Risk Factor For Left Ventricular Hypertrophy Research Articles

Correlation between indole-3-acetic acid and left ventricular hypertrophy in hemodialysis patients.

Among hemodialysis patients, left ventricular hypertrophy (LVH) is a prevalent cardiac abnormality. The uremic toxin indole-3-acetic acid (IAA) is elevated in uremia patients, but the connection between IAA and LVH in individuals undergoing hemodialysis remains uncertain. Hence, the objective of this research was to examine the correlation between blood IAA levels and LVH in individuals undergoing hemodialysis. In total, 205 individuals undergoing hemodialysis were chosen and categorized into two groups, with (143 patients) and without LVH (62 patients). Patient clinical data were collected, and serum creatinine, calcium, phosphorus, hemoglobin, and IAA levels were measured. Compared to the non-LVH group, the LVH group had higher IAA and serum phosphorus but lower hemoglobin. The serum IAA concentration was positively correlated with both left ventricular mass (LVM) and left ventricular mass index (LVMI) but negatively correlated with both left ventricular ejection fraction (LVEF) and the ratio of left ventricular transmitral early peak flow velocity to left ventricular transmitral late peak flow velocity (E/A). Logistic regression analysis indicated that increased IAA levels are a risk factor for LVH and are not influenced by other factors. In addition, we exposed primary neonatal cultured mouse cardiomyocytes to varying concentrations of IAA in a controlled environment. Cardiomyocyte hypertrophy was induced by IAA in a concentration-dependent manner. Serum IAA is correlated with alterations in both the function and structure of the left ventricle. The serum IAA concentration is an independent risk factor for LVH. IAA may be a novel biomarker of LVH in hemodialysis patients.

Hypericin Alleviates Chronic Kidney Disease-induced Left Ventricular Hypertrophy by Regulation of FGF23-FGFR4 Signaling Pathway.

Chronic kidney disease (CKD) is a significant global health threat that imposes a substantial burden on both individuals and societies. CKD frequently correlates with cardiovascular events, particularly left ventricular hypertrophy (LVH), which contributes to the high mortality rate associated with CKD. Fibroblast growth factor 23 (FGF23), a hormone primarily involved in regulating calcium and phosphorus metabolism, has been identified as a major risk factor for LVH in CKD patients. Elevated serum FGF23 levels are known to induce LVH and myocardial fibrosis by activating the fibroblast growth factor receptor 4 (FGFR4) signal pathway. Therefore, targeting FGFR4 and its downstream signaling pathways holds potential as a treatment strategy for cardiac dysfunction in CKD. In our current study, we have discovered that Hypericin, a key component derived from Hypericum perforatum , has the ability to alleviate CKD-related LVH by targeting the FGFR4/phospholipase C gamma 1 (PLCγ1) signaling pathway. Through in vitro experiments using rat cardiac myocyte H9c2 cells, we observed that Hypericin effectively inhibits FGF23-induced hypertrophy and fibrosis by suppressing the FGFR4/PLCγ1/calcineurin/nuclear factor of activated T-cell (NFAT3) signaling pathway. In addition, our in vivo studies using mice on a high-phosphate diet and rat models of 5/6 nephrectomy demonstrated that Hypericin has therapeutic effects against CKD-induced LVH by modulating the FGFR4/PLCγ1/calcineurin/NFAT3 signaling pathway. In conclusion, our research highlights the potential of Hypericin as a candidate for the treatment of CKD-induced cardiomyopathy. By suppressing the FGFR4/PLCγ1 signaling pathway, Hypericin shows promise in attenuating LVH and myocardial fibrosis associated with CKD.

Maternal poor glycemic control increases risk of neonatal left ventricular hypertrophy.

