Independent Risk Factor For Left Ventricular Hypertrophy Research Articles

Clinical features and risk factors of left ventricular hypertrophy in children with primary hypertension

Objective: To assess the clinical features and relative factors of left ventricular hypertrophy (LVH) in children with primary hypertension. Methods: In this retrospective cohort study, 430 children diagnosed with primary hypertension in Children's Hospital, Capital Institute of Pediatrics from January 2019 to September 2022 were enrolled. Their clinical data was analyzed and LVH was assessed by echocardiography. According to left ventricular geometry, these children were assigned to the LVH group and normal geometry group. General conditions, laboratory indicators and ambulatory blood pressure parameters between two groups were compared by independent sample t-test or Mann-Whitney U test. Spearman correlation coefficient was used to analyze the correlation between LVH and clinical indicators including blood pressure, biochemical and metabolic indicators. The independent risk factors of LVH were analyzed by multivariable logistic regression. The receiver operating characteristic (ROC) curve was used to explore the value of risk factors in the diagnosis of LVH. Results: Among the 430 children with primary hypertension, 342 (79.5%) were males and 88 (20.5%) females. Their age was (12.6±2.3) years, and 123 children (28.6%) of them had LVH. Body mass index (BMI) ((30.0±5.2) vs. (26.2±4.3) kg/m2), ratio of stage 2 hypertension (75.6% (93/123) vs. 59.6% (183/307)), 24-hour systolic blood pressure (24 h SBP)((131±10) vs. (128±10) mmHg,1 mmHg=0.133 kPa), daytime systolic blood pressure (SBP) ((135±11) vs. (131±11) mmHg), nighttime SBP ((128±11) vs. (123±10) mmHg), cholesterol level ((4.0±0.7) vs. (3.9±0.7) mmol/L), serum uric acid level ((447±81) vs. (426±91) μmol/L) and incidence of hyperinsulinemia (69.9% (86/123) vs.59.0% (181/307)) were significantly elevated in the LVH group compared with those in the normal geometry group (all P<0.05). There were more patients with a disease course over 5 years in the LVH group than in the normal geometry group, with a statistically significant difference (χ2=8.90,P=0.031). Spearman correlation analysis showed that BMI, 24 h SBP, daytime SBP, nighttime SBP, triglyceride, uric acid, and serum sodium level were positively correlated with LVMI (r=0.43, 0.20, 0.18, 0.18, 0.18, 0.16, and 0.12, all P<0.05). BMI, hyperinsulinemia, and cholesterol level were positively correlated with relative wall thickness (RWT) (r=0.22, 0.12, and 0.16, all P<0.05). The multivariate logistic regression analysis showed that BMI (OR=1.17, 95%CI 1.10-1.25) and 24 h SBP (OR=1.04, 95%CI 1.01-1.08) were the independent risk factors for LVH (both P<0.05). The area under the receiver operator characteristic curve, combined with BMI and 24 h SBP, was 0.72 (95%CI 0.67-0.77, P<0.05), with a sensitivity and specificity of 71.5% and 64.8%, respectively. Conclusions: BMI and 24 h SBP are the independent risk factors for LVH in children with primary hypertension, and the combination of BMI and 24 h SBP has an acceptable diagnostic value for LVH. Early monitoring of these indexes is necessary to predict preclinical cardiac damage.

Hypersensitive C-reactive protein as a potential indicator for predicting left ventricular hypertrophy in elderly community-dwelling patients with hypertension

