scholarly journals Factors and Prognostic Significance of Impaired Exercise Tolerance in Women over 40 with Arterial Hypertension

2021 ◽  
Vol 11 (8) ◽  
pp. 759
Author(s):  
Agata Bielecka-Dabrowa ◽  
Katarzyna Gryglewska ◽  
Agata Sakowicz ◽  
Stephan von Haehling ◽  
Kamil Janikowski ◽  
...  

The aim of this study was to identify factors influencing maximal oxygen uptake (VO2max) and early identification of the profile of hypertensive women in the perimenopausal period at risk of heart failure. This study included 185 female patients. Regression analyses determined predictors of the lowest VO2max (quartile 1: VO2max < 17 mL/kg/min). Females with the lowest oxygen consumption had a significantly higher level of high sensitive cardiac Troponin T (hs-cTnT) (p = 0.001), higher values of the left atrial (LA) volume, late diastolic mitral annulus velocity (A′), E/E′ (p = 0.0003, p = 0.02, p = 0.04; respectively), higher BMI and fat content (kg and %) (p < 0.0001), higher fat free mass (FFM) (kg) (p < 0.0001), total body water content (TBW) (p = 0.0002) as well as extracellular body water content (ECW) (p < 0.0001) and intracellular body water content (ICW) (p = 0.005), ECW/TBW × 100% (p < 0.0001) and metabolic age (p < 0.0001) and lower E′ (p = 0.001) compared to controls. In a multiple logistic regression model independently associated with VO2max were: ECW/TBW × 100% (OR 4.45, 95% CI: 1.77–11.21; p = 0.002), BMI (OR 7.11, 95% CI: 2.01–25.11; p = 0.002) and hs-cTnT level (OR 2.69, 95% CI: 1.23–5.91; p = 0.013). High-sensitivity cardiac troponin may serve as an early biomarker of heart failure in hypertensive women. Hydration status should be considered in overall hypertensive women care. There is an importance of body mass compartments analysis in the early identification of hypertensive females at risk of heart failure. Optimization and personalization of body structure may be a preventive method for this disease. ClinicalTrials.gov Identifier: NCT04802369.

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A.M Bielecka-Dabrowa ◽  
K Gryglewska ◽  
A Sakowicz ◽  
K Janikowski ◽  
M Maciejewski ◽  
...  

Abstract Purpose The aim was to identify factors influencing maximal oxygen uptake (VO2max) and early identification of hypertensive women at risk of heart failure (HF). Methods The 185 consecutive females with controlled hypertension were divided according VO2max quartiles. The patients underwent echocardiography, non-invasive body mass analysis, spiroergometry and hemodynamic parameters. Regression analyses determined predictors of the lowest VO2max (quartile 1: VO2max &lt;17 ml/kg/min). Results Females with the worst oxygen consumption had significantly higher level of high sensitive cardiac Troponin T (hs-cTnT) [p=0.001], higher values of the left atrial (LA) volume, late diastolic mitral annulus velocity (A'), ratio of peak velocity of early diastolic transmitral flow to peak velocity of early diastolic mitral annular motion (E/E') [p=0.0003, p=0.02, p=0.04; respectively] and lower E' [p=0.001] compared to controls. Women with the worst exercise capacity had higher body mass index (BMI) and fat content (kg and %) [p&lt;0.0001], higher fat free mass (FFM) (kg) [p&lt;0.0001], higher total body water content (TBW) [p=0.0002] as well as extracellular body water content (ECW) [p&lt;0.0001] and intracellular body water content (ICW) [p=0.005], ECW/TBW x 100% [p&lt;0.0001] and metabolic age [p&lt;0.0001] compared to counterparts. In a multiple logistic regression model independently associated with VO2max were: ECW/TBW x 100% (OR 4.45, 95% CI: 1.77–11.21; p=0.002) Figure 1, BMI (OR 7.11, 95% CI: 2.01–25.11; p=0.002) Figure 2 and hs-cTnT level (OR 2.69, 95% CI: 1.23–5.91; p=0.013). Conclusions High-sensitivity cardiac troponin may serve as early biomarker of heart failure in hypertensive women. Hydration status should be considered in overall hypertensive women care. There is an importance of body mass compartments analysis in early identification of hypertensive females at risk of heart failure. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Project is financed by the Polish National Agency for Academic Exchange under the Foreign Promotion Programme. Figure 1 Figure 2


2004 ◽  
Vol 68 (12) ◽  
pp. 1160-1164 ◽  
Author(s):  
Ryoji Taniguchi ◽  
Yukihito Sato ◽  
Tasuku Yamada ◽  
Muneo Ooba ◽  
Hirokazu Higuchi ◽  
...  