Left ventricular hypertrophy (LVH) is an important complication of infants of diabetic mothers (IDMs). However, the defined factors, such as the influence of glycemic control, insulin administration of diabetic mothers and large for gestational age (LGA) in infants, are largely unknown on the incidence of LVH. Therefore, this study aimed to evaluate the prevalence of maternal and neonatal risk factors associated with LVH in IDMs. This prospective analytic study was conducted at tertiary care hospitals in a 1-year period. Inborn IDMs were enrolled, and ventricular hypertrophy was identified by 2D echocardiography in the first 72 hours after birth. A total of 160 IDMs met the inclusion criteria, 33 (20.6%) of which had LVH. The incidence of infants with LVH born to mothers with poor glycemic control (fasting blood sugar >95 mg/dL) was significantly elevated than those with good glycemic control (45.5% vs. 14.4%, P<0.001). Twelve IDMs (12/33, 36.5%) of LVH and 17 IDMs (17/127, 13.4%) of non-LVH were LGA. IDMs with LVH, compared those with non-LVH, had significantly increased left ventricular (LV) geometry; IVSd (6.5±0.8 vs. 4.0±0, 7 mm), LV IDd (16.8±3.3 mm vs. 18.4±1.1), left ventricular ejection fraction (LVEF) (68.3±8.5% vs. 62.9±17.5%), left ventricular fraction shortening (LVFS) (35.9±6.6% vs. 32.2±5.5%), LV mass (15.3±11.6 vs. 9.3±2.5 g) and LV mass index (66.2±17.5 vs. 46.6±9.7 g/m2), all with P<0.001. There was significant correlation in LV mass with infants' weight, height and body surface area (BSA) (r=0.408, 0.337 and 0.424, respectively; P<0.001). The prevalence of neonatal ventricular hypertrophy in IDMs was 20.6%. Maternal poor glycemic control and LGA status in IDMs were dominant risk factors of LVH.

The correlation between serum fibroblast growth factor-23 levels and left ventricular hypertrophy in chronic kidney disease patients

Introduction: Hyperphosphatemia in chronic kidney disease (CKD) patients can stimulate the production of the fibroblast growth factor-23 (FGF-23) phosphatonin hormone, which is associated with cardiac remodeling resulting in left ventricular hypertrophy (LVH). Objectives: To determine the correlation between FGF-23 level and LVH incidence in CKD patients and establish the associated risk factors. Materials and Methods: This cross-sectional study involved 74 CKD patients who were classified as stage 3 (n=18), stage 4 (n=17), stage 3 (n=18), dialysis stage 5 (n=20), or non-dialysis stage 5 (n=19). The FGF-23 levels of the patients were measured using the ELISA (enzyme-linked immunosorbent assay) kit method, whereas a cardiologist verified LVH using an echocardiographic examination based on the LVH criteria of &gt;95 g/m2 for females and &gt;115 g/m2 for males. Results: A significant difference was observed in the mean FGF-23 values between the LVH and non-LVH patients (443.27±437.047 RU/mL and 172.68±185.56 RU/mL, respectively; P&lt;0.05). The receiver operating characteristics revealed that patients with FGF-23 levels &gt;123.95 RU/mL had a 3.6 times greater risk of LVH compared to those with values ≤123.95 RU/mL. The LVH risk factors of gender and age, as well as hypertension, diabetes mellitus, and obesity diagnoses were not associated with LVH incidence in CKD patients. Conclusion: A significant association was found between FGF-23 level and LVH incidence in CKD patients, in which an FGF-23 level &gt;123.95 RU/mL corresponded to a 3.6 times greater risk of LVH than those with FGF-23 levels below this value.

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.

Association of depression with hypertensive left ventricular hypertrophy in age, sex, and education level-specific differences.

Previous studies have shown that hypertension and depression are associated with worse cardiovascular outcomes and reduced quality of life. Left ventricular hypertrophy (LVH) is strongly linked to increased mortality and cardiovascular disease, and depression may be one of the key factors contributing to hypertensive LVH. The authors consecutively enrolled 353 patients with uncomplicated hypertension between November 2017 and May 2021. All participants completed the Hamilton Depression Scale (HAM-D) to assess their depression status, with depression defined as a HAM-D score of 20 or higher. Linear regression analysis revealed a positive association between HAM-D and LVMI (adjusted β, 1.51, 95% CI, 1.19-1.83, p<.001). Logistic regression models showed that individuals with hypertension and depression had a higher risk of LVH than those with hypertension alone (adjusted OR, 2.51, 95% CI, 1.14-5.52, p=.022). The association between depression and LVH significantly interacted with age, sex, education levels, but not BMI and household income. Following age, sex, and education levels stratification, an independent association of depression and LVH was observed only in age<60 years (age<60 years: OR, 7.36, 95% CI, 2.25-24.13, p<.001), male (male: OR, 16.16, 95% CI, 3.80-68.73, p<.001), and higher education levels (high school and above: OR, 11.09, 95% CI, 2.91-42.22, p<.001). Our findings suggest that depression is a significant risk factor for LVH in hypertensive patients, particularly in those who are under 60 years of age, male, and have higher education levels.

