNP in blood was determined among other laboratory tests. All pts had preserved LV ejection fraction (LVEF).Results.Results of the study confirmed positive relationships between Sf, Sf% and LA diameter, LVMI, and NT-proBNP level. Negative relationship was noted between Sf, Sf%, the UTAH degree and LVEF. Such LV geometry type as eccentric hypertrophy was associated with a higher number of LA fibrosis zones compared to the normal LV geometry, while significant differences in other types of geometry were not found.Conclusion. Thus, LA fibrosis extent was associated with LA size, LV function, and LV geometric remodeling pattern.

scholarly journals Left ventricular systolic function impairment in children after balloon valvuloplasty for congenital aortic stenosis assessed by 2D speckle tracking echocardiography

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0248862
Author(s):  
Krzysztof Godlewski ◽  
Paweł Dryżek ◽  
Elżbieta Sadurska ◽  
Bożena Werner
Keyword(s):  
Strain Rate ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Strain And Strain Rate ◽  
Eccentric Hypertrophy

Aims The aim of the study was to evaluate left ventricular (LV) remodeling and systolic function using two-dimensional speckle tracking echocardiographic (2D STE) imaging in children at a long-term (more than 36 months, 107.5±57.8 months) after balloon valvuloplasty for aortic stenosis (BAV). Methods and results 40 patients (mean age 9,68 years, 75% male) after BAV and 62 control subjects matched to the age and heart rate were prospectively evaluated. The 2D STE assessment of LV longitudinal and circumferential strain and strain rate was performed. Left ventricular eccentric hypertrophy (LVEH) was diagnosed in 75% of patients in the study group. Left ventricular ejection fraction (LVEF) was normal in all patients. In study group, global longitudinal strain (GLS), global longitudinal strain rate (GLSr) were significantly lower compared with the controls: GLS (-19.7±2.22% vs. -22.3±1.5%, P< 0.001), GLSr (-0.89±0.15/s vs. -1.04 ±0.12/s, P < 0.001). Regional (basal, middle and apical segments) strain and strain rate were also lower compared with control group. Global circumferential strain (GCS), global circumferential strain rate (GCSr) as well as regional (basal, middle and apical segments) strain and strain rate were normal. Multivariable logistic regression analysis included: instantaneous peak systolic Doppler gradient across aortic valve (PGmax), grade of aortic regurgitation (AR), left ventricular mass index (LVMI), left ventricular relative wall thickness (LVRWT), left ventricular end-diastolic diameter (LVEDd), peak systolic mitral annular velocity of the septal and lateral corner (S’spt, S’lat), LVEF before BAV and time after BAV and showed that the only predictor of reduced GLS was LV eccentric hypertrophy [odds ratio 6.9; (95% CI: 1.37–12.5), P = 0.045]. Conclusion Patients at long-term observation after BAV present the subclinical LV systolic impairment, which is associated with the presence of its remodeling. Longitudinal deformation is the most sensitive marker of LV systolic impairment in this group of patients.

scholarly journals The effect of left ventricular remodeling on the longitudinal myocardial kinetics of both heart ventricles in patients with arterial hypertension and cardiovascular risk factors

2019 ◽  
Vol 26 (3) ◽  
pp. 27-34
Author(s):  
O. S. Barabash ◽  
Yu. A. Ivaniv ◽  
I. M. Tumak ◽  
Y. R. Barabash
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Systolic Function ◽  
Left Ventricular ◽  
Concentric Hypertrophy ◽  
Diastolic Velocity ◽  
Eccentric Hypertrophy ◽  
The Right ◽  
Kinetics Of

