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Eren H, Omar MB, Kaya Ü, Öcal L, İnanir M, GÖzek Öcal A, GenÇ Ö, GenÇ S, GÜner A, Yetİm M. Increased epicardial adipose tissue thickness is associated with microalbuminuria in hypertensive patients with left ventricular hypertrophy. Clin Exp Hypertens 2021; 43:18-25. [PMID: 32657169 DOI: 10.1080/10641963.2020.1790588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Epicardial adipose tissue (EAT) is a cardiometabolic risk factor, and its possible relationship with hypertension has been previously reported. Microalbuminuria (MA) is associated with target-organ damage, especially in patients with hypertension with left ventricular hypertrophy (LVH) and suggest endothelial dysfunction. This study aimed to investigate the relationship between echocardiographic EAT thickness and presence of MA in patients with hypertension. METHODS A total of 297 newly diagnosed hypertension patients who applied to the outpatient clinic were enrolled consecutively in this study. Patients were divided into two groups regarding the presence of LVH in echocardiography. An age and gender matched control group was set including 156 healthy patients without HT. All subjects underwent transthoracic echocardiography for the measurement of EAT thickness. Spot urine samples were collected for the assessment of MA. RESULTS In hypertensive patients with LVH, the EAT thicknesses (6.6 ± 1.8 vs 5.3 ± 1.5 vs 5.1 ± 1.3, p < .001; respectively) and prevalence of MA (41.2 vs 20.1 vs 3.2%; p < .001 respectively) were significantly higher than the other two groups. In hypertensive patiens without LVH, no relationship was found between the presence of MA and EAT thickness. In multivariate regression analyses, EAT thickness (OR: 3.141, 95%CI: 2.425-6.123, p < .001) and left ventricular mass index (OR: 1.339, 95%CI: 1.145-2.143, p = .003) were determined as independent predictors for MA development in hypertensive patients with LVH. CONCLUSION Measurement of EAT thickness may help to identify high-risk hypertensive patients for target-organ damage especially among patients with LVH.
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Affiliation(s)
- Hayati Eren
- Department of Cardiology, Elbistan State Hospital , Kahramanmaraş, Turkey
| | - Muhammed Bahadır Omar
- Department of Cardiology, Istanbul Fatih Sultan Mehmet Training and Research Hospital , Istanbul, Turkey
| | - Ülker Kaya
- Department of Cardiology, Elbistan State Hospital , Kahramanmaraş, Turkey
| | - Lütfi Öcal
- Department of Cardiology, Kosuyolu Kartal Heart Training and Research Hospital , Istanbul, Turkey
| | - Mehmet İnanir
- Department of Cardiology, Bolu Abant Izzet Baysal University , Bolu, Turkey
| | - Aslı GÖzek Öcal
- Department of Internal Medicine, Kartal Dr Lütfi Kırdar Training and Research Hospital , Istanbul, Turkey
| | - Ömer GenÇ
- Department of Internal Medicine, Kahramanmaraş Necip Fazıl City Hospital , Kahramanmaraş, Turkey
| | - Selin GenÇ
- Department of Internal Medicine, Türkoğlu Kemal Beyazıt State Hospital , Kahramanmaraş, Turkey
| | - Ahmet GÜner
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital , Istanbul, Turkey
| | - Mucahit Yetİm
- Department of Cardiology, Hitit University Faculty of Medicine , Çorum, Turkey
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Chen XJ, Lerman A, Lerman LO. Cardiorenal biomarkers: one step closer. JOURNAL OF LABORATORY AND PRECISION MEDICINE 2017; 2:16. [PMID: 30148255 PMCID: PMC6107311 DOI: 10.21037/jlpm.2017.05.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Xiao-Jun Chen
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
- Department of Nephrology, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Amir Lerman
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Lilach O. Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
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Shrivastav TG, Kariya KP, Prasad PKV, Chaube SK, Kumar D. Development of enzyme-linked immunosorbent assay for estimation of urinary albumin. J Immunoassay Immunochem 2014; 35:300-13. [PMID: 24654825 DOI: 10.1080/15321819.2013.849729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Yearly estimation of urinary albumin is a prerequisite for predicting renal status in Diabetes Type II patients with negative dipstick results for overt proteinuria. A simple, sensitive, and cost-effective enzyme linked immunosorbent assay (ELISA) for urinary albumin has been developed using human serum albumin antiserum (HSA-antiserum), HSA-biotin, and streptavidin-horseradish peroxidase (SA-HRP) conjugates. To the antibody-coated wells, 100 μL of HSA standards followed by 1:100 diluted urine samples in duplicate were added and then 50 μL of HSA-biotin conjugates was added in all the wells. 100 μL of SA-HRP was added after washing. Bound enzyme activity was measured by adding 100 μL TMB/H2O2. The analytical sensitivity and ED50 of the developed method was found to be 0.01 μg/mL and 0.35 μg/mL, respectively. The percent recovery of the HSA from exogenously spiked urine pools were in the range of 98.13-100.29%. The intra- and inter-assay coefficient of variation (CVs) ranged from 3.38-10.32 % and 4.22-11.01%, respectively. The antibody showed 4.4% and 3.2% cross reactivity with monkey and horse serum albumin, respectively. There was no cross reaction with human β2-microglobulin, γ-globulin, and haemoglobulin.
