scholarly journals Interrogating the Haemodynamic Effects of Haemodialysis Arteriovenous Fistula on Cardiac Structure and Function

2021 ◽  
Author(s):  
Sokratis Stoumpos ◽  
Alastair Rankin ◽  
Pauline Hall Barrientos ◽  
Kenneth Mangion ◽  
Ellon McGregor ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Blood Flows ◽  
Lv Mass ◽  
Cardiac Structure And Function ◽  
Lv Ejection Fraction ◽  
And Function

Abstract Arteriovenous fistula (AVF) is the preferred type of vascular access for maintenance haemodialysis but it may contribute to maladaptive cardiovascular remodelling. We studied the effect of AVF creation on cardiac structure and function in patients with chronic kidney disease (CKD). In this prospective cohort study patients with CKD listed for first AVF creation underwent cardiac magnetic resonance (CMR) imaging at baseline and at 6 weeks. All participants had ultrasound measurements of fistula blood flow at 6 weeks. The primary outcome was the change in left ventricular (LV) mass. Secondary outcomes included changes in LV volumes, LV ejection fraction, cardiac output, LV global longitudinal strain and N-terminal-pro B-type natriuretic peptide (NT-proBNP). A total of 55 participants were enrolled, of whom 40 (mean age 59 years) had AVF creation and completed both scans. On the second CMR scan, a mean increase of 7.4g (95%CI, 1.1–13.7, p=0.02) was observed in LV mass. Significant increases in LV end-diastolic volumes (p=0.04) and cardiac output (p=0.02) were also seen after AVF creation. No significant changes were observed in LV end-systolic volumes, LV ejection fraction, NT-proBNP and LV global longitudinal strain. In participants with fistula blood flows ≥600mL/min (n=22) the mean increase in LV mass was 15.5g (95%CI, 7.3–23.8) compared with a small decrease of 2.5g (95%CI, −10.6 to 5.6) in participants with blood flows <600mL/min (n=18). Creation of AVF for haemodialysis resulted in a significant increase of LV myocardial mass within weeks after surgery, which was proportional to the fistula flow.

scholarly journals Interrogating the haemodynamic effects of haemodialysis arteriovenous fistula on cardiac structure and function

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sokratis Stoumpos ◽  
Alastair Rankin ◽  
Pauline Hall Barrientos ◽  
Kenneth Mangion ◽  
Ellon McGregor ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Blood Flows ◽  
Lv Mass ◽  
Cardiac Structure And Function ◽  
Lv Ejection Fraction ◽  
And Function

AbstractArteriovenous fistula (AVF) is the preferred type of vascular access for maintenance haemodialysis but it may contribute to maladaptive cardiovascular remodelling. We studied the effect of AVF creation on cardiac structure and function in patients with chronic kidney disease (CKD). In this prospective cohort study patients with CKD listed for first AVF creation underwent cardiac magnetic resonance (CMR) imaging at baseline and at 6 weeks. All participants had ultrasound measurements of fistula blood flow at 6 weeks. The primary outcome was the change in left ventricular (LV) mass. Secondary outcomes included changes in LV volumes, LV ejection fraction, cardiac output, LV global longitudinal strain and N-terminal-pro B-type natriuretic peptide (NT-proBNP). A total of 55 participants were enrolled, of whom 40 (mean age 59 years) had AVF creation and completed both scans. On the second CMR scan, a mean increase of 7.4 g (95% CI 1.1–13.7, p = 0.02) was observed in LV mass. Significant increases in LV end-diastolic volumes (p = 0.04) and cardiac output (p = 0.02) were also seen after AVF creation. No significant changes were observed in LV end-systolic volumes, LV ejection fraction, NT-proBNP and LV global longitudinal strain. In participants with fistula blood flows ≥ 600 mL/min (n = 22) the mean increase in LV mass was 15.5 g (95% CI 7.3–23.8) compared with a small decrease of 2.5 g (95% CI − 10.6 to 5.6) in participants with blood flows < 600 mL/min (n = 18). Creation of AVF for haemodialysis resulted in a significant increase of LV myocardial mass within weeks after surgery, which was proportional to the fistula flow.