BackgroundThe aim of this study was to investigate the relationship between Hypersensitive C-reactive protein (hs-CRP) and left ventricular hypertrophy (LVH) in elderly community-dwelling patients with hypertension.MethodsA cross-sectional study was conducted, involving the recruitment of 365 elderly hypertensive residents ≥ 65 years of age from five communities. The participants were divided into two groups: an LVH group (n = 134) and a non-LVH group (n = 231), based on the left ventricular mass index (LVMI) determined by echocardiography. Spearman correlation analysis was used to assess the relationship between hs-CRP and LVH. Univariate and Multivariate analysis was performed to detect variables associated with LVH. The diagnostic value of hs-CRP for LVH was expressed as the area under the receiver operating characteristic (ROC) curve.ResultsThe incidence of LVH in elderly hypertension patients in the community was 36.7%. The hs-CRP levels were significantly higher in subjects with LVH compared to those without LVH (1.9 [0.8, 2.9] vs. 0.7 [0.4, 1.4], P = 0.002). Spearman correlation analysis demonstrated a positive correlation between hs-CRP and LVMI (r = 0.246, P < 0.001), as well as with IVST (r = 0.225, P < 0.001) and LVPWT (r = 0.172, P = 0.001). Among elderly hypertensive residents in the community, the cut-off value of hs-CRP for diagnosing LVH was 1.25 mg/L (sensitivity: 57.5%; specificity: 78.4%), and the area under the ROC curve for hs-CRP to predict LVH was 0.710 (95%CI: 0.654–0.766; P < 0.001). In the final model, hs-CRP ≥ 1.25 mg/L (OR = 3.569; 95%CI, 2.153–5.916; P<0.001) emerged as an independent risk factor for LVH. This association remained significant even after adjusting for various confounding factors (adjusted OR = 3.964; 95%CI, 2.323–6.765; P < 0.001).ConclusionsThis community-based cohort of elderly hypertensive individuals demonstrates a strong association between hs-CRP levels and the presence of LVH. The hs-CRP ≥ 1.25 mg/L may serve as an independent predictor for LVH in hypertensive subjects and exhibit good diagnostic efficacy for LVH.

Risk Factors for Left Ventricular Hypertrophy in Patients with Diabetic Kidney Disease: A Multi-Center Study.

One of the earliest echocardiographic features of the left ventricle explored extensivelywas left ventricular hypertrophy (LVH). Numerous studies have identified a few risk factors for LVH, however, there are few for people with diabetic kidney disease (DKD). Therefore, we evaluated the risk factors in DKD patients with LVH by analyzing laboratory data and clinical traits. In total, 500 DKD patients in the Baoding area from February 2016 and June 2020 were admitted and classified as an experimental group (240 cases, LVH group) and a control group (260 cases, non-LVH group). The clinical parameters and laboratory tests of the participants were collected and analyzed retrospectively. Compared with the control group, low-density lipoprotein (LDL), body mass index (BMI), intact parathyroid hormone (iPTH), systolic blood pressure, and 24-hour urine protein were higher in the experimental group (all P<0.01). Multivariable logistic regression analysis results confirmed that high BMI (OR=1.332, 95% CI 1.016-1.537, P=0.006), LDL (OR=1.279, 95% CI 1.008-1.369, P=0.014) and 24-hour urine proteins (OR=1.446, 95% CI 1.104-1.643, P=0.016) were statistically significant. The ROC analysis illustrated that the optimum cutoff value of BMI, LDL, and 24-hour urine proteins for diagnosis of LVH in patients with DKD was 27.36 kg/m2, 4.18 mmol/L, and 1.42 g respectively. The increase in BMI, LDL, and 24-hour urine proteins quantification are independent risk factors for LVH in patients with DKD.

PS-P13-2: ASSOCIATION BETWEEN TRIGLYCERIDE-GLUCOSE INDEX AND TARGET ORGAN DAMAGES IN HYPERTENSIVE PATIENTS

Objective: To investigate the association between triglyceride-glucose index (TyG index) and albuminuria and left ventricular hypertrophy (LVH) in adults with hypertension. Methods: The study participants were recruited from a residential area in the suburb of Putuo district in Shanghai. We administered a standard questionnaire for basic information and history of diseases. Clinic blood pressure was measured by an experienced physician with the Omron HEM-7124 monitor (Omron HealthCare, Kyoto, Japan). Venous blood samples were drawn after overnight fasting for biochemical measurements, electrocardiogram (ECG)- left ventricular hypertrophy (LVH) was defined according to the Cornell product index and urinary routine test was performed on fresh urine samples. Results: The 5 190 subjects had a mean age of (66.41 ± 7.77) years, and included 2 423 (46.7%) men. Compared with women, men has a little lower TyG index (8.64 ± 0.58 vs 8.69 ± 0.55, P = 0.001). when divided the patients into three groups according to the tertile of TyG index (TyG index less than 8.39, 8.39 - TyG - 8.85, TyG index greater or equal to 8.85), the prevalence of LVH were 4.0%, 3.7% and 6.0%, P for trend = 0.004, and the prevalence of albuminuria were 1.9%, 2.0% and 3.0%, P for trend = 0.03, respectively. After adjustment for related risk factors, the risk for LVH elevated 64% with one unite increase of TyG index, the odds ratio (OR) and 95% confidence interval (CI) was 1.64 (1.31–2.04, P = 0.001). However, there was no significant association between the prevalence of albuminuria and TyG index (OR 0.92, 95% CI 0.56–1.50, P = 0.73). Conclusions: TyG index was associated with LVH and albuminuria, and was an independent risk factor for LVH in hypertension.