Metabolic syndrome as risk factor for left ventricular hypertrophy in children with chronic kidney disease.

The metabolic syndrome (MS), a cluster of clinical and biochemical abnormalities including insulin resistance, dyslipidemia and hypertension, is often diagnosed in chronic kidney disease (CKD) children. Left ventricular hypertrophy (LVH) is a major target organ damage in hypertension and an important cardiovascular risk factor in CKD patients. We aimed to identify the most significant risk factors of LVH in children with CKD. Children with CKD stage 1-5 were enrolled in the study. MS was diagnosed according to De Ferranti (DF) as ≥3 from 5 criteria. Ambulatory blood pressure measurements (ABPM) and echocardiographic evaluation were performed. LVH was defined as ≥95th percentile of LV mass index related to height and age. Clinical and laboratory parameters included: serum albumin, Ca, HCT, cystatin C, creatinine, estimated glomerular filtration rate (eGFR) based on Schwartz formula, triglycerides, high-density lipoprotein (HDL), proteinuria, BMI standard deviation score (SDS), height SDS, waist circumference, ABPM data. 71 children (28 girls/43 boys) with median age 14.05 (25%-75%:10.03-16.30) years and median eGFR 66.75 (32.76-92.32) ml/min/1.73m2 were evaluated. CKD stage 5 was diagnosed in 11 pts (15.5%). MS (DF) was diagnosed in 20 pts (28.2%). Glucose ≥ 110 mg/dL was present in 3 pts (4.2%); waist circumference ≥75th pc in 16 pts (22.5%); triglycerides ≥ 100 mg/dL in 35 pts (49.3%); HDL < 50mg/dL in 31 pts (43.7%) and BP ≥ 90th pc in 29 pts (40.8%), respectively. LVH was detected in 21 (29.6%) children. In univariate regression the strongest risk factor for LVH was CKD stage 5 (OR 4.9, p=0.0019) and low height SDS (OR 0.43,p=0.0009). In stepwise multiple logistic regression analysis (logit model) of the most important risk factors for LVH in CKD children, only three were statistically significant predictors: 1)MS diagnosis based on DF criteria (OR=24.11; 95%CI 1.1-528.7; p=0.043; Chi2=8.38,p=0.0038); 2), high mean arterial pressure (MAP SDS) in ABPM (OR=2.812; 95%CI 1.057-7.48; p=0.038;Chi2=5.91, p=0.015) and 3) low height SDS (OR=0.078; 95%CI 0.013-0.486;p=0.006; Chi2=25.01, p<0.001). In children with chronic kidney disease LVH is associated with the cluster of multiple factors, among them the components of MS, hypertension, stage 5 CKD and growth deficit were the most significant.

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.

Quadratic stratification of left ventricular hypertrophy and association with mitral insufficiency grading: a retrospective study using cardiac magnetic resonance.