P1322EFFECTS OF HAEMODIALYSIS ARTERIOVENOUS FISTULA CREATION ON CARDIAC STRUCTURE AND FUNCTION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sokratis Stoumpos ◽  
Alastair Rankin ◽  
Pauline Hall Barrientos ◽  
Peter Thomson ◽  
Ram Kasthuri ◽  
...  
Keyword(s):  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Structure And Function ◽  
High Flow ◽  
Low Flow ◽  
Lv Mass ◽  
Flow Group ◽  
Cardiac Structure And Function ◽  
Lv Ejection Fraction ◽  
And Function

Abstract Background and Aims Arteriovenous fistula (AVF) is considered the preferred type of access for maintenance haemodialysis. The creation of an AVF may contribute to maladaptive cardiovascular remodelling. We conducted a study to evaluate the effect of AVF creation on cardiac structure and function in patients with end-stage renal disease (ESRD). Method In this prospective cohort study, patients with ESRD listed for AVF creation underwent cardiac magnetic resonance imaging at baseline and at 6 weeks. All participants had ultrasound measurements of AVF blood flow at 6 weeks. The primary outcome was the change in left ventricular (LV) mass. Secondary outcomes included changes in LV volumes, left atrial volume, LV ejection fraction, LV global longitudinal strain, cardiac output/index, and septal thickness. Results A total of 65 patients were enrolled, of whom 40 had an AVF creation and completed both scans. Patients were divided into 2 groups based on AVF blood flows: 22 in the high flow group (≥ 600mL/min) and 18 in the low flow group (&lt; 600mL/min). On the second cardiac magnetic resonance scan, a mean increase of 7.4 g (95% CI, 1.1–13.7, P=0.02) was observed in LV mass; in the high flow group the mean increase was 15.5 g (95% CI, 7.3–23.8) compared with a small decrease of 2.5 g (95% CI, −10.6 to 5.6) in the low flow group (P=0.003). Significant increases in LV end-diastolic volumes, cardiac output, and cardiac index were also seen after AVF creation (P&lt;0.04). No significant changes were observed in LV ejection fraction (P=0.52), LV end-systolic volumes (P=0.12), and LV global longitudinal strain (P=0.21). Conclusion Creation of AVF in adults with ESRD resulted in significant increase of LV myocardial mass early after surgery.

scholarly journals Occupational Exposures and Cardiac Structure and Function: ECHO‐SOL (Echocardiographic Study of Latinos)

2020 ◽  
Vol 9 (17) ◽  
Author(s):  
Melissa S. Burroughs Peña ◽  
Jean Claude Uwamungu ◽  
Catherine M. Bulka ◽  
Katrina Swett ◽  
Krista M. Perreira ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Occupational Exposures ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Vehicle Exhaust ◽  
Cardiac Structure And Function ◽  
Lv Ejection Fraction ◽  
And Function

Background Our objective was to determine associations of occupational exposures with cardiac structure and function in Hispanic/Latino adults. Methods and Results Employed participants were included (n=782; 52% women, mean age 52.9 years). Occupational exposures to burning wood, vehicle exhaust, solvents, pesticides, and metals at the current and longest‐held job were assessed by questionnaire. Survey multivariable linear regression analyses were used to model the relationship of each self‐reported exposure with echocardiographic measures of cardiac structure and function. Exposure to burning wood at the current job was associated with decreased left ventricular (LV) ejection fraction (−3.1%; standard error [SE], 1.0 [ P =0.002]). When the analysis was restricted to exposure at the longest‐held job, occupational exposure to burning wood was associated with increased LV diastolic volume (6.7 mL; SE, 1.6 [ P <0.0001]), decreased LV ejection fraction (−2.7%; SE, 0.6 [ P <0.0001]), worse LV global longitudinal strain (1.0%; SE, 0.3 [ P =0.0009]), and decreased right ventricular fractional area change (−0.02; SE, 0.004 [ P <0.001]). Exposure to pesticides was associated with worse average global longitudinal strain (0.8%; SE, 0.2 [ P <0.0001]). Exposure to metals was associated with worse global longitudinal strain in the 2‐chamber view (1.0%; SE, 0.5 [ P =0.04]), increased stroke volume (3.6 mL; SE, 1.6 [ P =0.03]), and increased LV mass indexed to BSA (9.2 g/m 2 ; SE, 3.8 [ P =0.01]) or height (4.4 g/m 2.7 ; SE, 1.9 [ P =0.02]). Conclusions Occupational exposures to burning wood, vehicle exhaust, pesticides, and metals were associated with abnormal parameters of LV and right ventricular systolic function. Reducing exposures to toxic chemicals and particulates in the workplace is a potential opportunity to prevent cardiovascular disease in populations at risk.