Expression of soluble ST2 in patients with essential hypertension and its relationship with left ventricular hypertrophy.

Identification and intervention of left ventricular hypertrophy (LVH) in essential hypertension (EH) are important for the prevention of adverse cardiovascular events. However, effective methods for diagnosing LVH are still lacking. This study aimed to explore the relationship between soluble ST2 (sST2) and LVH in EH patients to identify a potential specific biomarker for hypertensive LVH. This study included 97 EH patients. Based on the criteria for LVH, participants were divided into the LVH group (n=52) and the non-LVH group (n=45). The level of serum sST2 was detected by enzyme-linked immunosorbent assay. Pearson correlation analysis, logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were used to investigate the potential of sST2 as a biomarker of LVH in EH patients. Compared with the non-LVH group, the sST2 level was elevated in EH patients with LVH (P<0.001). Pearson correlation analysis indicated that the sST2 level was positively correlated with the left ventricular mass index in EH patients (r=0.454, P<0.001). Logistic regression analysis showed that the odds ratio (OR) value of LVH was 2.990, suggesting that sST2 is an independent risk factor for LVH in EH patients [OR=2.990, 95% confidence interval (CI), 1.650-5.419; P<0.001]. The area under the ROC curve was 0.767 (95% CI, 0.669-0.866; P<0.001), with a sensitivity of 0.808 and specificity of 0.689, indicating the possibility of considering sST2 as a biomarker for diagnosing LVH. Up-regulation of sST2 is strongly related to LVH in EH patients, is an independent risk factor for hypertensive LVH, and can be used as a biomarker for the diagnosis of LVH.

Value of Monocyte to High-Density Lipoprotein Cholesterol Ratio in Screening of Left Ventricular Hypertrophy in Young and Middle-Aged Patients With Essential Hypertension

Abstract Background To investigate the relationships of monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) with left ventricular hypertrophy (LVH) in young and middle-aged patients with essential hypertension (EH). Methods A retrospective analysis was performed on clinical data of 294 young and middle-aged patients with EH (aged from 18 to 65 years old). According to the left ventricular mass index (LVMI), the patients were divided into LVH (n = 98) and non-LVH (n = 196) groups. The data on echocardiography, routine blood test, biochemical examination, and so on were collected in all subjects, then LVMI and MHR were calculated. The association between MHR and hypertensive LVH was analyzed by correlation and binary logistic regression analyses. The receiver operating characteristic curve (ROC) was used to determine the predict value of MHR. Results MHR was higher while HDL-C was lower in the LVH group compared with the non-LVH group (MHR: 0.47 ± 0.11 vs. 0.33 ± 0.12, P &amp;lt; 0.001; HDL-C: 1.05 [0.94–1.22] vs. 1.27 [1.07–1.47] mmol/l, P &amp;lt; 0.001). Correlation analysis showed that LVMI was positively correlated with MHR (r = 0.381, P &amp;lt; 0.001). Multivariate logistic regression analysis showed that MHR was an independent risk factor for LVH in young and middle-aged EH patients (odds ratio = 2.914, 95% confidence interval [CI] 2.084–4.068, P &amp;lt; 0.001) after adjusting for body mass index, smoking, HDL-C, and other confounding factors. The area under the ROC curve of MHR for predict LVH was 0.831 (95% CI 0.782–0.880), and the optimal cutoff value of MHR was 0.37, with a sensitivity of 93.9% and a specificity of 75.5%. Conclusions MHR is positively correlated with LVH in young and middle-aged patients with EH. MHR is an independent risk factor for LVH in this population, and can be used for LVH risk screening.

