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McCarty MF. Nutraceutical, Dietary, and Lifestyle Options for Prevention and Treatment of Ventricular Hypertrophy and Heart Failure. Int J Mol Sci 2021; 22:ijms22073321. [PMID: 33805039 PMCID: PMC8037104 DOI: 10.3390/ijms22073321] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 12/12/2022] Open
Abstract
Although well documented drug therapies are available for the management of ventricular hypertrophy (VH) and heart failure (HF), most patients nonetheless experience a downhill course, and further therapeutic measures are needed. Nutraceutical, dietary, and lifestyle measures may have particular merit in this regard, as they are currently available, relatively safe and inexpensive, and can lend themselves to primary prevention as well. A consideration of the pathogenic mechanisms underlying the VH/HF syndrome suggests that measures which control oxidative and endoplasmic reticulum (ER) stress, that support effective nitric oxide and hydrogen sulfide bioactivity, that prevent a reduction in cardiomyocyte pH, and that boost the production of protective hormones, such as fibroblast growth factor 21 (FGF21), while suppressing fibroblast growth factor 23 (FGF23) and marinobufagenin, may have utility for preventing and controlling this syndrome. Agents considered in this essay include phycocyanobilin, N-acetylcysteine, lipoic acid, ferulic acid, zinc, selenium, ubiquinol, astaxanthin, melatonin, tauroursodeoxycholic acid, berberine, citrulline, high-dose folate, cocoa flavanols, hawthorn extract, dietary nitrate, high-dose biotin, soy isoflavones, taurine, carnitine, magnesium orotate, EPA-rich fish oil, glycine, and copper. The potential advantages of whole-food plant-based diets, moderation in salt intake, avoidance of phosphate additives, and regular exercise training and sauna sessions are also discussed. There should be considerable scope for the development of functional foods and supplements which make it more convenient and affordable for patients to consume complementary combinations of the agents discussed here. Research Strategy: Key word searching of PubMed was employed to locate the research papers whose findings are cited in this essay.
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Affiliation(s)
- Mark F McCarty
- Catalytic Longevity Foundation, 811 B Nahant Ct., San Diego, CA 92109, USA
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Baldo MP, Gonçalves MA, Capingana DP, Magalhães P, da Silva ABT, Mill JG. Prevalence and Clinical Correlates of Left Ventricular Hypertrophy in Black Africans. High Blood Press Cardiovasc Prev 2018; 25:283-289. [PMID: 29956112 DOI: 10.1007/s40292-018-0267-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 06/23/2018] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION African-Americans present higher prevalence of left ventricular hypertrophy (LVH) when compared with white populations. However, there is a lack of information about the prevalence and determinants of LVH in black individuals living in Africa. METHODS A cross-sectional study was performed with a non-probabilistic sample comprised of 609 University workers from Angola/Africa, describing the prevalence of LVH and the determinants of left ventricular mass. Echocardiographic measurements were performed and left ventricular mass was indexed to body surface area. Systolic and diastolic blood pressures were measured, along with anthropometric and clinical variables. RESULTS Chamber diameter and wall thickness were higher in men compared to women. Additionally, LVM was higher in men (114.2 ± 36 vs 98.4 ± 31.9, P < 0.001), and the overall prevalence of LVH in black Angolans was 41.1%, which tended to be higher in women (44.5 vs 37.4%, P = 0.096). In men, systolic blood pressure and BMI were independently associated with LVM, while age, systolic blood pressure and waist circumference were associated with LVM in women. CONCLUSIONS In summary, blood pressure levels were the main determinants of LVH in black Africans, although different anthropometric variables showed mild influence in LVM. Our data suggests that LVH prevalence and determinants in black Africans are similar to that reported for African-Americans.