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Affiliation(s)
- Tulsidas G Shrivastav
- a Department of Reproductive Biomedicine , National Institute of Health and Family Welfare , Munirka , New Delhi , India
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Kaur S, Singh P, Indu V, Singla G. Fibrinogen, Lp(a), Microalbuminuria and Left Ventricular Mass Index: Cardiovascular Disease Risk factors in Diabetes. Indian J Clin Biochem 2012; 27:94-6. [PMID: 23277719 PMCID: PMC3286583 DOI: 10.1007/s12291-011-0184-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Accepted: 11/10/2011] [Indexed: 10/14/2022]
Abstract
The present work was undertaken to study interrelation of Fibrinogen, Lp(a) and LVMI in Type II diabetes patients with or without nephropathy. 100 Type II Diabetic patients attending OPD/IPD of DMC&H, Ludhiana were included. They were divided in two groups. Group I: 50 patients without microalbuminuria (MAU). Group II: 50 patients with MAU. Fibrinogen (Clauss method), Lp(a) and MAU were estimated on Multichannel Autoanalyzer Hitachi-911 (Roche). LVMI was estimated by echocardiography using formula of Devereux and Reicheck. Type II diabetes patients with MAU had significantly raised levels of Fibrinogen, Lp(a), and LVMI as compared to normoalbuminuric diabetics (P < 0.01). Group II patients had positive correlation between Lp(a) and LVMI but no relation between Fibrinogen and LVMI. MAU, marker of microangiopathy, is associated with higher Fibrinogen and Lp(a) levels. This becomes basis of increase cardiovascular risk as demonstrated by higher mean LVMI in Group II patients.
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Affiliation(s)
- Satinder Kaur
- Department of Biochemistry, Dayanand Medical College & Hospital, Ludhiana, 141 001 Punjab India
| | - Parminder Singh
- Department of Endocrinology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Verma Indu
- Department of Biochemistry, Dayanand Medical College & Hospital, Ludhiana, 141 001 Punjab India
| | - Gaurav Singla
- Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, India
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Andrikou E, Tsioufis C, Dimitriadis K, Flessas D, Chatzistamatiou V, Grassos C, Papavasiliou M, Papadopoulos D, Stefanadis C. Parallel deterioration of albuminuria, arterial stiffness and left ventricular mass in essential hypertension: integrating target organ damage. Nephron Clin Pract 2011; 119:c27-34. [PMID: 21654180 DOI: 10.1159/000324215] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Accepted: 01/07/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Albuminuria, arterial stiffening and left ventricular hypertrophy (LVH) constitute target organ damage. We estimated whether increased urinary albumin excretion, assessed by albumin-to-creatine ratio (ACR), and carotid to femoral pulse wave velocity (c-f PWV) were accompanied by augmented left ventricular (LV) mass index (LVMI) in hypertension. METHODS In 428 non-diabetic untreated hypertensives (257 men, mean age = 52 years, office blood pressure (BP) = 146/93 mm Hg) the distributions of ACR and c-f PWV were split by the median (8 mg/g and 7.8 m/s, respectively). RESULTS Age, male sex, 24 h systolic BP, ACR and c-f PWV were the independent predictors of LVMI (R(2) = 0.478, p < 0.0001). Among patients with low ACR (n = 198), those with high c-f PWV (n = 84) compared to those with low c-f PWV (n = 114) were characterized by increased LVMI (by 8.9 g/m(2), p = 0.012) and prevalence of LVH (30 vs. 14%, p = 0.015). Similarly among patients with high ACR (n = 230), those with high c-f PWV (n = 123) compared to those with low c-f PWV (n = 107) exhibited heightened LVMI (by 13.6 g/m(2), p = 0.001). CONCLUSIONS Increased ACR in conjunction with pronounced arterial stiffness is accompanied by augmented LV mass and higher LVH rates. Furthermore, the interrelationships between albuminuria, c-f PWV and LVMI suggest parallel target organ damage progression.
