Prevalence Of Cardiac Hypertrophy Research Articles

Cardiac Hypertrophy in Neonates Born to Diabetic Mothers at Farhat Hached of Sousse University Hospital

<i>Introduction:</i> The association between cardiac hypertrophy and hyperinsulinism is mainly observed in the newborn, although the onset in older infants has also been described. The aim of our study is to research a cardiac hypertrophy in newborns of diabetic mothers. <i>Methodology</i>: This was a cross-sectional study, involving one hundred and twenty (120) newborns of diabetic mothers from August 1^stto November 30, 2020. These newborns of diabetic mothers had received an echocardiographic examination at the laboratory of the FARHAT HACHED University Hospital in Sousse (Tunisia) regardless of the associated cardiac or extracardiac pathology, during the study period, to detect cardiac hypertrophy. <i>Results:</i> The sex ratio was in favor of the female gender at 0.90. The average weight was 3554.04 g, with extremes ranging from 1,600 g to 5,200 g. Twelve (12) newborns had a weight greater than or equal to 4,000 g (10.00% of macrosomes). Among mothers, there were 03 types of diabetes: type 1 diabetes (2.65%), type 2 diabetes (0.88%) and gestational diabetes (96.46%). Echocardiography was normal in 91 neonates (75.83%) and abnormal in 29 neonates (24.17%). The prevalence of cardiac hypertrophy was 09.17% and that of other associated cardiac abnormalities was 21.66%. There were 11 cases of patent foramen ovale, 11 cases of patent ductus arteriosus, 02 cases of ostium secundum atrial septal defect, 01 case of interrupted aortic arch, 01 case of pulmonary stenosis. These abnormalities were associated on the one hand with the septal hypertrophy and on the other hand, associated with each other in the same newborn. Left ventricular ejection function was normal in all neonates with an average of 66% and extremes between 59% and 76%. <i>Conclusion:</i> Cardiac hypertrophy described in the newborn of diabetic mother is characterized by hypertrophy of the ventricular walls more often predominating over the septum. Transthoracic echocardiography is the reference (non-invasive) technique for diagnosing and monitoring these hypertrophies.

Cardiac structural and functional abnormalities in epilepsy: A systematic review and meta-analysis.

Epilepsy is associated with an increased risk of cardiovascular disease and mortality. Whether cardiac structure and function are altered in epilepsy remains unclear. To address this, we conducted a systematic review and meta-analysis of studies evaluating cardiac structure and function in patients with epilepsy. We searched the electronic databases MEDLINE, PubMed, COCHRANE, and Web of Science from inception to 31 December 2021. Primary outcomes of interest included left ventricular ejection fraction (LVEF) for studies reporting echocardiogram findings and cardiac weight and fibrosis for postmortem investigations. Study quality was assessed using the National Heart, Lung, and Blood Institute (NHLBI) assessment tools. Among the 10 case-control studies with epilepsy patients (n=515) and healthy controls (n=445), LVEF was significantly decreased in epilepsy group compared with controls (MD: -1.80; 95% confidence interval [CI]: -3.56 to -0.04; P= 0.045), whereas A-wave velocity (MD: 4.73; 95% CI: 1.87-7.60; P=0.001), E/e' ratio (MD: 0.39; 95% CI: 0.06-0.71; P= 0.019), and isovolumic relaxation time (MD: 10.18; 95% CI: 2.05-18.32; P= 0.014) were increased in epilepsy, compared with controls. A pooled analysis was performed in sudden unexpected death in epilepsy (SUDEP) cases with autopsy data (n=714). Among SUDEP cases, the prevalence of cardiac hypertrophy was 16% (95% CI: 9%-23%); cardiac fibrosis was 20% (95% CI: 15%-26%). We found no marked differences in cardiac hypertrophy, heart weight, or cardiac fibrosis between SUDEP cases and epilepsy controls. Our findings suggest that epilepsy is associated with altered diastolic and systolic echocardiogram parameters compared with healthy controls. Notably, SUDEP does not appear to be associated with a higher incidence of structural cardiac abnormalities, compared with non-SUDEP epilepsy controls. Longitudinal studies are needed to understand the prognostic significance of such changes. Echocardiography may be a useful noninvasive diagnostic test in epilepsy population.