The aim – to study the longitudinal kinetics of the left, right ventricles and interventricular septum (IVS), depending on the type of left ventricular (LV) remodeling in patients with arterial hypertension (AH) in combination with additional cardiovascular risk factors with preserved LV contractility, as well as to determine the correlation of changes in the right ventricular systolic and diastolic parameters estimated with the tissue pulsed-wave Doppler imaging (TDI) with the same indices of the LV and IVS. Materials and methods. The study included 71 patients (average age – 54) with essential AH (68 % men) with a normal LV ejection fraction. The patients had the obese stage 1, combined hyperlipidemia, 29.6 % of patients had type II diabetes, 33.8 % were smokers. The patients were distributed into 4 groups depending on the types of remodeling: 1 – normal geometry (12.7 %); 2 – concentric remodeling (47.9 %); 3 – concentric hypertrophy (35.2 %); 4 – eccentric hypertrophy (4.2 %). TDI of the left and right ventricles and IVS was performed, systolic and diastolic TDI indices were determined, and the index of isovolumic myocardial acceleration (IVA) was calculated for the right ventricle (RV). Results and discussion. The type of LV concentric hypertrophy negatively affects the longitudinal myocardial kinetics of LV and IVS in the study group. The early diastolic velocity Em and the systolic velocity Sm were significantly decreased for the LV and IVS, the late diastolic velocity Am was decreased for the IVS and the E/Em for LV ratio was notably increased. Among the diastolic RV TDI indices only the deceleration time DTEm was significantly longer in LV concentric remodeling and concentric hypertrophy, than in its normal geometry. The IVA index was decreased in changing the type of LV geometry from normal to eccentric hypertrophy, indicating worsening of the RV longitudinal myocardial systolic function. There was a close correlation between diastolic and systolic TDI indices of the RV and IVS, which potentially indicated the importance of IVS in the mechanism of interventricular interaction and its effect on the RV function. The reliable dependence of systolic and diastolic RV TDI indices on the LV contractility was established. Conclusions. The type of LV remodeling, especially concentric hypertrophy, negatively affects the longitudinal myocardial kinetics of both ventricles in patients with AH in combination with additional cardiovascular risk factors. IVA can be a sensitive diagnostic criterion in the detection of early myocardial disorders of the RV systolic function with the changes of the LV geometry in this category of patients. Indices of RV longitudinal myocardial kinetics are closely dependent on changes in the function of IVS, which has a leading role in the formation of interventricular interaction.

P5651Association of left atrial fibrosis extent with left ventricular geometric remodeling and diastolic dysfunction in patients with paroxysmal atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Gizatulina ◽  
A V Pavlov ◽  
L U Martyanova ◽  
G V Kolunin ◽  
I V Shorochova ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Diastolic Dysfunction ◽  
Left Atrial ◽  
Low Voltage ◽  
Left Ventricular ◽  
Lv Function ◽  
Atrial Fibrosis ◽  
Concentric Hypertrophy ◽  
Eccentric Hypertrophy ◽  
Left Atrial Fibrosis

Abstract Introduction Whether left atrial fibrosis (LAf) in patients with atrial fibrillation (AF) is a consequence of left ventricular (LV) diastolic dysfunction or primary atrial pathology continues to be a debatable issue. Electroanatomical mapping (EAM) allows to image and to define LAf as a substrate of AF. Purpose To study the relationship of LAf extent with LV diastolic function and geometric remodeling in patients (pts) with paroxysmal AF. Methods 56 pts with paroxysmal AF (mean age 57.1±8.4 years, 31 males), undergone catheter ablation, were enrolled in the study, including 30 pts with arterial hypertension (AH), 15 – with coronary artery disease (CAD) and AH. Comprehensive transthoracic echocardiography was carried out in all pts to assess chamber volumes, systolic and LV diastolic functions and geometry patterns according to Recommendations of ASE and EACVI. Before ablation, EAM was performed in sinus rhythm. The bipolar low voltage areas of LAf were identified with the cut-off <0.5 mV. For the LAf quantification following indicators were calculated: total square of LAf (Sf, cm2) and LAf degree, estimated as an analog of the UTAH staging system, by selection of UTAH I: <5% fibrosis; II: 5–19%; III: 20–35% and IV: >35%. Results All patients had preserved systolic LV function. To assess the influence of LV geometry on LAf extent all pts were distributed in accordance to LV geometry patterns (p): normal geometry (pI) – 27 pts, concentric remodeling (pII) – 13, eccentric hypertrophy (pIII) – 10, concentric hypertrophy (pIV) – 6. Pts with pIII were older than pI pts: 60.8±6.4 vs 53.9±10.4 (p=0.048). All pts with pIII and pIV had AH. From 11 pts without AH, 10 had pI of LV geometry. PIII was revealed more often in CAD pts compared to those without CAD: 29.2 vs 10.5% (p=0.04). PIII pts had bigger LA volume compared to pI pts (74.3±22.5 vs 58.8±19.4 ml, p=0.019) and pII pts (61.9±14.9, p=0.05), but LA volume of pIII pts didn't differ from pIV pts (71.9±14.5, p=0.78). PIII pts had more extent Sf than pI pts (28.32±8.9 vs 13.4±6.5, p=0.05), while Sf of pII (17.3±8.7, p=0.495) and pIV pts (16.4±9.5, p=0.699) didn't differ significantly from Sf of pI pts. As for the degree of LAf, UTAH I was absent in pts with pIII and UTAH IV was revealed in 40% of these pts, while in pts with pI UTAH I was in 26% and UTAH IV - in 14.8% (p=0.049). However, Sf and UTAH degree did not depend on age, CAD and heart failure presence. As for diastolic dysfunction, in pIII and pIV pts e∼septal and e∼lateral were lower compared to pI pts: 6.3±1.9, 5.5±2.4 vs 8.5±2.2 (p<0.01) and 8.2±2.7, 8.0±3.8 vs 11.3±2.9 (p<0.01), respectively, while E/e∼ in pIII pts didn't differ from pI pts (8.0±1.6 vs 7.2±1.6, p=0.17), but in pIV was more than in pI pts (10.4±2.8, p=0.003). Conclusion LAf extent in paroxysmal AF is associated more with such LV geometry pattern as eccentric hypertrophy, than with diastolic disorders, which accompany both eccentric and concentric hypertrophy.