Chronic primary mitral regurgitation (MR) is caused by the defect in >1 component of the mitral valve, potentially leading to left ventricular hypertrophy (LVH). The relationship between LVH subtypes and the insufficiency grading of chronic MR remains unclear. Thus, we aimed to investigate this association and explore the impact of unhealthy habits on LVH development in patients with chronic primary MR through a cross-sectional study. Cardiac magnetic resonance (CMR) data was retrospectively collected from 3T magnetic resonance imaging (MRI) scanners in 71 patients with chronic primary MR (range, 20-84 years, 52% men). Considered patients (with mild-to-severe MR) were enrolled between March 2015 and September 2022 from the Cardiovascular Imaging Registry of Calgary (CIROC) database. Left ventricle (LV) function was assessed using cvi42 v5.11.5. Patients were categorized into 'mild-to-severe' MR using regurgitation fraction (RF), according to the current imaging guidelines. LVH subtypes were determined using mass-to-volume (M/V) calculations. IBM SPSS was used to run all the statistical analyses. This study employed normality checks by using the Shapiro-Wilk test; one-way analysis of variance (ANOVA) and Kruskal-Wallis tests with post-hoc pairwise comparisons; Chi-squared tests, Fisher's Exact test, crosstabulation analysis, and multinomial logistic regression to examine relationships between MR severity, LVH types, and impact of lifestyle factors, significance at P<0.05. Eccentric LVH was significantly associated with increased severity of MR, while concentric remodeling (CR) was linked to decreased MR severity (χ2=13.276, P=0.03, stratified by sex χ2=7.729, P=0.005). Sex differences emerged in the overall study population. Eccentric LVH was dominantly higher than CR in both males and females (females: 57.7% vs. 42.3%, P=0.05, males: 82.8% vs. 17.2%, P=0.26). No differences were observed between age groups ('Young-Middle' = under 60 years, and 'Middle-Old' = over 60 years). Still, there were notable differences in LVH prevalence within the 'Young-Middle' age group for mild-moderate (P=0.01) and moderate-severe MR (P=0.02). Eccentric LVH was associated with higher body mass index (BMI), smoking, and frequent alcohol consumption [odds ratio (OR) 1.02, 95% confidence interval (CI): 0.56-1.26; OR 1.65, 95% CI: 1.31-6.52; OR 1.15, 95% CI: 0.26-1.34], while CR was solely associated with increased BMI (smokers OR =1.84, 95% CI: 1.25-3.91 and alcohol consumers OR =1.32, 95% CI: 0.86-2.48). Nicotine and caffeine consumption did not appear to be a risk factor for LVH (nicotine: eccentric, OR =0.99, 95% CI: 0.65-1.86; CR, OR =0.97, 95% CI: 0.69-2.39 and caffeine: eccentric, OR =0.69, 95% CI: 0.48-1.61; CR, OR =0.97, 95% CI: 0.78-4.01). This study reveals sex-based associations between LVH subtypes and severity of chronic primary MR. Lifestyle factors such as cigarette smoking, alcohol consumption, and elevated BMI influence LVH risk, while nicotine and caffeine consumption exhibit minimal effects.

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.

PS-BPC05-3: THE RELATIONSHIP BETWEEN THE WEIGHT-ADJUSTED-WAIST INDEX AND LEFT VENTRICULAR HYPERTROPHY IN CHINESE HYPERTENSION ADULTS

Abstract Background: Left ventricular hypertrophy (LVH) is a major cardiac complication of hypertension. weight-adjusted-waist index (WWI) is a new obesity index that has been found to be positively associated with cardiovascular disease mortality. We aimed to investigate the relationship between the weight-adjusted-waist index and left ventricular hypertrophy in Chinese hypertension adults. Methods: The study is a community-based cross-sectional study that included 4715 patients with hypertension and integrated clinical and echocardiographic data. LVH was diagnosed by transthoracic echocardiography in these patients based on a criterion of left ventricular mass index (LVMI) over 49.2 g/m2.7 in men and 46.7 g/m2.7 in women. The independent association between the WWI quartiles and LVH prevalence was analyzed by logistic regression models. Results: The prevalence of LVH in the first quartile of WWI (Q1:less than 10.16), second (Q2:10.16∼10.67), the third (Q3:10.68∼11.19), and the highest quartile (Q4:greater or equal to11.20) was 34.1%, 38.4%, 42.4%, 51.5%, respectively. Logistic regression analysis suggested that the WWI was independently correlated with the risk of LVH with adjustment of confounding factors, and increased across the quartile of WWI. Compared to the first quartile of WWI (Q1), the odds ratios (ORs) and their 95% confidence intervals (CIs) for LVH in the increasing quartiles (Q2-Q4) were 1.33(1.08–1.63), 1.50 (1.19–1.89) and 2.28(1.74–2.99), respectively. In stratified analyses, the relationship between WWI and LVH risk persisted. Conclusions: The WWI may be an independent risk factor of LVH in Chinese hypertension adults.