P896Effects of tafamidis in patients with transthyretin amyloid cardiomyopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Rettl ◽  
F Duca ◽  
C Binder ◽  
C Capelle ◽  
S Aschauer ◽  
...  
Keyword(s):  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Structure And Function ◽  
Walking Distance ◽  
Cardiac Structure ◽  
Positive Effects ◽  
Cardiac Structure And Function ◽  
Amyloid Cardiomyopathy ◽  
And Function

Abstract Background Transthyretin amyloid cardiomyopathy (ATTR-CA) is caused by deposition of amyloid fibrils in the myocardium. The deposition occurs when transthyretin (TTR) becomes unstable and misfolds. Tafamidis is a kinetic stabilizer of TTR that prevents tetramer dissociation and amyloidogenesis by TTR. Methods Eighteen patients with diagnosis of ATTR-CA (hATTR or wtATTR) from our national amyloidosis registry were treated with 20 mg of tafamidis for a period of six months. In our explorative analysis we aimed to evaluate the effects of tafamdis by changes from baseline of the serum NT-proBNP concentration, 6-minute walking distance, as well as cardiac structure and function. Results The exploratory analysis showed a decrease in serum NT-proBNP concentration in tafamidis treated patients, compared to increase in untreated patients (median difference, −481.0 pg/mL). Tafamidis improved the walking distance during the 6-minute walk test at month six, compared to baseline (mean, 31.25 m). Echocardiographic findings revealed an improvement of the global longitudinal strain (mean, 0.77%), a decrease in left atrial size (mean, −1.65 mm) and a decrease in left ventricular size (mean, −4.13 mm) in tafamidis treated patients compared to untreated patients. Due to insufficient power the results did not differ significantly between tafamidis treated patients and untreated patients. Change from baseline Tafamidis No treatment Treatment Difference p-value Cardiac Biomarkers n=18 n=15   NT-proBNP, ng/L Baseline, median 2740.0 2835.0 CFB to 6 months, median −207.0 274.0 −481.0 0.329 Functional Status n=8 n=7   6MWT, m Baseline, mean 441.00 420.50 CFB to 6 months, mean 31.25 −16.50 +47.75 0.373 Echocardiogram n=17 n=15   LA, mm Baseline, mean 63.41 61.33 CFB to 6 months, mean −1.65 0.60 −2.25   LV, mm Baseline, mean 44.13 41.80 CFB to 6 months, mean −4.13 0.33 −4.46 0.075   LV wall thickness, mm Baseline, mean 22.06 18.47 CFB to 6 months, mean 0.68 −0.60 +1.28 0.055   Longitudinal strain, % Baseline, mean −10.66 −12.42 CFB to 6 months, mean 0.77 −1.03 +1.80 0.652 MRI n=7 n=6   ECV, % Baseline, mean 52.26 44.22 CFB to 6 months, mean 0.81 3.70 − 2.89 0.493   LV mass, g Baseline, mean 187.71 170.33 CFB to 6 months, mean 24.29 19,67 +4.62 0.612 Conclusion Treatment with tafamidis for a period of six months in patients with ATTR-CA leads to positive effects on NT-proBNP level, 6-minute walking distance, as well as cardiac structure and function compared to untreated patients.

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

Circulation ◽  
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.