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Affiliation(s)
- Marcelo Perim Baldo
- Department of Pathophysiology, Montes Claros State University-UNIMONTES, Av Rui Braga, Vila Mauricéia, 39401-089, Montes Claros, MG, Brazil.
| | - Mauer A Gonçalves
- Department of Physiology, Faculty of Medicine, University Agostinho Neto, Luanda, Angola
| | - Daniel P Capingana
- Department of Physiology, Faculty of Medicine, University Agostinho Neto, Luanda, Angola
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Pedro Magalhães
- Department of Physiology, Faculty of Medicine, University Agostinho Neto, Luanda, Angola
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Amilcar B Tomé da Silva
- Department of Physiology, Faculty of Medicine, University Agostinho Neto, Luanda, Angola
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - José Geraldo Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
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Dini FL, Fabiani I, Miccoli M, Galeotti GG, Pugliese NR, D'Agostino A, Scartabelli A, Conte L, Salvetti G, Santini F, Pedrinelli R. Prevalence and determinants of left ventricular diastolic dysfunction in obese subjects and the role of left ventricular global longitudinal strain and mass normalized to height. Echocardiography 2018; 35:1124-1131. [PMID: 29664200 DOI: 10.1111/echo.13890] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Left ventricular (LV) diastolic dysfunction (DD) is a frequent finding in obesity and may predispose to the development of heart failure (HF). However, no data are available on the prevalence of DD after the introduction of the 2016 Recommendations of the American Society of Echocardiography and the European Association of Cardiovascular Imaging. METHODS AND RESULTS To assess the impact of the new Recommendations on the prevalence of DD and on their clinical and echocardiographic correlates in obesity, a prospective study was performed in 588 subjects with an ejection fraction (EF) ≥50% and no history of HF either obese (n = 402; mean age: 47 ± 12 years; women 71%; body mass index [BMI]: 44 ± 8 kg/m2 ), overweight (n = 86; BMI: 28 ± 1 kg/m2 ), or with a normal weight (n = 100; BMI: 22 ± 2 kg/m2 ). All subjects underwent an echocardiographic and Doppler study, including the assessment of global longitudinal strain (GLS). DD occurred in 19% of obese patients, 12% of overweight subjects, and 2% of normal weight subjects. We used multivariable logistic analysis to assess the risk of DD. In patients with BMI ≥30 kg/m2 , LV mass normalized to height (2.7) (OR: 1.04, P = .0028), and GLS (OR: 0.85, P = .0032) were associated with an increased risk of DD followed by EF (OR: 0.91, P = .045), diabetes (OR: 1.91, P = .065), and systolic blood pressure (OR: 1.02, P = .076). CONCLUSION These results show that DD is highly prevalent among obese subjects and impairment of longitudinal systolic mechanics, as reflected by GLS reduction, and LV mass normalized to height are major independent predictors of DD in this patients' population.
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Affiliation(s)
- Frank Lloyd Dini
- Cardiovascular and Thoracic Department, University of Pisa, Pisa, Italy
| | - Iacopo Fabiani
- Cardiovascular and Thoracic Department, University of Pisa, Pisa, Italy
| | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | | | | | | | - Lorenzo Conte
- Cardiovascular and Thoracic Department, University of Pisa, Pisa, Italy
| | - Guido Salvetti
- Department of Endocrinology, University of Pisa, Pisa, Italy
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Gallic Acid Reduces Blood Pressure and Attenuates Oxidative Stress and Cardiac Hypertrophy in Spontaneously Hypertensive Rats. Sci Rep 2017; 7:15607. [PMID: 29142252 PMCID: PMC5688141 DOI: 10.1038/s41598-017-15925-1] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 11/04/2017] [Indexed: 12/22/2022] Open
Abstract
Gallic acid (GA) has been reported to have beneficial effects on cancer, vascular calcification, and diabetes-induced myocardial dysfunction. We hypothesized that GA controls hypertension via oxidative stress response regulation in an animal model for essential hypertension. Spontaneously hypertensive rats (SHRs) were administered GA for 16 weeks. GA treatment lowered elevated systolic blood pressure in SHRs through the inhibition of vascular contractility and components of the renin-angiotensin II system. In addition, GA administration reduced aortic wall thickness and body weight in SHRs. In SHRs, GA attenuated left ventricular hypertrophy and reduced the expression of cardiac-specific transcription factors. NADPH oxidase 2 (Nox2) and GATA4 mRNA expression was induced in SHR hearts and angiotensin II-treated H9c2 cells; this expression was downregulated by GA treatment. Nox2 promoter activity was increased by the synergistic action of GATA4 and Nkx2-5. GA seems to regulate oxidative stress by inhibiting the DNA binding activity of GATA4 in the rat Nox2 promoter. GA reduced the GATA4-induced Nox activity in SHRs and angiotensin II-treated H9c2 cells. GA administration reduced the elevation of malondialdehyde levels in heart tissue obtained from SHRs. These findings suggest that GA is a potential therapeutic agent for treating cardiac hypertrophy and oxidative stress in SHRs.
