Left ventricular mass: correlation with fatness, hemodynamics and renal morphology

Investigation of Kidney Morphology and Somatotype Components in Early-Stage Kidney Patients

Objectives

The aim of this study is to examine the kidney morphology and somatotype components of adult patients with early-stage chronic kidney disease (CKD).

Methods

The sample consisted of 46 individuals with early-stage CKD (26 men and 20 women, mean age=45.92±16.53 years). The pathological subjects were compared with a control group consisting of 46 healthy subjects (28 men and 18 women, mean age=41.96±11.48 years). The Heath-Carter method was used to determine somatotype components. Abdominal computed tomography (CT) of patients with Stage 2 CKD and healthy volunteers taken within the past 3 months was scanned to determine kidney morphology. Kidney measurements were performed on CTs (length, width, depth, and volume of kidney).

Results

Kidney patients (mean somatotype: 6.33-5.37-0.6) were less ectomorphic and more endomorphic than the controls (mean somatotype: 4.35-4.40-3.02). Moderate effect size (ES) was found in endomorphy (ES=0.87; p=0.035) and ectomorphy (ES=1.08; p=0.012) between groups. No significant difference was observed in the kidney morphology (ES=0.04-0.19; p>0.05).

Conclusion

In the early-stage CKD, kidney morphology may not be the distinguishing factor. On the other hand, patients differed significantly in terms of endomorph components. Being overweight can also be one of the negative findings for kidney disease. Somatotype classification could be a suitable tool for monitoring kidney disease.

Inter-relationships between left ventricular mass, geometry and arterial stiffness

Objective

To investigate the inter-relationships between left ventricular mass (LVM), left ventricular (LV) geometry and arterial stiffness parameters (aortic pulse wave velocity [Ao-PWV] and heart rate-corrected augmentation index [c-AIx]) in patients with chronic heart failure (CHF).

Methods

This study was a secondary analysis of existing data that were collected from patients with CHF New York Heart Association class I–III with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF). Transthoracic echocardiography was performed on all patients, along with measurement of arterial stiffness parameters (Ao-PWV and c-AIx) using sphygmocardiography.

Results

A total of 73 patients (58 males) with a mean ± SD age of 55.9 ± 11.6 years were enrolled in this study. Of these, 20 patients (27.4%) had systemic hypertension, 46 (63.0%) had type 2 diabetes mellitus. Ischaemic heart disease was the main aetiology of CHF (63 of 73 patients; 86.3%). In multiple linear regression, the left ventricular mass index (LVMI) was significantly associated with c-AIx (β = –1.59) and EF (β = –1.51). Comparison of Ao-PWV among the four LV geometric patterns revealed significant differences.

Conclusion

In this cohort of CHF patients, LVMI was predicted by c-AIx and EF. The corresponding values of Ao-PWV were parallel in different LV geometric patterns and confirmed their adverse prognostic values.

Heart Protection by Herb Formula BanXia BaiZhu TianMa Decoction in Spontaneously Hypertensive Rats

Modern research has shown that BanXia BaiZhu TianMa decoction (BBT) has the potential effect of lowering BP in vitro and in vivo. However, its therapeutic mechanism has not been clearly defined. The present study was designed to evaluate the protective effect of BBT on the heart by examining heart functioning and anti-inflammatory characteristics and to obtain scientific evidence for its further medical applications. BBT was extracted by decocting the herb extraction and analysed by HPLC. The left ventricular mass index (LVMI) was measured, and a histological examination of samples of the heart was performed. Inflammatory status was investigated by measuring tissue levels of interleukin-1 (IL-1), interleukin-6 (IL-6), tumour necrosis factor (TNF-α), inducible nitric oxide synthase (iNOS), and molecules of the nuclear factor κB (NF-κB) pathway. The BBT treatment significantly reversed the course of hypertension-derived heart damage. Meanwhile, the herb formula markedly reduced levels of IL-1, IL-6, TNF-α, and iNOS. In addition, the traditional compound suppressed the activity of the NF-κB pathway. The present study provides evidence of heart protection by BBT in SHRs. The action mechanisms may be partially attributable to the anti-inflammatory characteristic of the formula. Understanding the pharmacological action of BBT will benefit its impending use.

Excessive physical activity in young girls with restrictive-type anorexia nervosa: its role on cardiac structure and performance

PURPOSE

The aim of this study was to investigate the influence of hyperactivity on left ventricular mass (LVM) in Anorexia Nervosa restricting-type (AN-R) and the correlation between LVM and auxologic parameters/circulating hormones.

METHODS

Echocardiography was performed in 44 AN-R girls, subgrouped in 24 hyperactive (ANH+) and 20 non-hyperactive (ANH-), and in 20 controls (HC). LVM indexed to Body Surface Area (LVMi) and LVM indexed to height (LVMh) were calculated.

RESULTS

LVMi and LVMh were significantly lower in the AN-R subjects compared to HC. Moreover, both LVMi and LVMh were higher in the ANH+ than in the ANH-. In the HC, LVMi was higher when compared to the ANH- subjects than to the ANH+. Stepwise analysis revealed that in the ANH+ group, fT4 was the only independent predictor of LVMh, while in the ANH- group, height was the only independent predictors of LVMi.

CONCLUSIONS

Despite its negative influence on disease severity and outcome, hyperactivity from the standpoint of cardiac function makes the LVM of AN-R young girls more similar to HC.

LEVEL OF EVIDENCE

Level III, case-control study.