The prevalence and some related factors to left ventricular hypertrophy in peritoneal dialysis patients

Background: Cardiovascular complications are the main cause of mortality in peritoneal dialysis (PD)[5]. Left ventricular hypertrophy (LVH) is common in dialysis patients and an independent predictor of mortality. Objective: To describe and compare percentages, some related factors to LVH in PD patients and hemodialysis (HD) patients. Materials and methods: A controlled, descriptive cross-sectional study on 148 patients ≥ 18 years old, duration of dialysis ≥ 3 months at Can Tho General Hospital, including 74 PD patients and 74 HD patients (control group).Results: The percentage of LVH in the group of patients on PD was 86.5% (90.6% as concentric hypertrophy, 9.4% as eccentric hypertrophy) similar to the control group (HD) was 90.5% (86.6% as concentric hypertrophy, 13.4% as eccentric hypertrophy). Left ventricular mass index (LVMI) of patient PD had positive correlation with duration of dialysis (r=0.2), systolic blood pressure (r=0.54), diastolic blood pressure (r=0.419) and negative correlated with Hb (r=-0.363), urine 24- hour volume (r=-0.448) in univariate analysis. In multivariable logistic analysis, loss of residual renal function was an independent risk factor for LVH in PD patients. There was no difference in factors related to left ventricular hypertrophy between peritoneal dialysis patients and the control group (HD) (p&lt;0.05). Conclusions: LVH high percentage in PD and HD patients, similar; there is no difference in factors related to LVH in two group. In PD patients, loss of residual renal function is an independent risk factor for LVH.

Association of central arterial blood pressure and left ventricular hypertrophy in patients with chronic kidney disease.

In the general population, central arterial blood pressure has proved to be more closely related to left ventricular hypertrophy (LVH) than brachial arterial blood pressure. We aimed to investigate whether this relationship was true in patients with chronic kidney disease (CKD). In this retrospective study, we reviewed the medical records of 289 adult patients with CKD from the Zhejiang Provincial People's Hospital in Zhejiang, China. Demographic, echocardiographic and brachial and central blood pressure parameters were retrieved from medical records. Central blood pressure was measured using the SphygmoCor® CvMS (AtCor, Australia) device and its corresponding software. Multivariate logistic regression analyses were performed to identify independent predictors of LVH. Receiver operating characteristic curves were used to determine the ability of central and brachial blood pressure to predict LVH. The left ventricular mass index was positively associated with both central and brachial blood pressures. However, multiple logistic regression analysis demonstrated that a central pulse pressure (CPP) ≥ 58 mm Hg was an independent risk factor for LVH (OR=5.597, 95%CI 2.363-13.259, p < .001). Brachial pulse pressure is not superior to CPP in predicting LVH (area under the curve [AUC]=0.695, 95%CI 0.634-0.756, p < .001 vs. AUC=0.687, 95%CI: 0.626-0.748, p < .001, respectively; p=.4824). Our results suggested that, similarly to the general population, CPP is a better parameter for predicting the occurrence of LVH in patients with CKD.

Correlations of circulating miR-26b level with left ventricular hypertrophy and cardiac function in elderly patients with hypertension.

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.

Prevalence of Cardiac Abnormalities in Children with Chronic Kidney Disease: A Cross-sectional Study from a Developing Country.

Improved therapeutic modalities in chronic kidney diseases (CKD) children and consequent extension of life expectancy, draws more attention towards secondary complications. Cardiovascular adaptations precipitating such terminal events, begin in pre-dialysis CKD. Hence, it's imperative to identify modifiable risk factors to direct care and resources in haltering CKD progression, evade long-term dialysis and anticipate kidney transplantation to avert cardiac complications in predialysis period. One hundred and six pre-dialysis patients aged one year to 15 years, with estimated glomerular filtration rate of <90 mL/min/1.73 m2 and proteinuria were included. Patient's history, weight, height and blood pressures (BPs) performed. Left ventricular mass index (LVMI) calculated to correct for patient height to determine raised values of >38.6 g/m2.7 and of left ventricular hypertrophy (LVH) >55 g/m2.7. Shortening fraction and ejection fraction measured to assess systolic function. Diastolic function assessed by Doppler measuring the mitral inflow (e/a) ratio. Hemoglobin, calcium phosphorous product, parathyroid hormone and hypertension measured to assess cardiac risk factor. The total prevalence of cardiac abnormality was found in 66.9% (95% confidence interval [CI] 57.6%-75.2%. Raised LVMI was seen in 64%, among which 34.9% had LVH. Diastolic and systolic dysfunction was found in 12.2% and 11.3% respectively. The cardiac abnormality was more prevalent in CKD grade IV and V. The independent risk factors were anemia and abnormal diastolic BP index which increase the risk for LVH by 3-fold and 5-fold respectively. Proportion of cardiac abnormalities were more prevalent in CKD IV and V. Anemia and diastolic hypertension were independent risk factors for LVH.