Abstract P015: Fibroblast Growth Factor 23 and Echocardiographic Measures of Cardiac Structure and Function among African Americans: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Jeffrey R Misialek ◽  
Alvaro Alonso ◽  
Erin D Michos ◽  
Scott D Solomon ◽  
Amil M Shah ◽  
...  
Keyword(s):  
Growth Factor ◽  
Fibroblast Growth Factor ◽  
Fibroblast Growth Factor 23 ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Fibroblast Growth ◽  
Lv Mass ◽  
Cardiac Structure And Function ◽  
And Function ◽  
Aric Study

Introduction: Fibroblast growth factor 23 (FGF23), an endocrine hormone, induced left ventricular (LV) hypertrophy through direct action in experimental animal models. The association of FGF23 with echocardiographic measures in humans is relatively uncharacterized. Hypothesis: Higher levels of FGF23 will be cross-sectionally associated with more adverse echocardiographic measures of LV structure and function. Methods: We conducted a cross-sectional analysis of 2086 African-American adults (66% female, median age 55) from a subset of the ARIC Study, a community-based cohort in the United States. Intact active FGF23 was assessed in blood samples collected at ARIC visit two (1990-1992). Echocardiography was performed at visit three (1993-1995) in participants recruited at the Jackson field center only. We used multivariable linear regression to evaluate the associations of FGF23 (per 15 pg/mL change) with echocardiographic measures after adjustment for traditional cardiovascular risk factors assessed at visit two. We also examined differences in observed associations by age and sex using interaction terms. Results: FGF23 was significantly associated with greater left atrial diameter and LV mass index (Table). A significant sex interaction was identified for LV diameter (p-interaction = 0.005). No association was observed in men while a positive association was observed among women. An adverse, decreasing trend in percent fractional shortening of the LV diameter at higher levels of FGF was stronger in individuals aged >55 (p-interaction = 0.03). No linear association was found between FGF23 and E/A ratio. Conclusion: FGF23 was associated with higher LV mass, larger LV size, and lower LV systolic function. These findings are consistent with results from experimental animal studies and provide evidence suggesting that cardiac structure and function may be influenced by FGF23 in humans. Prospective studies are needed to evaluate whether FGF23 is associated with change in markers of cardiac structure and function.

Abstract P138: Alterations in Cardiac Structure and Function in Young Adults Born Extremely Preterm: Impact of Neonatal Bronchopulmonary Dysplasia

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Muhammad Oneeb Rehman Mian ◽  
Jean-Luc Bigras ◽  
Rafael Fernandes ◽  
Mariane Bertagnolli ◽  
Li Feng Xie ◽  
...  
Keyword(s):  
Young Adults ◽  
Preterm Birth ◽  
Cardiac Remodeling ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Lv Mass ◽  
Extremely Preterm ◽  
Cardiac Structure And Function ◽  
And Function

Objective: Studies support a causal association between preterm birth and increased risk of cardiovascular diseases. Increased left and right ventricular mass and impaired systolic and diastolic function has been reported in young adults born preterm. However, the impact of extreme preterm birth and prematurity-specific complications on adult cardiac structure and function has not been evaluated. We assessed cardiac structure and function in young adults born extremely preterm (EPT) versus term, and correlated long term cardiac remodeling with neonatal bronchopulmonary dysplasia (BPD). Methods: Eighty five EPT (gest. age = 27.1±1.4 weeks) were recruited along with term-born controls matched for age, sex and socioeconomic status. Birth and neonatal data (gestational age, birth weight, BPD indicated by O 2 requirements at 36 weeks postmenstrual age) was collected. Ambulatory blood pressure (Spacelabs) and echocardiographic measurements (Phillips) were taken. Comparisons were performed using ANOVA or T-test. Results: EPT presented with increased systolic (119±9 vs 116±8 mmHg, P<0.05) and diastolic (68±5 vs 66±6 mmHg, P<0.05) blood pressures. EPT exhibited reduced septal thickness (IVS, 6.8±0.8 vs 7.1±1.1 mm, P<0.05), left ventricular internal dimension (LVID, 46±4 vs 48±5 mm, P<0.05), LV end-diastolic (98±20 vs 106±24 ml, P<0.05) and end-systolic (36±9 vs 40±11 ml, P<0.01) volumes, right ventricular internal dimension (RVID, 22±3 vs 24±4 mm, P<0.05), and LV mass (104±27 vs 115±30 g, P<0.05), but similar LV mass and volume indexes. EPT exhibited increased LV myocardial performance index (0.41±0.04 vs 0.39±0.04, P<0.01), reduced mitral lateral e’ (17.6±2.8 vs 19.1±2.6 cm/s, P<0.01), mitral s’ (10.7±2.3 vs 11.6±2.3 cm/s, P<0.01), tricuspid E’ (15.8±2.7 vs 16.8±2.1 cm/s, P<0.05), and tricuspid S’ (13.1±2.0 vs 14.0±2.0 cm/s, P<0.01) waves, and a trend in reduced mitral E wave (81±14 vs 85±15 cm/s, P=0.09). EPT with neonatal BPD exhibited greater reduction in IVS (6.5±0.8 mm, P<0.05 vs terms), LVID (45±4 mm, P<0.05), LV Mass (98±22 g, P<0.05), and RVID (20±3 mm, P<0.01). Conclusions: EPT exhibit cardiac structural and functional alterations compared to term-born individuals. Neonatal BPD in EPT is a key contributor to long term cardiac remodeling.

