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Fu J, Lin F, Pan Z, Wu C. Correlations of circulating miR-26b level with left ventricular hypertrophy and cardiac function in elderly patients with hypertension. Pak J Med Sci 2021; 37:966-971. [PMID: 34290767 PMCID: PMC8281164 DOI: 10.12669/pjms.37.4.4048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/08/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives: To study the correlations of circulating miR-26b level with left ventricular hypertrophy (LVH) and cardiac function in elderly patients with hypertension. Methods: A total of 132 eligible patients were divided into low and high miR-26b level groups. Their baseline clinical data and biochemical indices were compared. The correlations between miR-26b level and echocardiographic parameters were studied by Pearson’s analysis. Factors affecting LVH were explored by multivariate logistic regression analysis. The role of miR-26b in diagnosing LVH was predicted by receiver operating characteristic curve. Results: The relative expression level of miR-26b was 4.56-16.93, with a median of 7.62. The two groups had similar baseline clinical data and biochemical indices (P>0.05). Compared with high miR-26b level group, interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular mass index (LVMI) and number of LVH cases in low miR-26b level group significantly increased (P<0.05), and mitral ratio of peak early to late diastolic filling velocity (E/A) decreased (P<0.05). Circulating miR-26b level was negatively correlated with IVST, LVPWT and LVMI (P<0.0001), and positively correlated with E/A (P<0.0001). The proportion of cardiac hypofunction cases in low miR-26b level group significantly exceeded that of high miR-26b level group (P<0.05). Age and increased IVST, LVPWT and LVMI were independent risk factors for LVH (P<0.05), and elevated miR-26b level was a protective factor (P<0.05). AUC was 0.836, and the optimal cutoff value was 8.83, with high sensitivity and specificity. Conclusions: MiR-26b level is negatively correlated with LVH and positively correlated with left ventricular diastolic function in elderly hypertensive patients. It is a protective factor for LVH complicated with diastolic dysfunction and a potential biomarker for diagnosis.
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Affiliation(s)
- Jian Fu
- Jian Fu, Department of Cardiac Surgery, Children's Hospital of Chongqing Medical University, National International Science and Technology Cooperation Base for Children's Developmental Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, P.R. China
| | - Fang Lin
- Fang Lin, The Second Affiliated Hospital of The Army Medical University, No. 136, Zhongshan Second Road, Yuzhong District, Chongqing 400014, P.R. China
| | - Zhengxia Pan
- Zhengxia Pan, Department of Cardiac Surgery, Children's Hospital of Chongqing Medical University, National International Science and Technology Cooperation Base for Children's Developmental Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, P.R. China
| | - Chun Wu
- Chun Wu, Department of Cardiac Surgery, Children's Hospital of Chongqing Medical University, National International Science and Technology Cooperation Base for Children's Developmental Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, P.R. China
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de Hartog-Keyzer JML, El Messaoudi S, Harskamp R, Vart P, Ringoir L, Pop V, Nijveldt R. Electrocardiography for the detection of left ventricular hypertrophy in an elderly population with long-standing hypertension in primary care: a secondary analysis of the CHELLO cohort study. BMJ Open 2020; 10:e038824. [PMID: 32819998 PMCID: PMC7443300 DOI: 10.1136/bmjopen-2020-038824] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To investigate: (1) the prevalence of left ventricular hypertrophy (LVH) in elderly primary care patients with long-standing asymptomatic hypertension, and (2) the diagnostic value of ECG as a screening tool in the detection of LVH compared with echocardiography in this specific patient population. DESIGN AND SETTINGS A cross-sectional study in five general practices in the south-east of the Netherlands. PARTICIPANTS Patients with primary care-managed hypertension, aged between 60 and 85 years, without known heart failure. PRIMARY AND SECONDARY OUTCOME MEASURES Between June 2010 and January 2013, the patients underwent structured interviews, blood pressure assessment, laboratory testing, ECGs and echocardiograms. The primary outcome was to investigate the ability of ECG to detect LVH, compared with echocardiography as a reference test (gold standard). RESULTS Four hundred and twenty-two patients (44% male; ages 70±7 years) who underwent ECG and echocardiographic assessment to determine LVH were included. The median duration of hypertension was 10 (4-15) years. The overall prevalence of LVH was 44%, which increased with age (p<0.001); up to 60% of patients were ≥75 years. ECG intimated LVH in 47 patients (11%) but in only 26 of those (55%) was LVH confirmed by echocardiography. The sensitivity of ECG for detecting LVH was poor (14%). CONCLUSIONS Asymptomatic primary care patients with long-standing hypertension have a high prevalence of previously undetected LVH, which increases with age. ECG is inadequate for detecting LVH in these patients. Early detection of LVH could potentially create more awareness for the optimal regulation of hypertension and compliance to therapy. Therefore, echocardiography should be considered a screening device for the detection of LVH in this population.