Abstract 15047: Effects of Blood Pressure Percentile, Body Mass Index, and Race on Left Ventricular Mass in Children

Introduction: Childhood hypertension, obesity, and left ventricular hypertrophy (LVH) are risk factors for premature cardiovascular events in adulthood, particularly among minorities. In children, race and body mass index (BMI) have been shown to be independently associated with LVH, with conflicting data on the association of systolic blood pressure (SBP) level with risk of LVH and utility of ECG in assessing LVH. This study looks at the association of SBP percentile, race, and BMI with LVH on electrocardiogram (ECG) and echocardiogram (echo) to define populations at risk. Methods: This is a retrospective cross-sectional study design utilizing a data analytics tool (Tableau) combining ECG and echo databases from 2003-2020. Customized queries identified patients ages 2-18 years old who had an outpatient ECG and echo on the same date with available SBP and body measurements. Cases with congenital heart disease, cardiomyopathy, or arrhythmia diagnoses were excluded. Echos with left ventricle mass (indexed to height 2.7 ) were included. The main outcome was LVH on echo defined as LV mass index greater than the 95 th percentile for age. Results: In a cohort of 13,926 patients, 6.9% of studies had LVH on echo. SBP percentile &gt; 90% has a sensitivity of 36% and specificity of 82% for LVH on echo. LVH on ECG was a poor predictor of LVH on echo (9% sensitivity and 92% specificity). African American race (OR 1.31, 95% CI = 1.11, 1.55, p=.001), SBP percentile &gt; 95% (OR=1.64, 95% CI = 1.37, 1.95, p &lt;.001), and higher body mass index (OR= 7.43, 95% CI = 6.44, 8.55, p &lt;.001) were independently associated with LVH on echo. Figure 1 shows the prevalence of LVH by African American race, obesity, and SBP. Conclusions: African American race, obesity, and hypertension are independent risk factors for LVH in children. Outpatient ECG has low utility in screening for LVH.

A3981 Relationship between methylenetetrahydrofolate reductase C677T gene polymorphism and left ventricular hypertrophy with hypertension

Objectives: This study was performed to explore the effects of homocysteine (Hcy) and 5,10-methylenetetrahydrofolate reductase (MTHFR) C677T on the left ventricular hypertrophy (LVH) among hypertensive Chinese Han population. Methods: This study included 456 hypertensive patients. MTHFR C677T polymorphism was analyzed by by taqman probe and fluorescent quantitative PCR. Cardiac structure and function indicators were measured by transthoracic echocardiography. According to left ventricular mass index (LVMI), 132 cases were elected out as essential hypertension with LVH group and 324 cases as non-left ventricular hypertrophy (NLVH) group. According to LVMI and left ventricular relative wall thickness (LVRWT), essential hypertension was divided into 4 subgroups: normal geometry (NG) group, concentric remodeling (CR) group, concentric hypertrophy (CH) group, and eccentric hypertrophy (EH) group. Results: (1) The frequency of TT genotype and T allele in LVH group was higher than those in NLVH group (P < 0.05). (2) The level of Hcy in TT genotype was higher than that in CT and CC genotype (P < 0.01). The values of LVMI and LVPWT in CT and TT genotype, were higher than that in CC (P < 0.01). (3) Subgroup analysis showed that there were significant differences in genotype frequency and level of Hcy among different subgroups, and highest frequency of TT genotype and highest level of Hcy were in EH group. (4) 1 umol/l increase in Hcy was associated with a 7.9% increase in the incident risk of LVH. Genetic model analysis showed that MTHFR were associated with LVH [OR 2.264 (95% CI 1.337–3.834),P = 0.002]. Conclusion: Hcy and MTHFR C677T polymorphism were an independent risk factor for LVH. TT genotype carriers or T allele carriers had a higher susceptibility to LVH incidence, especially EH.