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Affiliation(s)
- Eirini Andrikou
- First Cardiology Clinic, University of Athens, Hippokration Hospital, Greece
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Shim CY, Park S, Choi EY, Kang SM, Cha BS, Ha JW, Rim SJ, Lee HC, Chung N. Is albuminuria an indicator of myocardial dysfunction in diabetic patients without overt heart disease? A study with Doppler strain and strain rate imaging. Metabolism 2008; 57:448-52. [PMID: 18328343 DOI: 10.1016/j.metabol.2007.11.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2007] [Accepted: 11/20/2007] [Indexed: 11/28/2022]
Abstract
The aim of this study was to address whether albuminuria could predict myocardial dysfunction in diabetic patients without overt heart disease. We studied 67 patients with normal left ventricular (LV) ejection fraction and no evidence of LV hypertrophy or coronary artery disease (47 patients with type 2 diabetes mellitus and hypertension and 20 patients with hypertension only). Diabetes patients were divided into 3 groups based on albuminuria status: group II = no albuminuria (n = 20, <30 mg/d), group III = microalbuminuria (n = 13, 30-300 mg/d), and group IV = macroalbuminuria (n = 14, >300 mg/d). Twenty patients with hypertension only served as a control group (group I). Conventional 2-dimensional and Doppler echocardiography was done. Peak strain, peak systolic strain rate (SR), and peak diastolic SR of 6 LV segments in the apical views were measured and averaged in each patient. Conventional 2-dimensional parameters such as LV ejection fraction; left atrium volume index; LV mass; deceleration time; and mitral early peak, mitral late peak, myocardial early peak diastolic, and myocardial peak systolic velocities were not different among the 4 groups. However, peak strains were significantly lower in group III (P = .002) and group IV (P < .001) than in group I; and the absolute value of peak systolic SR was lower in group III (P = .033) and group IV (P < .001) than in group I. Furthermore, the value of peak diastolic SR was lower in group IV than in group I (P = .014). In diabetic patients with albuminuria, Doppler strain and SR imaging detected subclinical LV systolic and diastolic dysfunction; and albuminuria was associated with myocardial dysfunction in diabetic patients without overt heart disease.
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Affiliation(s)
- Chi Young Shim
- Cardiology Division, Yonsei Cardiovascular Center and Research Institute, Yonsei University College of Medicine, Seoul 120-752, Korea
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Salmasi AM, Frost P, Dancy M. Impaired left ventricular diastolic function during isometric exercise in asymptomatic patients with hyperlipidaemia. Int J Cardiol 2004; 95:275-80. [PMID: 15193832 DOI: 10.1016/j.ijcard.2003.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2003] [Accepted: 06/29/2003] [Indexed: 11/17/2022]
Abstract
BACKGROUND Left ventricular (LV) diastolic dysfunction is an early sign, and may be more sensitive indicator, of ischaemic heart disease (IHD) than systolic dysfunction. METHODS LV diastolic function was assessed during isometric exercise (IME) in 37 consecutive normotensive hyperlipidaemics (LIP), without cardiac history or symptoms. Each patient underwent a stress ECG test and 2-D echo and Doppler cardiography. During the latter, transmitral flow at rest and at peak standardised IME using handgrip was studied. From the tracings, the E/A (peak velocity of the early/atrial components), the contribution of atrial systole to LV filling (ACF), the deceleration time (DT) of the E wave and the isovolumic relaxation time (IVRT) were calculated. Results were compared to 37 age-matched normal healthy volunteers (NOR). RESULTS Resting E/A was not different between NOR and the LIP. A significant reduction in E/A with IME was observed in LIP but not in NOR. Impaired LV filling (shown by E/A<1) was demonstrated in five patients (13%) at rest and in 20 patients (54%) at peak IME. All NOR had E/A>1 suggesting normal LV filling. Fifteen of the 30 patients with negative stress ECG test demonstrated LV diastolic dysfunction. ACF was higher in LIP than NOR and increased significantly (P<0.005) by 23% during IME. DT and IVRT in LIP were not different from NOR. In neither NOR nor LIP, were the LV diastolic functional parameters related to gender, smoking habit or levels of total cholesterol, LDL- or HDL-cholesterol or triglycerides. CONCLUSION The prevalence of LV diastolic dysfunction in asymptomatic patients with hyperlipidaemia despite a negative stress ECG test may be evidence of early underlying pre-clinical myocardial ischaemia.
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Affiliation(s)
- Abdul-Majeed Salmasi
- Cardiac Research Unit, Cardiology Department, The Central Middlesex Hospital, Acton Lane, London NW10 7NS, UK.
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