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Affiliation(s)
| | | | - Ralf Harskamp
- Department of General Practice, Amsterdam UMC, Amsterdam, The Netherlands
| | - Priya Vart
- Department of Cardiology, Radboudumc, Nijmegen, The Netherlands
- Health Evidence, Radboudumc, Nijmegen, The Netherlands
| | | | - Victor Pop
- Department of Medical Health Psychology, Tilburg University, Tilburg, The Netherlands
| | - Robin Nijveldt
- Department of Cardiology, Radboudumc, Nijmegen, The Netherlands
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Rendón-Giraldo JA, Godoy-Palomino AL. Detección temprana de la falla cardiaca en pacientes diabéticos: Más allá de la fracción de eyección. REVISTA COLOMBIANA DE CARDIOLOGÍA 2020. [DOI: 10.1016/j.rccar.2019.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Zhao Z, Hou C, Ye X, Cheng J. Echocardiographic Changes in Newly Diagnosed Type 2 Diabetes Mellitus Patients with and without Hypertension. Med Sci Monit 2020; 26:e918972. [PMID: 31982890 PMCID: PMC7001517 DOI: 10.12659/msm.918972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Whether type 2 diabetes mellitus (T2DM) is independently associated with structural heart abnormalities is controversial because of confounders associated with T2DM. This study aimed to investigate echocardiographic features in patients with newly diagnosed T2DM, exploring changes in cardiac structure and function. Material/Methods This was a retrospective study of new T2DM cases treated at the Second People’s Hospital Affiliated to Nanjing Medical University (Changzhou) in 2014–2016. In all, 128 T2DM cases were included (62 hypertensive and 66 non-hypertensive individuals). Controls were selected among individuals who underwent examination at the same department/period. Interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVEDD), posterior left ventricular wall thickness (PWTD), left ventricle mass (LVM), end-diastolic thickness of left ventricular posterior wall (Dd), aortic root diameter, left atrial diameter (LAd), left atrial diameter fraction-shortening values, and left ventricular ejection fraction (LVEF) were determined routinely. Results IVST, LVEDD, PWTD, Dd, LAd, and left atrial diameter fraction-shortening values were larger in patients with T2DM (all P<0.05 vs. controls). LVM was higher in T2DM patients (median, 57.12 vs. 54.77 g, P=0.001). There were no differences in aortic root diameter and EF (both P>0.05). Multivariable analysis showed that IVST (OR=1.33, 95% CI: 1.01–1.76, P=0.04), LAd (OR=1.16, 95% CI: 1.07–1.25, P<0.001), TGs (OR=1.34, 95% CI: 1.09–1.63, P=0.005), and HDL (OR=1.46, 95% CI: 1.02–2.08, P=0.04) were independently associated with hypertension in patients with T2DM. Conclusions Patients with newly diagnosed T2DM already display structural heart abnormalities. LAd and IVST are independently associated with hypertension in these patients, probably contributing to increased cardiovascular risk.
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Affiliation(s)
- Zhen Zhao
- Department of Endocrinology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China (mainland)
| | - Can Hou
- Department of Cardiology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China (mainland)
| | - Xinhua Ye
- Department of Endocrinology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China (mainland)
| | - Jinluo Cheng
- Department of Endocrinology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China (mainland)
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Cohen A, Angoulvant D. Cardiomyopathie du diabétique, dépistage et épidémiologie. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2019. [DOI: 10.1016/s1878-6480(19)30963-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bunn PDS, Lima NDS, Venturini GRDO, Silva EBD. The chronic effects of muscle-resistance training in arterial pressure of hypertensive older adults: a meta-analysis. FISIOTERAPIA EM MOVIMENTO 2019. [DOI: 10.1590/1980-5918.032.ao05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Little research has been done on the effects of muscle-resistance training (RT) in hypertensive older adults. Objective: The aim of this meta-analysis was to verify the efficacy of RT, on a chronic basis, on the systolic (SBP) and diastolic blood pressure (DBP) of hypertensive older adults. Method: Several literature databases were explored to find studies on controlled and randomized trials that evaluated the effects of RT in hypertensive older adults for more than 10 weeks. Profile of the participants, sample size, intervention protocol, and results of SBP and DBP were analyzed. The PEDro scale and the Cochrane tool were used to analyze the methodological quality of the studies and the risk of bias, respectively. The RevMan5.3 program was used to analyze the results on the SBP and DBP after the RT intervention and in the control groups. Results: The meta-analysis of five studies considering 96 hypertensive individuals who underwent RT and 104 hypertensive control subjects showed that the regular practice of RT from 12 to 16 weeks, three times a week, with three sets from 8 to 12 repetitions at an intensity of 60% to 80% of one-repetition maximum (1-RM), significantly reduced SBP by 7.26 mmHg (95%CI = -9.16 - 5.37) and DBP by 4.84 mmHg (95%CI = -5.89 - 3.79). Conclusion: The muscle-resistance training was effective in reducing, chronically, the blood pressure of hypertensive older adults. It can also decrease the need for medication inherent to hypertension.