2020 ◽  
Vol 56 (1) ◽  
pp. 4
Author(s):  
Yen Yen Ari Indrawijaya ◽  
Suharjono Suharjono ◽  
Muhammad Aminuddin ◽  
Endang Retnowati ◽  
Gilang Mauladi Rahman

Patients with advanced heart failure (NYHA FC III and IV heart failure) had positive cardiac troponin levels in previous cohort studies. In heart failure, cardiac troponin T (cTnT) is a biomarker that is sensitive to myocardial damage, especially myocardial necrosis. However, there is still little information regarding changes in cTnT levels during standard therapy. This prospective observational study is aimed at evaluating changes in cTnT levels before and after the administration of standard therapy and evaluating symptom improvement before and after the administration of standard therapy in patients with severe heart failure. Measurement of cTnT levels and symptom improvement parameters before treatment was carried out on the first day of the inpatient and measurement after therapy was carried out on the last day of the inpatient. Sampling was done by consecutive sampling and found 30 patients in the inpatient room of the SMF Cardiovascular Disease, Dr. Soetomo Hospital, Surabaya during the months of May-July 2017. The results of the study obtained the average cTnT levels before therapy 33.48 + 31.88 pg/ml and the average cTnT levels after therapy 46.32 + 52.68 pg/ml. Based on the statistical difference test with the Wilcoxon sign-ranked test, there was no significant change in cTnT levels (p = 0.318). On the parameter of clinical symptom improvement, there was a significant decrease in pulse, respiratory rate, blood pressure, and mean arterial pressure before and after administration of therapy (p <0.05). There was no change in troponin T levels before and after the administration of therapy meant there was no worsening of myocardial necrosis.


2003 ◽  
Vol 49 (12) ◽  
pp. 2020-2026 ◽  
Author(s):  
Junnichi Ishii ◽  
Wei Cui ◽  
Fumihiko Kitagawa ◽  
Takahiro Kuno ◽  
Yuu Nakamura ◽  
...  

Abstract Background: Recent studies have suggested that cardiac troponin T (cTnT) and troponin I may detect ongoing myocardial damage involved in the progression of chronic heart failure (CHF). This study was prospectively designed to examine whether the combination of cTnT, a marker for ongoing myocardial damage, and B-type natriuretic peptide (BNP), a marker for left ventricular overload, would effectively stratify patients with CHF after initiation of treatment. Methods: We measured serum cTnT, plasma BNP, and left ventricular ejection fraction (LVEF) on admission for worsening CHF [New York Heart Association (NYHA) functional class III to IV] and 2 months after initiation of treatment to stabilize CHF (n = 100; mean age, 68 years). Results: Mean (SD) concentrations of cTnT [0.023 (0.066) vs 0.063 (0.20) μg/L] and BNP [249 (276) vs 753 (598) ng/L], percentage increased cTnT (&gt;0.01 μg/L; 35% vs 60%), NYHA functional class [2.5 (0.6) vs 3.5 (5)], and LVEF [43 (13)% vs 36 (12)%] were significantly (P &lt;0.01) improved 2 months after treatment compared with admission. During a mean follow-up of 391 days, there were 44 cardiac events, including 12 cardiac deaths and 32 readmissions for worsening CHF. On a stepwise Cox regression analysis, increased cTnT and BNP were independent predictors of cardiac events (P &lt;0.001). cTnT &gt;0.01 μg/L and/or BNP &gt;160 ng/L 2 months after initiation of treatment were associated with increased cardiac mortality and morbidity rates. Conclusion: The combination of cTnT and BNP measurements after initiation of treatment may be highly effective for risk stratification in patients with CHF.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Bill Mcevoy ◽  
Chiadi E Ndumele ◽  
Yuan Chen ◽  
Scott D Solomon ◽  
Michael Steffes ◽  
...  

Background: Serial changes in high-sensitivity cardiac troponin-T (hs-cTNT) indicate progressive subclinical myocardial damage and have been associated with heart failure (HF) and death in asymptomatic older adults. Whether these associations exist in middle-age and whether serial hs-cTNT is more strongly associated with HF with reduced ejection fraction (HFREF) or HF with preserved ejection fraction (HFPEF) is poorly understood. Methods: We studied 8,838 participants of the Atherosclerosis Risk in Communities Study, initially free of coronary heart disease and HF, who had hs-cTNT measured at two time-points, 6 years apart. Using proportional hazards regression, we examined the association of absolute and relative change in hs-cTNT with incident HF hospitalization or death. Sensitivity analyses for HFPEF and HFREF were also conducted. Results: Mean age at baseline was 57 years, 57% were female and 21% were black. Over a maximum of 16 years follow-up there were 965 HF events and 1813 deaths. In adjusted models, incident detectable hs-cTNT (≥5ng/L) was associated with subsequent HF (Hazard Ratio [HR] 1.86, 95% Confidence Interval [CI] 1.53-2.25) and death (1.46 [1.28-1.68]). HRs were larger for incident hs-cTNT elevation (≥14ng/L) but similar for those with a relative increase >50% from baseline hs-cTNT (Table). In contrast, risk was lower for relative reductions >50% from baseline hs-cTNT. Temporal increases in hs-cTNT were associated with both HFREF and HFPEF in categorical analyses, however, when modeled continuously (per SD increase), absolute 6-year hs-cTNT change appeared to be more strongly associated with HFPEF hospitalization (HR 1.30 [1.06-1.60]) than with HFREF hospitalization (1.08 [0.88-1.33]). Conclusions: Absolute and relative change in hs-cTNT were independently associated with incident CHD, HF and death, even after adjustment for baseline hs-cTNT. Associations were generally consistent for both the HFREF and HFPEF phenotypes


2019 ◽  
Vol 34 (10) ◽  
pp. 1650-1656
Author(s):  
Sho Suzuki ◽  
Hirohiko Motoki ◽  
Masatoshi Minamisawa ◽  
Yukari Okuma ◽  
Wataru Shoin ◽  
...  

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