Cardiac Remodeling Patterns in Severe Obesity According to Arterial Hypertension Grade.

The purpose of this study is to correlate the left ventricular hypertrophy (LVH) patterns according to severe obesity and arterial hypertension (AHT) grades. A cross-sectional prospective study was conducted in 379 patients with severe obesity. Obesity was classified according to the BMI in the following: morbidly obese (MO; 40<BMI<50kg/m2) and super obese (SO; BMI>50kg/m2). The AHT was classified into classes 1 and 2 according to American Heart Association. The presence of LVH and the pattern of cardiac remodeling were determined by transthoracic echocardiography. LVH was present in 58.6% of patients. Obesity and AHT had additive effects in LVH prevalence. LVH was found in 32.9 and 46.7% of MO with AHT grades 1 and 2, respectively. LVH was diagnosed in 39.1% in SO with AHT grade 1 and in 50% of AHT grade 2. Patients with AHT presented a significantly higher risk of developing LVH (OR 1.97; p=0.003). Hypertension grade was also a determinant variable in the development of LVH. Patients with AHT 2 had 4.31-fold greater risk (p<0.001) when compared to normotensive patients. BMI was only considered an independent risk factor for LVH in patients with BMI greater than 47.17kg/m2 (OR 1.62; p=0.023). AHT is a stronger predictive factor of LVH than obesity grade.

Retraction Note to: Risk factors for increased left ventricular hypertrophy in patients with chronic kidney disease.

Although left ventricular hypertrophy (LVH) has been established as a predictor of cardiovascular events in chronic kidney disease (CKD), the relationship between the prevalence of LVH and CKD stage during the predialysis period has not been fully examined. We measured left ventricular mass index (LVMI) in a cross-sectional cohort of participants in the Chronic Kidney Disease Japan Cohort (CKD-JAC) study in order to identify factors that are associated with increased LVMI in patients with stage 3–5 CKD. LVH was defined as LVMI > 125 g/m2 in male patients and >110 g/m2 in female patients. We analyzed baseline characteristics in 1185 participants (male 63.7 %, female 36.3 %). Diabetes mellitus was the underlying disease in 41.3 % of patients, and mean age was 61.8 ± 11.1 years. LVH was detected in 21.7 % of patients at baseline. By multivariate logistic analysis, independent risk factors for LVH were past history of cardiovascular disease (odds ratio [OR] 0.574; 95 % confidence interval [CI] 0.360–0.916; P = 0.020), systolic blood pressure (OR 1.179; 95 % CI 1.021–1.360; P = 0.025), body mass index (OR 1.135; 95 % CI 1.074–1.200; P < 0.001), and serum calcium level (OR 0.589; 95 % CI 0.396–0.876; P = 0.009). Cross-sectional baseline data from the CKD-JAC study shed light on the association between LVH and risk factors in patients with decreased renal function. Further longitudinal analyses of the CKD-JAC cohort are needed to evaluate the prognostic value of LVH in CKD patients.

Correlations of Serum Cyclophilin A and Melatonin Concentrations with Hypertension-induced Left Ventricular Hypertrophy

Cyclophilin A (CyPA) is an abundantly expressed pro-inflammatory cytokine and a major secreted oxidative stress-induced factor (SOXF). Melatonin is an important chronobiological regulatory molecule that is mainly released from the pineal gland and exerts antioxidant effects by acting as a radical scavenger. Based on accumulating evidence, both CyPA and melatonin play important roles in cardiovascular diseases. However, further investigations are required to determine whether CyPA and melatonin are associated with hypertension-induced left ventricular hypertrophy (LVH). A total of 135 patients with essential hypertension were divided into an LVH (+) group and an LVH (-) group according to Doppler echocardiography results. Clinical data of the two groups were evaluated. High CyPA levels and low melatonin levels are independent risk factors for LVH (p=0.000). In addition, body mass index (BMI) and systolic blood pressure (SBP) are correlated with the risk of LVH (p=0.000). However, other factors did not display statistically significant associations (p>0.05). The Pearson correlation and linear regression analyses show that BMI, SBP, and CyPA levels were positively correlated with left ventricular mass (LVM) and the left ventricular mass index (LVMI) (p<0.05), whereas melatonin levels were negatively correlated with LVM and the LVMI (p=0.000). Furthermore, according to the results of the Pearson correlation analysis, CyPA levels were negatively correlated with melatonin levels (p<0.01) in subjects with LVH. Based on these results, both CyPA and melatonin are closely related to the pathogenesis of LVH. As CyPA was negatively correlated with melatonin in patients with LVH, additional studies are required to determine whether melatonin may partially protect the myocardium by decreasing CyPA levels.