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Gong FF, Campbell DJ, Prior DL. Noninvasive Cardiac Imaging and the Prediction of Heart Failure Progression in Preclinical Stage A/B Subjects. JACC Cardiovasc Imaging 2018; 10:1504-1519. [PMID: 29216977 DOI: 10.1016/j.jcmg.2017.11.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 10/25/2017] [Accepted: 11/01/2017] [Indexed: 12/16/2022]
Abstract
Heart failure (HF) continues to grow as a cause of morbidity and mortality in our community and presents a significant public health problem, predominantly in individuals ≥65 years of age. Early intervention in asymptomatic HF subjects (Stage A/B) at risk of progression to symptomatic HF (Stage C/D) may provide an opportunity to halt this epidemic. The ability of cardiac imaging to assess cardiac structure and function permits early identification of those at increased risk of developing symptomatic HF. Systolic, diastolic, and structural left ventricular parameters each predict symptomatic HF, but no single parameter has sufficient sensitivity for screening to identify individuals with Stage A/B HF who are at increased risk of disease progression. Transthoracic echocardiography (TTE) has the advantage over other imaging modalities in being able to measure systolic, diastolic, and structural left ventricular parameters, and it identified at least 1 abnormal parameter in >50% of individuals with Stage A/B HF ≥65 years of age. Moreover, identification of at least 1 abnormality according to TTE in individuals with Stage A/B HF ≥65 years of age had 72% to 82% sensitivity for detection of those who subsequently developed symptomatic HF. Therefore, a case can be made for cardiac imaging by using TTE for community-dwelling populations with Stage A/B HF ≥65 years of age to identify those with increased risk of symptomatic HF who can be offered preventative therapies. Further studies are required to determine the best strategy for identifying the risk of symptomatic HF in younger individuals.
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Affiliation(s)
- Fei Fei Gong
- Department of Medicine, University of Melbourne, St. Vincent's Hospital Melbourne, Fitzroy, Australia; St. Vincent's Institute of Medical Research, Fitzroy, Australia
| | - Duncan J Campbell
- Department of Medicine, University of Melbourne, St. Vincent's Hospital Melbourne, Fitzroy, Australia; St. Vincent's Institute of Medical Research, Fitzroy, Australia
| | - David L Prior
- Department of Medicine, University of Melbourne, St. Vincent's Hospital Melbourne, Fitzroy, Australia; Department of Cardiology, St. Vincent's Hospital Melbourne, Fitzroy Australia.
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Girerd N, Huttin O, Zannad F. Echocardiography in Hypertension in the Era of Risk Stratification and Personalized Medicine. Am J Hypertens 2016; 29:792-5. [PMID: 27114425 DOI: 10.1093/ajh/hpw042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 04/06/2016] [Indexed: 12/21/2022] Open
Affiliation(s)
- Nicolas Girerd
- Clinical Investigation Center, INSERM, CHU Nancy, Institut Lorrain du Cœur et des Vaisseaux, Vandoeuvre lès Nancy, France; Université de Lorraine, Nancy, France; F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists) Network, Nancy, France;
| | - Olivier Huttin
- Clinical Investigation Center, INSERM, CHU Nancy, Institut Lorrain du Cœur et des Vaisseaux, Vandoeuvre lès Nancy, France; Université de Lorraine, Nancy, France; Cardiology Department, CHU Nancy, Institut Lorrain du Cœur et des Vaisseaux, Vandoeuvre lès Nancy, France
| | - Faiez Zannad
- Clinical Investigation Center, INSERM, CHU Nancy, Institut Lorrain du Cœur et des Vaisseaux, Vandoeuvre lès Nancy, France; Université de Lorraine, Nancy, France; F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists) Network, Nancy, France
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