Types Of Left Ventricular Remodeling Research Articles

Usefulness of three-dimensional spherical index to assess different types of left ventricular remodeling: A meta-analysis.

Background:Left ventricular (LV) remodeling after myocardial injury, volume or pressure overload is characterized by a change in LV shape from an ellipse to more of a sphere. The usefulness of 3-dimensional (3D) sphericity index (SpI) for accurate evaluation of LV remodeling remains uncertain despite extensive research.Methods:We searched Pubmed, Embase, Web of Science, and Cochrane databases to identify relevant studies from January 1, 1990 to August 1, 2016. The quality of each study was evaluated using the Newcastle-Ottawa Scale. Meta regression and sensitivity and subgroup analyses based on patterns of LV remodeling were performed.Results:Thirteen studies with a total of 1064 patients were included in this meta-analysis. There was evidence of obvious heterogeneity (I2 = 82.4%; P < .001), which was mainly accounted for by the pattern of remodeling according to meta-regression. The result of subgroup meta-analyses suggested that SpI in patients with eccentric remodeling was significantly higher compared with control group (95% confidence interval [CI], 0.78–1.10). No statistic difference was found in LV SpI between healthy controls and patients with concentric hypertrophy (95% CI, −0.89 to 0.16) or myocardial injury (95% CI, −0.13 to 0.41).Conclusion:3D SpI can be widely used to assess LV remodeling in patients with eccentric remodeling, but has limitations in predicting concentric hypertrophy and regional or chronic myocardial injury.

Plasma Level of High-Sensitive C-Reactive Protein in Patients with Acute Myocardial Infarction and Arterial Hypertension

Arterial hypertension is an independent predictor of acute myocardial infarction. Nowadays, plasma level of high-sensitive C-reactive protein is a marker of cardiovascular risk. The objective of the research was to evaluate plasma level of high-sensitive C-reactive protein in patients with acute myocardial infarction and arterial hypertension depending on myocardial remodeling type. Materials and methods. 130 patients with myocardial infarction (63 individuals with concomitant arterial hypertension and 67 individuals without it) were observed. Transthoracic echocardiogram was used. To evaluate plasma level of high-sensitive C-reactive protein the ELISA method was applied. Results. Plasma level of high-sensitive C-reactive protein in patients with acute myocardial infarction increased by 5.11 times compared to the control group: (10.67 [5.43; 12.89]) mg/l and (2.09 [1.40; 4.60]) mg/l, respectively (p&lt;0.001). In myocardial infarction and arterial hypertension, this parameter increased by 6.57 times (to (13.73 [7.05; 15.17]) mg/l) (p&lt;0.001), and by 1.27 times (p&lt;0.05) as compared to patients without arterial hypertension. No differences in plasma level of high-sensitive C-reactive protein were detected in patients with different types of left ventricular remodeling.Conclusions. Acute myocardial infarction caused by high plasma level of high-sensitive C-reactive protein is severer in co-existent arterial hypertension. There are no differences in blood levels of high-sensitive C-reactive protein depending on the type of left ventricular remodeling.

Racial/Ethnic Differences in Left Ventricular Structure and Function in Chronic Kidney Disease: The Chronic Renal Insufficiency Cohort.

Chronic kidney disease (CKD) is associated with increased risk of cardiovascular disease (CVD) and it is especially common among Blacks. Left ventricular hypertrophy (LVH) is an important subclinical marker of CVD, but there are limited data on racial variation in left ventricular structure and function among persons with CKD. In a cross-sectional analysis of the Chronic Renal Insufficiency Cohort Study, we compared the prevalence of different types of left ventricular remodeling (concentric hypertrophy, eccentric hypertrophy, and concentric remodeling) by race/ethnicity. We used multinomial logistic regression to test whether race/ethnicity associated with different types of left ventricular remodeling independently of potential confounding factors. We identified 1,164 non-Hispanic Black and 1,155 non-Hispanic White participants who completed Year 1 visits with echocardiograms that had sufficient data to categorize left ventricular geometry type. Compared to non-Hispanic Whites, non-Hispanic Blacks had higher mean left ventricular mass index (54.7 ± 14.6 vs. 47.4 ± 12.2 g/m2.7; P < 0.0001) and prevalence of concentric LVH (45.8% vs. 24.9%). In addition to higher systolic blood pressure and treatment with >3 antihypertensive medications, Black race/ethnicity was independently associated with higher odds of concentric LVH compared to White race/ethnicity (odds ratio: 2.73; 95% confidence interval: 2.02, 3.69). In a large, diverse cohort with CKD, we found significant differences in left ventricular mass and hypertrophic morphology between non-Hispanic Blacks and Whites. Future studies will evaluate whether higher prevalence of LVH contribute to racial/ethnic disparities in cardiovascular outcomes among CKD patients.