Risk factors of left ventricular hypertrophy in obstructive sleep apnea.

Obstructive sleep apnea (OSA) and left ventricular hypertrophy (LVH) are both related to major cardiovascular diseases. Previous studies have indicated that, compared with non-OSA, OSA is related to LVH with an odds ratio (OR) of 1.70 (95% CI: 1.44-2.00), particularly in patients with coronary artery disease. Meta-analysis has revealed that the severity of OSA is significantly associated with left ventricular mass compared with non-OSA controls. There is, however, limited data on the risk factors of LVH in patients with OSA. The present study aimed to assess the prevalence and clinical factors that are predictive of LVH in patients with OSA. A retrospective analysis of adult patients diagnosed with OSA who had undergone echocardiography was performed. LVH defined by echocardiography indicated an enlarged LV mass index. Clinical factors predictive of LVH were assessed using multivariate logistic regression analyses. An unadjusted OR and an adjusted OR with 95% confidence intervals (CI) were determined. During the study period, 130 patients met the study criteria, with an LVH prevalence of 27.69% (36 patients). The final predictive model of LVH comprised six factors: Age, sex, unrefreshed sleep, body mass index, systolic blood pressure and apnea-hypopnea index. Only age was independently associated with LVH, with an adjusted OR of 1.048 (95% CI: 1.002-1.096). The prevalence rate of LVH in patients with OSA was 27.69%. Older age was independently related to LVH in patients with OSA.

Left ventricular hypertrophy in pediatric patients on maintenance dialysis: a report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS).

Cardiovascular disease is the leading cause of death in pediatric patients with kidney failure. Left ventricular hypertrophy (LVH) is recognized as the most common cardiovascular abnormality in these patients. There remains a paucity of longitudinal studies evaluating LVH during maintenance dialysis in children. NAPRTCS has collected echocardiographic data of pediatric maintenance dialysis patients since 2013 and is one of the largest registries to assess longitudinal changes in LVH. Patients aged 1-18years with echocardiographic data and without underlying structural cardiovascular diseases were included. LVH was defined as left ventricular mass index (LVMI, height-indexed) > 95th percentile for age and sex. Univariate and multivariable logistic regression was performed to assess risk factors for LVH at baseline. Generalized estimating equation was used to assess risk factors of changes in LVH during maintenance dialysis. A total of 518 patients had echocardiographic data available for analysis during time on maintenance dialysis. Of 179 patients with baseline echocardiography (within 30days of dialysis initiation), 67% had LVH. In multivariable logistic regression adjusted for age, race, and sex, uncontrolled hypertension (OR 9.4, 95% CI 2.8-31) and anemia (OR 2.3, 95% CI 1.0-5.3) were associated with LVH at baseline. Prevalence of LVH remained high at 40-50% during follow-up. Controlled and uncontrolled hypertension as well as phosphorus level were independently associated with increased likelihood of LVH during maintenance dialysis. LVH is prevalent in pediatric patients at dialysis initiation and remains prevalent during follow-up. Hypertension is the strongest risk factor for LVH in children on maintenance dialysis. A higher resolution version of the Graphical abstract is available as Supplementary information.

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 estimated glucose disposal rate to detect prevalent left ventricular hypertrophy: implications from a general population