scholarly journals HIV and pericardial fat are associated with abnormal cardiac structure and function among Ugandans

Heart ◽  
2019 ◽  
Vol 106 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Jonathan Buggey ◽  
Leo Yun ◽  
Chung-Lieh Hung ◽  
Cissy Kityo ◽  
Grace Mirembe ◽  
...  
Keyword(s):  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Structure And Function ◽  
People Living With Hiv ◽  
Cardiac Structure ◽  
Pericardial Fat ◽  
Cardiac Structure And Function ◽  
And Function

ObjectivesTo examine the relationship between pericardial fat (PCF) and cardiac structure and function among HIV-infected patients in the sub-Saharan African country of Uganda. People living with HIV (PLHIV) have altered fat distribution and an elevated risk for heart failure. Whether altered quantity and radiodensity of fat surrounding the heart relates to cardiac dysfunction in this population is unknown.MethodsOne hundred HIV-positive Ugandans on antiretroviral therapy were compared with 100 age and sex-matched HIV-negative Ugandans; all were >45 years old with >1 cardiovascular disease risk factor. Subjects underwent ECG-gated non-contrast cardiac CT and transthoracic echocardiography with speckle tracking strain imaging. Multivariable linear and logistic regression models were used to explore the association of PCF with echocardiographic outcomes.ResultsMedian age was 55% and 62% were female. Compared with uninfected controls, PLHIV had lower body mass index (27 vs 30, p=0.02) and less diabetes (26% vs 45%, p=0.005). Median left ventricular (LV) ejection fraction was 67%. In models adjusted for traditional risk factors, HIV was associated with 10.3 g/m2 higher LV mass index (LVMI) (95% CI 3.22 to 17.4; p=0.005), 0.87% worse LV global longitudinal strain (GLS) (95% CI −1.66 to −0.07; p=0.03) and higher odds of diastolic dysfunction (OR 1.96; 95% CI 0.95 to 4.06; p=0.07). In adjusted models, PCF volume was significantly associated with increased LVMI and worse LV GLS, while PCF radiodensity was associated with worse LV GLS (all p<0.05).ConclusionsIn Uganda, HIV infection, PCF volume and density are associated with abnormal cardiac structure and function.

scholarly journals Maladaptive Changes Associated With Cardiac Aging Are Sex-Specific and Graded by Frailty and Inflammation in C57BL/6 Mice

2020 ◽  
Author(s):  
Alice E Kane ◽  
Elise S Bisset ◽  
Stefan Heinze-Milne ◽  
Kaitlyn M Keller ◽  
Scott A Grandy ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Wall Thickness ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Septal Wall ◽  
Serum Cytokines ◽  
Lv Mass ◽  
Septal Wall Thickness ◽  
Cardiac Structure And Function ◽  
And Function