Evaluation of hormonal balance indicators in men with arterial hypertension in various types of left ventricular remodeling

Aim. To evaluate features of the hormonal balance in men with hypertension with different types of left ventricular geometry.Methods. The study included 63 men (mean age 49.74±4.91 years) with II degree hypertension (the disease duration 6.03±3.64 years). In all patients the level of testosterone, estradiol, prolactin, thyroid-stimulating hormone in blood serum were determined and echocardiography was performed, which was done on the expert class machine PHILIPS iE33 (Netherlands).Results.. According to echocardiographic examination data concentric hypertrophy prevailed in the left ventricular hypertrophy structure - 33 (52.38%) patients, eccentric hypertrophy occured in 18 (28.57%), concentric remodeling - in 12 (19.04%) patients. When analyzing the hormonal profile of patients a significant difference in testosterone levels in patients with various types of the left ventricular remodeling was revealed. In the concentric left ventricular hypertrophy, testosterone levels were lowest, and in some patients were beyond the lower limit of the normal range. Estradiol level exceeded the reference range values in men with concentric type of hypertrophy. The estradiol content in the group of men with concentric left ventricular remodeling was significantly higher than in patients with eccentric hypertrophy (pConclusion. In patients with hypertension, concentric left ventricular hypertrophy (as compared with eccentric hypertrophy and concentric remodeling) occurs more often, it is accompanied by a decrease in total testosterone level in blood serum; timely correction of early androgen deficiency will allow to reduce the risk of cardiovascular complications.

Cardiac remodeling and dysfunction in childhood obesity: a cardiovascular magnetic resonance study.

BackgroundObesity affects nearly one in five children and is associated with increased risk of premature death. Obesity-related heart disease contributes to premature death. We aimed to use cardiovascular magnetic resonance (CMR) to comprehensively characterize the changes in cardiac geometry and function in obese children.Methods and resultsForty-one obese/overweight (age 12 ± 3 years, 56 % female) and 29 healthy weight children (age 14 ± 3 years, 41 % female) underwent CMR, including both standard cine imaging and displacement encoded imaging, for a complete assessment of left ventricular (LV) structure and function. After adjusting for age, LV mass index was 23 % greater (27 ± 4 g/m2.7 vs 22 ± 3 g/m2.7, p <0.001) and the LV myocardium was 10 % thicker (5.6 ± 0.8 mm vs 5.1 ± 0.8 mm, p <0.001) in the obese/overweight children. This evidence of cardiac remodeling was present in obese children as young as age 8. Twenty four percent of obese/overweight children had concentric hypertrophy, 59 % had normal geometry and 17 % had either eccentric hypertrophy or concentric remodeling. LV mass index, thickness, ejection fraction and peak longitudinal and circumferential strains all correlated with epicardial adipose tissue after adjusting for height and gender (all p <0.05). Peak longitudinal and circumferential strains showed a significant relationship with the type of LV remodeling, and were most impaired in children with concentric hypertrophy (p <0.001 and p = 0.003, respectively).ConclusionsObese children show evidence of significant cardiac remodeling and dysfunction, which begins as young as age 8. Obese children with concentric hypertrophy and impaired strain may represent a particularly high risk subgroup that demands further investigation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12968-016-0247-0) contains supplementary material, which is available to authorized users.