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Share BL, La Gerche A, Naughton GA, Obert P, Kemp JG. Young Women With Abdominal Obesity Have Subclinical Myocardial Dysfunction. Can J Cardiol 2015; 31:1195-201. [PMID: 26002065 DOI: 10.1016/j.cjca.2015.02.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 02/04/2015] [Accepted: 02/04/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Abdominal obesity is an independent risk factor for cardiovascular disease. The effect of abdominal obesity on myocardial function in young obese women remains unknown. Therefore, we aimed to investigate cardiac morphology and function, myocardial deformation, and mechanical indices, in young women with and without abdominal obesity. METHODS Cross-sectional analyses of 39 women with abdominal obesity (waist circumference ≥ 80 cm) and 33 nonobese control subjects (waist circumference < 80 cm) aged 18-30 years underwent conventional echocardiographic measures of cardiac morphology and function together with tissue Doppler, and 2-dimensional speckle tracking measures of myocardial deformation and mechanics. Cardiometabolic risk factors including anthropometric, hypertension, biochemistry, and fitness were also assessed. RESULTS Standard echocardiography results for cardiac morphology and function were similar between groups, with the exception of larger left atrial dimensions in women with abdominal obesity (P ≤ 0.05). Compared with control subjects, women with abdominal obesity also demonstrated reduced systolic and diastolic mitral annular plane velocities, increased left atrial pressure surrogates (E/diastolic mitral annular plane velocity), and prolonged timing measures of diastolic function including isovolumic relaxation time and transmitral deceleration time (P ≤ 0.05). In addition, longitudinal strain and diastolic strain rate were reduced in women with abdominal obesity (P ≤ 0.05) but circumferential deformation and myocardial mechanics (twist indices and rotation) were preserved. Markers of abdominal obesity retained an independent direct correlation with parameters of cardiac dysfunction, explaining 12%-39% of the overall variability. CONCLUSIONS A young, otherwise healthy group of women with abdominal obesity displayed subclinical cardiac dysfunction indicated using selected tissue Doppler imaging and speckle tracking echocardiography measures.
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Affiliation(s)
- Bianca L Share
- School of Exercise Science, Australian Catholic University, Melbourne, Australia.
| | - André La Gerche
- School of Exercise Science, Australian Catholic University, Melbourne, Australia; Cardiac Investigation Unit, St Vincent's Hospital, Melbourne, Australia
| | - Geraldine A Naughton
- School of Exercise Science, Australian Catholic University, Melbourne, Australia; Murdoch Childrens Research Institute, Royal Childrens Hospital, Melbourne, Australia
| | - Philippe Obert
- School of Exercise Science, Australian Catholic University, Melbourne, Australia; LAPEC, EA4278, Avignon University, Avignon, France
| | - Justin G Kemp
- School of Exercise Science, Australian Catholic University, Melbourne, Australia
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Left-ventricular hypertrophy and obesity: a systematic review and meta-analysis of echocardiographic studies. J Hypertens 2014; 32:16-25. [PMID: 24309485 DOI: 10.1097/hjh.0b013e328364fb58] [Citation(s) in RCA: 137] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM Left-ventricular hypertrophy (LVH) is a frequent complication in obese individuals; an updated review and meta-analysis focusing on this issue is lacking. Thus, we analysed the literature in order to provide a comprehensive information on the left-ventricular structural changes, as assessed by echocardiography, associated to obesity. DESIGN A literature search using the keywords 'left ventricle', 'left-ventricular hypertrophy', 'cardiac hypertrophy', 'obesity', 'hypertension' and 'echocardiography' was performed in order to identify relevant papers. Full articles published in English language in the past 12 years reporting studies in adult obese individuals were considered. RESULTS A total of 22 studies including 5486 obese individuals were considered. Overall, in the pooled obese population, prevalence of LVH, defined by 12 criteria, was 56.0% (range 20.0-85.0%). Data provided by 15 studies (n = 4999 obese individuals), including 6623 non-obese controls, showed that the probability of having LVH was much higher in cases than in non-obese counterparts (odds ratio 4.19, 95% confidence interval 2.67-6.53, P < 0.01). A meta-regression analysis (n = 2214; 14 studies) showed a direct correlation between BMI and left-ventricular mass (P < 0.01). Among obese patients with LVH (n = 1930; 15 studies), eccentric hypertrophy was more frequent than the concentric phenotype (66 versus 34%; P < 0.01). CONCLUSIONS Our analysis shows that LVH is present in a consistent fraction of the obese population and that eccentric hypertrophy prevails over the concentric phenotype. As obesity-related LVH is a powerful risk factor for systolic/diastolic dysfunction, the prevention/treatment of obesity may have a strong, favourable impact on incident heart failure.