Abstract We investigated whether late-life changes in cardiac structure and function were related to high levels of frailty and inflammation in male and female mice. Frailty (frailty index), ventricular structure/function (echocardiography), and serum cytokines (multiplex immunoassay) were measured in 16- and 23-month-old mice. Left ventricular (LV) mass and septal wall thickness increased with age in both sexes. Ejection fraction increased with age in males (60.4 ± 1.4 vs 68.9 ± 1.8%; p &lt; .05) but not females (58.8 ± 2.5 vs 62.6 ± 2.4%). E/A ratios declined with age in males (1.6 ± 0.1 vs 1.3 ± 0.1; p &lt; .05) but not females (1.4 ± 0.1 vs 1.3 ± 0.1) and this was accompanied by increased ventricular collagen levels in males. These changes in ejection fraction (r = 0.52; p = .01), septal wall thickness (r = 0.59; p = .002), E/A ratios (r = −0.49; p = .04), and fibrosis (r = 0.82; p = .002) were closely graded by frailty scores in males. Only septal wall thickness and LV mass increased with frailty in females. Serum cytokines changed modestly with age in both sexes. Nonetheless, in males, E/A ratios, LV mass, LV posterior wall thickness, and septal wall thickness increased as serum cytokines increased (eg, IL-6, IL-3, IL-1α, IL-1β, tumor necrosis factor-α, eotaxin, and macrophage inflammatory protein-1α), while ejection fraction declined with increasing IL-3 and granulocyte-macrophage colony stimulating factor. Cardiac outcomes were not correlated with inflammatory cytokines in females. Thus, changes in cardiac structure and function in late life are closely graded by both frailty and markers of inflammation, but this occurs primarily in males. This suggests poor overall health and inflammation drive maladaptive changes in older male hearts, while older females may be resistant to these adverse effects of frailty.

scholarly journals Cardiac structure and function with and without metabolic syndrome: the Echocardiographic Study of Latinos (Echo-SOL)

2018 ◽  
Vol 6 (1) ◽  
pp. e000484 ◽  
Author(s):  
Melissa Burroughs Peña ◽  
Katrina Swett ◽  
Neil Schneiderman ◽  
Daniel M Spevack ◽  
Sonia G Ponce ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Longitudinal Strain ◽  
Left Ventricular ◽  
Normal Weight ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Echocardiographic Study ◽  
Confounding Variables ◽  
Cardiac Structure And Function ◽  
And Function

ObjectiveWe assessed the hypothesis that metabolic syndrome is associated with adverse changes in cardiac structure and function in participants of the Echocardiographic Study of Latinos (Echo-SOL).MethodsNon-diabetic Echo-SOL participants were included in this cross-sectional analysis. Metabolic syndrome was defined according to the American Heart Association/National Heart, Lung, and Blood Institute 2009 Joint Scientific Statement. Survey multivariable linear regression analyses using sampling weights were used adjusting for multiple potential confounding variables. Additional analysis was stratified according to the presence/absence of obesity (body mass index (BMI) ≥25 kg/m2) and the presence/absence of metabolic syndrome.ResultsWithin Echo-SOL, 1260 individuals met inclusion criteria (59% female; mean age 55.2 years). Compared with individuals without metabolic syndrome, those with metabolic syndrome had lower medial and lateral E′ velocities (−0.4 cm/s, (SE 0.1), p=0.0002; −0.5 cm/s (0.2), p=0.02, respectively), greater E/E′ (0.5(0.2), p=0.01) and worse two-chamber left ventricular longitudinal strain (0.9%(0.3), p=0.009), after adjusting for potential confounding variables. Increased left ventricular mass index (9.8 g/m2 (1.9), p<0.0001 and 7.5 g/m2 (1.7), p<0.0001), left ventricular end-diastolic volume (11.1 mL (3.0), p=0.0003 and 13.3 mL (2.7), p<0.0001), left ventricular end-systolic volume (5.0 mL (1.4), p=0.0004 and 5.7 mL (1.3) p<0.0001) and left ventricular stroke volume (10.2 mL (1.8), p<0.0001 and 13.0 mL (2.0), p<0.0001) were observed in obese individuals with and without metabolic syndrome compared with individuals with normal weight without metabolic syndrome. In sensitivity analyses, individuals with normal weight (BMI <25 kg/m2) and metabolic syndrome had worse left ventricular global longitudinal strain (2.1%(0.7), p=0.002) and reduced left ventricular ejection fraction (−3.5%(1.4), p=0.007) compared with normal-weight individuals without metabolic syndrome.ConclusionsIn a sample of US Hispanics/Latinos metabolic syndrome was associated with worse left ventricular systolic and diastolic function. Adverse changes in left ventricular size and function were observed in obese individuals with and without metabolic syndrome but decreased left ventricular function was also present in normal-weight individuals with metabolic syndrome.

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