Abstract 15439: Obese Children With Concentric Hypertrophy and Impaired Cardiac Strain: A Potentially High-risk Subgroup Identified With Cardiac Magnetic Resonance

Objectives: Obesity affects nearly one in five children and is associated with increased risk of premature death. Heart disease may contribute to this premature death. We aimed to use cardiac magnetic resonance (CMR) to comprehensively assess the prevalence and severity of heart disease in obese children, with the hypothesis that obese children have cardiac remodeling and impaired cardiac function compared to healthy weight children. Methods and Results: Twenty obese (age 12 ± 3 years, 60% female) and 20 healthy weight children (age 13 ± 3 years, 50% female) underwent CMR, including both standard cine imaging and displacement encoded imaging, for a complete assessment of left ventricular (LV) structure and function. After adjusting for age, obese children had a 27% increase in LV mass (p &lt;0.001, Figure 1A) and a 12% increase in LV thickness (obese = 5.5 ± 0.7 mm, healthy = 5.0 ± 0.7 mm, p = 0.01). This evidence of cardiac remodeling was present in obese children as young as age 8. Forty percent of obese children had concentric hypertrophy, 40% had normal geometry and 20% had either eccentric hypertrophy or concentric remodeling. LV ejection fraction and peak strains were not different between the healthy weight and obese groups. However, peak longitudinal strain showed a significant relationship with the type of LV remodeling, and was most impaired in obese children with concentric hypertrophy (Figure 1B). Conclusions: Obese children show evidence of significant heart disease, which begins as young as age 8. The presence of concentric hypertrophy in 40% of obese children along with the association with impaired cardiac strain in these children may represent a high-risk subgroup. Given the associations between pediatric obesity and early mortality, these early signs of heart disease in obese children demand further investigation.

GW26-e4695 The value of three-dimensional spherical index in assessing different type of left ventricular remodeling

To investigate the value of three-dimensional spherical index (3D SpI) in assessing different type of left ventricular (LV) remodeling in patients with four different cardiovascular diseases; and to find a suitable reference intervals of 3D SpI in identifying LV remodeling. One hundred and seven

Insulin-like growth factor-1 and myocardial remodeling in female patients with arterial hypertension and metabolic syndrome

Aim. To establish the role of insulin-like growth factor-1 (IGF-1) in left ventricular remodeling in female patients with arterial hypertension (HT) and metabolic syndrome (MS) with different stages of obesity. Material and methods. The study included 108 women with HT and MS, who were divided into 3 groups according to the stage of obesity, and 28 healthy women. The level of IGF-1, hemodynamic status and types of left ventricular remodeling were assessed. Results. Concentric remodeling and IGF-1 elevation (165.3±12.03 ng/ml) prevailed in patients with HT and first stage of obesity. Concentric hypertrophy of left ventricle and normal level of IGF-1 (118.5±10.05 ng/ml) were established in patients with second stage of obesity. Lack of IGF-1 (96.4±8.11 ng / ml) was determined in women with third stage of obesity and eccentric hypertrophy. Correlation analysis in patients with 2-3 stages of obesity showed significant associations between the level of IGF-1 and hemodynamic parameters. Conclusion. Changes in the level of IGF-1 in patients with AH and MS correlate with types of remodeling and stage of obesity.

The value of three-dimensional spherical index in assessing different type of left ventricular remodeling

The value of three-dimensional spherical index in assessing different type of left ventricular remodeling

Dinamika indeksa massy miokarda levogozheludochka u patsientov s arterial'noygipertoniey II-III stepeni na fone terapiiKo-renitekom i Gizaarom

The regress or left ventricular (LV) hypertrophy is a main end-point of antihypertensive therapy. The aim of the present study was to compare antihypertensive effects of two fixed combination preparations of ACE inhibitor and thiazide diuretic, enalapril 20 mg/hydrochlorthiazide 12,5 mg (Co-renitec) and losartan 50 mg/hydrochlorthiazide 12,5 mg (Hyzaar) on LV mass index (LVMI), types of left ventricular remodeling in patients with grade II-III arterial hypertension. First group was treated with Co-renitec, second group with Hyzaar during 24-weeks period. Results showed that both preparations significantly and to the same degree decrease LVMI. Number of patients with normal LV geometry increases with accompanying decrease in number of patients with concentric hypertrophy and concentric remodeling. The favorable effects were more remarkable in group treated with Hyzaar.