P2485Cardiac abnormalities and vascular damage in young adults with type 1 diabetes mellitus: incidence and associations with kidney dysfunction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Medvedev ◽  
K Mahamat ◽  
N Soseliya ◽  
V Efimova ◽  
A Safarova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Arterial Stiffness ◽  
Cardiac Remodeling ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Applanation Tonometry ◽  
Cross Sectional

Abstract Background In contrast to type 2 diabetes mellitus (DM), cardiac and vascular abnormalities in type 1 DM (T1DM) are not well investigated. We aimed to evaluate occurrence of cardiac remodeling, arterial stiffness and blood pressure (BP) phenotypes in T1DM patients. Methods The cross-sectional study consecutively included T1DM patients 18–44 y.o. without known CVD, in whom 24-hour monitoring of peripheral and central BP (ABPM) with BPLab Vasotens, applanation tonometry and conventional and speckle tracking echo were performed. BP phenotypes were determined according to current guidelines, PWV and CBP - according to individual reference values. Presence of systolic dysfunction was defined as global longitudinal strain (GLS) <20%, left ventricular hypertrophy (LVH) as LV myocardial mass index (LVMI) >95/>115 g/m2 for women/men, LV remodeling (LVR) as RWT ≥0.43. P<0.05 was considered significant. Results A total of 125 patients with T1DM (mean age 29,2±7,6 years, 60% male, median duration of DM 6,9 [2; 11] years, HbA1c 9.9 [6; 12] %, mean BMI 23±3 kg/m2, smoking 39%, median GFR 100 [86; 117] ml/min/1.73 m2, GFR <60 ml/min/1.73 m2 – in 8.8%, median albuminuria 19 [8; 24] mg/g (moderate and high albuminuria in 14.6% and 2.2%) were investigated. According to office BP and ABPM hypertension (HTN) was diagnosed in 28% patients (true and masked in 4.8 and 23.2%, respectively) and true normotension in 72%. Isolated nocturnal HTN was observed in 14.4%. Majority of the patients were dippers (51.2%), non-dippers and night-peakers profiles were registered in and 43.2% and 5.6%, respectively. Central SBP and PWV elevation were observed in 17.6% and 57.6% (PWV >10 m/s - only in 2.4%). Cardiac abnormalities were revealed in 72.4% of patients: GLS<20%, LVH, LVR and diastolic dysfunction (DD) in 71.2, 12, 39.2 and 16.8% patients, respectively. Isolated GLS <20% was detected in 30%, combination of GLS<20% with LVH (or LVR) and DD in 47.2%. Patients with vs without HTN were characterized by higher PWV (7.8±1.5 vs 6.9±1.2, p<0.001), LVMI (89.9 [75; 96] vs 71.5 [64; 77] p<0.001), incidence of DD (29.6 vs 12.2%, p=0.03), LVH (28 vs 6%, p=0.002), trend towards higher rate of central SBP increase (32.7% vs 17.4%, p=0.08), lower incidence of LVR (26 vs 44%, p=0.002) and similar GLS (p=0.16). Groups with vs without nocturnal HTN did not differ by PWV, central SBP, GLS and LVMI. PWV increase was associated only with higher LVMI (88.2 [69; 95] vs 77.6 [68; 83], p=0.042). Correlations (p<0.05) with albuminuria were observed for GLS (r=−0.26), DD (r=0.22) and non-dipping state (r=−0.34). GFR correlated (p<0.05) with GLS (r=−0.32) and PWV (r=−0.32). Conclusion Incidence of prognostically unfavourable phenotypes of HTN, cardiac remodeling and arterial stiffness (even in patients without HTN) were relatively high in T1DM population. GLS and non-dipping state correlated with albuminuria, GLS and PWV with GFR

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