Abstract 428: Interventions Targeting Mitochondrial Function as Therapies to Reverse Cardiac Aging

Aging is associated with a higher incidence of cardiovascular disease and a significant decline in cardiac function. In individuals without overt cardiovascular disease, aging results in impaired diastolic function, reduced myocardial performance and increased prevalence of cardiac hypertrophy. Our laboratory has previously shown that transgenic mice expressing mitochondrial catalase (mCAT) have reduced mitochondrial oxidative damage and display delayed cardiac aging. This study aims to determine whether short-term treatments targeting mitochondrial function can reverse cardiac aging in old mice. The mitochondrial protective SS-31 peptide (elamipretide) has previously been shown to provide similar protection as mCAT in models of pressure overload-induced cardiac hypertrophy and failure. SS-31 binds to cardiolipin and improves the electron carrying function of cyt c , while reducing its peroxidase activity. We administered SS-31 to 24-month-old mice via osmotic minipump for 8 weeks, and found it to reduce cardiac hypertrophy and improve diastolic function and myocardial performance. SS-31 treatment attenuated the age-related increase in cyt c oxidation at Met-80, which has been associated with the disruption of Fe-S bond and activation of peroxidase activity of cyt c . SS-31 treatment also improved mitochondrial ultrastructure and induced AMPK activation in old hearts. To investigate whether SS-31 and mCAT protect cardiac aging by overlapping mechanisms, we administered SS-31 to old mCAT mice to study the effects of combined treatments. We found that SS-31 treatment cannot further improve the cardiac function of old mCAT mice. Concordantly, proteomic analysis revealed that changes in the cardiac proteome induced by SS-31 were partially overlapping with changes mediated by mCAT expression, particularly in the mitochondrial proteome, suggesting a convergence of molecular mechanisms of these two treatments. In addition, we showed that mCAT expression transduced by AAV9 in late-life also improved diastolic function, supporting the similar therapeutic effects of short-term mCAT and SS-31. In summary, these results support the therapeutic potential of mitochondrial-targeted interventions to reverse the effects of cardiac aging.

GNAQ TT(-695/-694)GC Polymorphism Is Associated with Increased Gq Expression, Vascular Reactivity, and Myocardial Injury after Coronary Artery Bypass Surgery.

Angiotensin II receptor type 1-mediated activation of the α-subunit of the heterotrimeric Gq protein evokes increased vasoconstriction and may promote hypertrophy-induced myocardial damage. The authors recently identified a TT(-695/-694)GC polymorphism in the human Gq promoter, the GC allele being associated with an increased prevalence of cardiac hypertrophy. In this article, the authors tested whether the TT(-695/-694)GC polymorphism is associated with differences in (1) myocardial Gq protein expression, (2) vascular reactivity, and (3) myocardial damage after coronary artery bypass grafting. Gq protein expression was measured in right atrial muscle from 55 patients undergoing coronary artery bypass grafting as were skin perfusion changes (n = 18; laser Doppler imaging), saphenous vein ring vascular reactivity (n = 50, organ bath) in response to angiotensin II, and myocardial damage (227 patients undergoing coronary artery bypass grafting), as assessed by postoperative cardiac troponin I concentration. Myocardial Gq expression was greater in GC/GC genotypes (GC/GC vs. 1.27-fold change; P = 0.006). Skin perfusion after intradermal angiotensin II injection decreased only in GC/GC genotypes (P = 0.0002). Saphenous vein rings exposed to increasing angiotensin II concentrations showed an almost doubled maximum contraction in GC/GC compared with individuals with the TT/TT genotype (P = 0.022). In patients undergoing coronary artery bypass grafting, baseline cardiac ejection fraction was different (GC/GC: 55 ± 13%; GC/TT: 54 ± 14%; TT/TT: 48 ± 15%; P = 0.037) and postoperative peak cardiac troponin I was greater in patients with the GC/GC (11.5 ± 13.8 ng/ml) than in patients with the GC/TT (9.2 ± 9.2 ng/ml) or patients with the TT/TT genotype (6.6 ± 4.8 ng/ml, P = 0.015). The GC/GC genotype of the TT(-695/-694)GC polymorphism is associated with increased Gq protein expression, augmented angiotensin II receptor type 1-related vasoconstriction, and increased myocardial injury after coronary artery bypass grafting, highlighting the impact of Gq genotype variation.