ABSTRACT Background Insulin resistance plays a pivotal role in developing left ventricular hypertrophy (LVH). Researchers have identified the estimated glucose disposal rate (eGDR) as a simple and cost-effective surrogate of insulin resistance. Our work aims to investigate the association between eGDR and the prevalent LVH and explore the incremental value of eGDR to detect prevalent LVH. Methods The present work enrolled 3839 subjects from a cross-sectional survey conducted between October 2019 to April 2020 in the rural areas of southeastern China. eGDR was calculated based on waist-to-hip circumference ratio, hypertension, and glycated hemoglobin. Results The prevalence of LVH was 17.30%. After adjusting demographic, anthropometric, laboratory, and medical history co-variates, each standard deviation increase of eGDR decreased a 29.6% risk of prevalent LVH. When dividing eGDR into quartiles, the top quartile had a 38.4% risk compared to the bottom quartile. Moreover, smooth curve fitting revealed that the association between eGDR and prevalent LVH was linear in the whole range of eGDR. Additionally, subgroup analysis demonstrated that our main finding was robust to age, sex, BMI, hypertension, and diabetes subgroups. Finally, ROC analysis exhibited a significant improvement by adding eGDR into LVH risk factors (0.780 vs. 0.803, P < 0.001), and category-free net reclassification index (0.702, P < 0.001) and integrated discrimination index (0.027, P < 0.001) also confirmed the improvement from eGDR to detect prevalent LVH. Conclusion Our analysis revealed a linear, robust association between eGDR and prevalent LVH and demonstrated the incremental value of eGDR to optimize the detection of prevalent 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 Value of Four Anthropometric Indicators for Identifying Left Ventricular Hypertrophy in Chinese Hypertensive Patients.

Left ventricular hypertrophy (LVH) has been classified separately as an independent risk factor for hypertension. However, comparisons between different body size indices and left ventricular hypertrophy (LVH) in hypertensive populations have not been reported yet. In this study, we enrolled 4,639 hypertensive patients from rural China. Anthropometric indices and cardiovascular disease risk factor variables were measured and analyzed using Spearman's correlation, logistic regression, and receiver operating characteristic (ROC) curve analyses. Patients in the highest quartile of body size indices were more likely to have left ventricular hypertrophy than those in the lowest quartile; these indices were BMI (adjusted OR: 3.55, 95% CI: 2.90; 4.35), WC (adjusted OR: 2.23, 95% CI: 1.84; 2.70), WHR (adjusted OR: 1.44, 95% CI: 1.18; 1.75), and WHtR (adjusted OR: 3.23, 95% CI: 2.62; 3.99). The areas under the ROC curves of BMI (AUC: 0.628, 95% CI: 0.612; 0.644), WHtR (AUC: 0.628, 95% CI: 0.560; 0.593), WHR (AUC: 0.530, 95% CI: 0.513; 0.547), and WC (AUC: 0.576, 95% CI: 0.513; 0.547) were all above 0.5, which indicated that the four anthropometric indicators may be associated with LVH. The four anthropometric indicators of obesity were identified as risk factors for LVH. Weight control might help reduce the risk of left ventricular hypertrophy.

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.

Middle age serum sodium levels in the upper part of normal range and risk of heart failure.

With increasing prevalence of heart failure (HF) owing to the ageing population, identification of modifiable risk factors is important. In a mouse model, chronic hypohydration induced by lifelong water restriction promotes cardiac fibrosis. Hypohydration elevates serum sodium. Here, we evaluate the association of serum sodium at middle age as a measure of hydration habits with risk to develop HF. We analysed data from Atherosclerosis Risk in Communities study with middle age enrolment (45-66 years) and 25 years of follow-up. Participants without water balance dysregulation were selected: serum sodium within normal range (135-146 mmol/L), not diabetic, not obese and free of HF at baseline (N = 11 814). In time-to-event analysis, HF risk was increased by 39% if middle age serum sodium exceeded 143 mmol/L corresponding to 1% body weight water deficit [hazard ratio 1.39, 95% confidence interval (CI) 1.14-1.70]. In a retrospective case-control analysis performed on 70- to 90-year-old attendees of Visit 5 (N = 4961), serum sodium of 142.5-143 mmol/L was associated with 62% increase in odds of left ventricular hypertrophy (LVH) diagnosis [odds ratio (OR) 1.62, 95% CI 1.03-2.55]. Serum sodium above 143 mmol/L was associated with 107% increase in odds of LVH (OR 2.07, 95% CI 1.30-3.28) and 54% increase in odds of HF (OR 1.54, 95% CI 1.06-2.23). As a result, prevalence of HF and LVH was increased among 70- to 90-year-old participants with higher middle age serum sodium. Middle age serum sodium above 142 mmol is a risk factor for LVH and HF. Maintaining good hydration throughout life may slow down decline in cardiac function and decrease prevalence of HF.