Serum uric acid level and left ventricular hypertrophy in elderly male patients with nonvalvular atrial fibrillation

Background and aimsRecent studies have suggested that serum uric acid (SUA) induces oxidative stress and inflammation, which are involved in the mechanism of cardiac hypertrophy. In patients with atrial fibrillation (AF), comorbidity of left ventricular hypertrophy (LVH) exacerbates cardiac function. In this study, we investigated the association between SUA and cardiac hypertrophy in AF patients. Methods and resultsInitially, 1296 consecutive elderly patients (age >60) with nonvalvular AF were retrospectively selected from the inpatient clinic between January 2012 and April 2015. Demographic, clinical, and echocardiographic characteristics were carefully recorded. The final study population was 577 patients. The mean SUA level was significantly higher in patients with LVH than those without LVH. Compared with the non-LVH group, the LVH group was older, had a higher percentage of female patients, and had lower hemoglobin levels and estimated glomerular filtration rates. Patients in the LVH group also had a higher rate of coronary heart disease and fewer had history of radiofrequency ablation compared with the non-LVH group. In the hyperuricemia group, B-type natriuretic peptide levels, left atrial diameter, left ventricular mass index, and percentage of NYHA (New York Heart Association) class III/IV were significantly higher than the SUA normal group. Multivariate logistic regression analysis indicated the independent risk factors for LVH in elderly AF patients included SUA, age, male sex, the presence of coronary heart disease, and diuretic therapy. Subgroup analysis identified SUA as a significant risk factor associated with LVH in men. ConclusionsSUA was independently associated with LVH in elderly male patients with nonvalvular AF.

Hyperuricemia is independently associated with left ventricular hypertrophy in post-menopausal women but not in pre-menopausal women in rural Northeast China

The aim of this article is to estimate the relationship between hyperuricemia and left ventricular hypertrophy (LVH) and to investigate whether menopause was associated with the relationship between hyperuricemia and LVH. This survey was conducted from July 2012 to August 2013. A total of 6029 women (3508, 58.2% were post-menopause) from the rural Northeast China were randomly selected and examined. LVH was defined using the 2007 Guidelines for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Age, body mass index, glucose, estimated glomerular filtration rate and lipid level were significantly correlated with serum uric acid level. LVH showed a gradual increase in accordance with the serum uric acid level in entire study population (<4.0 mg/dL, 11.4%; 4 to <5 mg/dL, 14.9%; 5 to <6 mg/dL, 18.9%; ≥6 mg/dL, 27.4%; p < 0.001). Multivariate analysis revealed that hyperuricemia was a significantly independent risk factor for LVH in post-menopausal women [OR (95% CI): 1.367 (1.026, 1.821)], but not in pre-menopausal women [OR (95% CI): 1.290 (0.669, 2.486)]. These findings suggested that hyperuricemia can be used as a risk marker of LVH in a female population and, in particular, as an independent risk factor in post-menopausal women but not in pre-menopausal women.

Independent influence of overweight and obesity on the regression of left ventricular hypertrophy in hypertensive patients: a meta-analysis.