Hemorrhagic transformation of acute ischemic stroke is limited in hypertensive patients with cardiac hypertrophy

BackgroundIt has been clearly demonstrated that hypertension and one of its main evoked effects, cardiac hypertrophy, are independent risk factors for ischemic stroke. However, the ischemic brain lesions can further be affected by a second wave of injury characterized by hemorrhagic transformation (HT) of the primary ischemic lesion, which significantly aggravates the clinical outcome. So far, the risk factors that could affect such a transition in hypertensive patients are still unclear. MethodsIn this study, we investigated whether in hypertensive patients the concomitant presence of cardiac hypertrophy can affect the transition of ischemic brain lesions toward HT. ResultsOur analysis was focused on a population of hypertensive patients admitted to our Acute Stroke Unit. The hypertensives with acute ischemic stroke suffering of HT were 18% of the sample. In these latter, the prevalence of cardiac hypertrophy was significantly lower than in those spared by HT as also shown by the levels of left ventricular mass index (LVMI) that were significantly higher in patients spared by HT. More important, cardiac hypertrophy was protective even from symptomatic HT. ConclusionHere we show that hypertensive patients with cardiac hypertrophy have less probability to develop HT during an acute episode of ischemic stroke. These results could help to identify patients with lower risk of spontaneous HT and that could have better beneficial effects from thrombolytic therapy during acute ischemic stroke.

Impact of specific training and competition on myocardial structure and function in different age ranges of male handball players.

Handball activity involves cardiac changes and demands a mixture of both eccentric and concentric remodeling within the heart. This study seeks to explore heart performance and cardiac remodeling likely to define cardiac parameters which influence specific performance in male handball players across different age ranges. Forty three players, with a regular training and competitive background in handball separated into three groups aged on average 11.78±0.41 for youth players aka “schools”, “elite juniors” 15.99±0.81 and “elite adults” 24.46±2.63 years, underwent echocardiography and ECG examinations. Incremental ergocycle and specific field (SFT) tests have also been conducted. With age and regular training and competition, myocardial remodeling in different age ranges exhibit significant differences in dilatation’s parameters between “schools” and “juniors” players, such as the end-diastolic diameter (LVEDD) and the end-systolic diameter of the left ventricle (LVESD), the root of aorta (Ao) and left atrial (LA), while significant increase is observed between “juniors” and “adults” players in the interventricular septum (IVS), the posterior wall thicknesses (PWT) and LV mass index. ECG changes are also noted but NS differences were observed in studied parameters. For incremental maximal test, players demonstrate a significant increase in duration and total work between “schools” and “juniors” and, in total work only, between “juniors” and “seniors”. The SFT shows improvement in performance which ranged between 26.17±1.83 sec to 31.23±2.34 sec respectively from “seniors” to “schools”. The cross-sectional approach used to compare groups with prior hypothesis that there would be differences in exercise performance and cardiac parameters depending on duration of prior handball practice, leads to point out the early cardiac remodeling within the heart as adaptive change. Prevalence of cardiac chamber dilation with less hypertrophy remodeling was found from “schools” to “juniors” while a prevalence of cardiac hypertrophy with less pronounced chamber dilation remodeling was noted later.

Association between plasma indoxyl sulfate levels and cardiac hypertrophy in patients with heart failure

Purpose: Although indoxyl sulfate (IS), one of a uremic toxin, is suggested be a novel prognostic marker in patients with chronic kidney disease, its clinical characteristics has remained uncertain in patients with heart failure (HF) and preserved renal function (RF). We aimed to determine the clinical characteristics of IS in patients with HF. Methods: We studied 726 participants without overt HF and renal disease from a community-living, and prospectively enrolled 154 consecutive hospitalized acute and chronic heart failure (CHF) patients with preserved RF (eGFR >40 ml/min/1.73 m2) (24 acute HF patients and 130 CHF patients, respectively). We also performed right heart catheterization (RHC) in CHF patients (n = 105). Results: The plasma IS (PIS) levels in patients with CHF were significantly higher than that of healthy population matched with gender and eGFR of HF patients (0.79 [25th to 75th IQR: 0.45-1.19] μg/ml vs. 0.07 [0.04-0.11] μg/ml, respectively, p<0.001) (Figure A.), PIS levels were significantly correlated with right atrial pressure (r = 0.19, p = 0.028) and cardiac output (r = -0.30, p<0.001) in RHC study. Echocardiography revealed that LV mass index in High IS group (≥0.79 μg/ml) was significantly higher than that of Low IS group (<0.79 μg/ml) (Figure B.) in CHF patients. Interestingly, of 24 acute HF patients, PIS levels at discharge were significantly elevated compared with the baseline, as preliminary data (0.67 [0.36-0.90] μg/ml to 0.94 [0.76-1.68] μg/ml, p = 0.005) (Figure C). ![Figure][1] Figure 1 Conclusions: The plasma IS levels were suggested to be related to renal perfusion pressure with the prevalence of cardiac hypertrophy. From the change of IS levels during HF hospitalization, IS might be a novel marker to predict remote renal and cardiac status in patients with heart failure. [1]: pending:yes