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Ajayi EA, Adekunle AE, Ajayi IA, Adeseye AI, Oyedeji TA, Adebayo OT, Adeoti AO, Olatayo AA, Omotoye OJ, Joseph OO, Adebayo RA, Ayodele AR. Left ventricular mass formulae and prevalence rates of echocardiographic left ventricular hypertrophy in nigerians with essential hypertension. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2013; 5:325-9. [PMID: 23814764 PMCID: PMC3690790 DOI: 10.4103/1947-2714.112481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background: Left ventricular hypertrophy (LVH) as a marker of cardiac damage in hypertension has important prognostic implications. With high prevalence of hypertension in Nigeria and the untoward effect of LVH, it is essential that the prevalence of LVH be determined. Aims: To determine prevalence of LVH and its severity in clinical practice among hypertensive patients referred for echocardiographic assessment in Nigeria. Materials and Methods: Devereux and Troy formulae were used to calculate echocardiographic LV mass (LVM) in 401 subjects and thereafter normalized to body surface area (BSA), heigth2 (ht2) and height2.7 (ht2.7) to define LVH to standard gender-specific thresholds. Results: Mean age was 53.22 ± 16.56 years (male = 53.18 ± 15.80; female = 53.27 ± 17.43; P = 0.958) with a male:female ratio of 1.13:1. Prevalence rates of LVH ranged between 38.9–51.3% using the Devereux Formula and 62.4–71.1% using the Troy formula. LVM/(ht2.7) using the Troy formula gave the highest prevalence rate of LVH. Majority of the patients with LVH had severe form of hypertrophy with the prevalence rates ranging from 22.3% (LVM/BSA; Devereux formula) to 47.1% (LVM/ht2.7; Troy formula). Conclusion: Prevalence of LVH by any echocardiographic criteria is high. There is a need to come to a consensus on the best formula and indexing variables, that will unify the reporting of LVH.
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Kong DG, Gao H, Lu YQ, Qi XW, Ma LL, Kong XQ, Yao DK, Wang LX. Anxiety disorders are associated with increased plasma adrenomedullin level and left ventricular hypertrophy in patients with hypertension. Clin Exp Hypertens 2013; 36:27-31. [PMID: 23638647 DOI: 10.3109/10641963.2013.783049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the association between anxiety disorders and left ventricular hypertrophy in patients with essential hypertension. METHODS Left ventricular structure and function were assessed with echocardiography in 56 patients with essential hypertension and anxiety disorder (study group) and in 56 patients with hypertension only (control group). Serum adrenomedullin levels were also measured in these patients. RESULTS There was no statistically significant difference in the left ventricular ejection fraction between the study and the control group (54.21 ± 88.81% versus 56.01 ± 7.85%, p>0.05). The left ventricular mass index (LVMI) in study group was higher than in control group (137.05 ± 9.42 versus 123.57 ± 7.01 g/m(2), p=0.001). The plasma levels of adrenomedullin in study group was higher than in control group (25.97 ± 5.48 versus 18.32 ± 6.97 ng/L, p=0.001). Levels of plasma adrenomedullin were positively correlated with LVMI in the study (r=0.734, p<0.05) and control group (r=0.592, p<0.05). CONCLUSION Anxiety disorders are associated with elevated plasma adrenomedullin levels and increased left ventricular hypertrophy in patients with essential hypertension. The clinical significance of these changes requires further investigation.
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Affiliation(s)
- De-Gui Kong
- Department of Cardiology, Liaocheng People's Hospital of Taishan Medical University , Shandong Province 252000 , China
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Sarzani R, Guerra F. Obesity and Hypertension in Cardiac Hypertrophy. High Blood Press Cardiovasc Prev 2012; 19:3-4. [DOI: 10.2165/11632080-000000000-00000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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