Overweight and obesity are associated with adverse cardiovascular outcomes. However, the role of overweight and obesity in left ventricular hypertrophy (LVH) of hypertensive patients is controversial. The aim of the current meta-analysis was to evaluate the influence of overweight and obesity on LVH regression in the hypertensive population.Twenty-eight randomized controlled trials comprising 2403 hypertensive patients (mean age range: 43.8–66.7 years) were identified. Three groups were divided according to body mass index: normal weight, overweight, and obesity groups.Compared with the normal-weight group, LVH regression in the overweight and obesity groups was more obvious with less reduction of systolic blood pressure after antihypertensive therapies (P < 0.001). The renin–angiotensin system inhibitor was the most effective in regressing LVH in overweight and obese hypertensive patients (19.27 g/m2, 95% confidence interval [15.25, 23.29], P < 0.001), followed by β-blockers, calcium channel blockers, and diuretics. In the stratified analysis based on blood pressure measurement methods and age, more significant LVH regression was found in 24-h ambulatory blood pressure monitoring (ABPM) group and in relatively young patients (40–60 years’ old) group (P < 0.01).Overweight and obesity are independent risk factors for LVH in hypertensive patients. Intervention at an early age and monitoring by ABPM may facilitate therapy-induced LVH regression in overweight and obese hypertensive patients.

Association between bioimpedance analysis parameters and left ventricular hypertrophy in peritoneal dialysis patients

Chronic volume overload, hypertension and left ventricular hypertrophy are major risk factors contributing to the high mortality rate in peritoneal dialysis (PD) patients. In this study, we aimed to determine the impact of blood pressure measurements and volume status determined by bioelectrical impedance analysis (BIA) measurements over left ventricular hypertrophy (LVH) in PD patients. Thirty-one prevalent PD patients were enrolled. Patients with a documented cardiovascular disease and uncontrolled hypertension were excluded. BIA and transthoracic echocardiography were performed in all patients All measurements were taken with the empty abdominal cavity. Routine laboratory parameters were also assessed in all patients. Extracellular water (ECW) in liters and ECW/total body water (TBW) ratio were used for determining volume status. Mean age of the patients was 43.9 ± 15.4 years, and mean PD duration was 39.5 ± 29.6 months. Mean ECW/TBW ratio was 44.3 %. Left ventricular mass index (LVMI) was 134.3 ± 34.9 g/m(2). Fifty-eight percent of patients had LVH. Mean LVMI was negatively correlated with daily urine volume (r -0.568, p 0.001) and weekly Kt/V (r -0.393, p 0.029); positively correlated with daily ultrafiltration (r +0.585, p 0.001) and office systolic (r +0.500, p 0.004) and diastolic (r +0.459, p 0.009) blood pressures. In linear regression analysis, daily urine volume (B -0.426, p 0.002) mean diastolic blood pressure (B 0.550, p <0.001), ECW/TBW ratio (B 0.313, p 0.02) and waist circumference (B 0.304, p 0.016) were independent risk factors for LVH. We want to underline that, besides maintaining residual renal function, strict blood pressure control, particularly diastolic blood pressure, and avoiding hypervolemia and abdominal obesity should be main clinical goals in follow-up of PD patients in order to prevent LVH progression.

Serum osteopontin, but not OPN gene polymorphism, is associated with LVH in essential hypertensive patients

This study aims to investigate the role of osteopontin (OPN) genetic polymorphisms in the occurrence of left ventricular hypertrophy (LVH) in Chinese patients with essential hypertension (EH). A total of 1,092 patients diagnosed with EH were recruited. Three single nucleotide polymorphisms (SNP) on the promoter region of the OPN gene, including -66T/G, -156G/GG, and -443C/T were genotyped. The serum thrombin-cleaved OPN levels were studied. Patients were divided into LVH+ (n = 443) and the LVH- (n = 649) groups. We found that none of the studied SNPs in the OPN gene was associated with the risk and severity of LVH. The SNPs in the OPN gene did not correlate with the serum OPN levels. However, the serum thrombin-cleaved OPN levels were found to be an independent risk factor for LVH in the EH patients. Multivariate logistic regression analysis showed that serum thrombin-cleaved OPN levels were independently associated with the development of LVH (adjusted OR = 2.47, 95% CI 1.56-4.01, adjusted P < 0.001). In vitro studies showed that the thrombin-cleaved OPN treatment increased the protein content per cell, the cardiomyocyte surface size, and the expression level of atrial natriuretic peptide protein in a dose-dependent manner. The thrombin-cleaved OPN serum level, but not OPN gene polymorphism, is associated with the development of LVH in EH patients. Serum OPN is related to LVH incidence in essential hypertension subjects. OPN stimulates cardiomyocyte hypertrophy in vitro. OPN SNPs are not related to LVH incidence.