437 Ultrasonic myocardial tissue characterization by cyclic variation of integrated backscatter in patients with aortic stenosis

s S63 Eur J Echocardiography Abstracts Supplement, December 2006 437 Ultrasonic myocardial tissue characterization by cyclic variation of integrated backscatter in patients with aortic stenosis M. Fijalkowski 1 ; A. Koprowski 1 ; R. Galaska 1 ; W. Dubaniewicz 1 ; J. Rogowski 1 ; A. Rynkiewicz 1 1Medical University Of Gdansk, 1St Department Of Cardiology, Gdansk, Poland Background: Ultrasonic myocardial tissue characterization by cyclic variation of integrated backscatter (CVIBS) has been successfully used for the differentiation of various myopathies from normal myocardium. Aim: The aim of the study was ultrasonic myocardial tissue characterization in patients with aortic stenosis (AS) by cyclic variation of integrated backscatter. Methods: The study population consisted of 128 patients (42 women; mean age 65±10 years). In the parasternal long-axis view two regions of interest were chosen to estimate CVIBS: the mid-septum and the mid-posterior wall. Types of left ventricular remodeling in our group were classified according to left ventricular mass index (LVMI) and relative wall thickness (RWT): normal LV (N), LV concentric remodeling (CR), LV concentric hypertrophy (CH) and LV excentric hypertrophy (EH). Results: The mean echocardiographic parameters were: the aortic valve area (AVA) 0.8±0.3 cm2, maximal pressure gradient (PG max) 86±29 mm Hg and mean pressure gradient (PG mean) 54±20 mm Hg, LVEF 71±14%, fractional shortening (FS) 35±10%, left LVMI 146±47 mg, circumferential end-systolic wall stress (cESS) 102±48 kdynes/cm2; CVIBS septum 5.6±2.3 db, CVIBS posterior wall 5.4±2.0 dB. We found inverse correlation between mean CVIBS and LVMI (r=-0.29; r=-24; p<0.05; for septum and posterior wall respectively) and cESS (r=-0.28; r=-32; p<0.05; for septum and posterior wall respectively) and direct correlation between mean CVIBS and LVEF (r=0.28; r=-25; p<0.05; for septum and posterior wall respectively) and FS (r=0.26; r=-22 p<0.05; for septum and posterior wall respectively). In addition mean CVIBS for both septum and posterior wall was significantly lower in group with LV excentric hypertrophy compared to patients with LV concentric remodeling and LV concentric hypertrophy (Table 1). There were no significant correlations between mean CVIBS and NYHA, AVA, PG max, PG mean and diastolic function indices. Conclusion: The severity of myocardial dysfunction and left ventricle remodeling in patients with aortic stenosis are associated with alterations in myocardial ultrasonic reflectivity detected by integrated backscatter analysis.

Inhibitors of protein kinase signaling pathways: emerging therapies for cardiovascular disease.

Protein kinases are enzymes that covalently modify proteins by attaching phosphate groups (from ATP) to serine, threonine, and/or tyrosine residues. In so doing, the functional properties of the protein kinase's substrates are modified. Protein kinases transduce signals from the cell membrane into the interior of the cell. Such signals include not only those arising from ligand-receptor interactions but also environmental perturbations such as when the membrane undergoes mechanical deformation (ie, cell stretch or shear stress). Ultimately, the activation of signaling pathways that use protein kinases often culminates in the reprogramming of gene expression through the direct regulation of transcription factors or through the regulation of mRNA stability or protein translation. Protein kinases regulate most aspects of normal cellular function. The pathophysiological dysfunction of protein kinase signaling pathways underlies the molecular basis of many cancers and of several manifestations of cardiovascular disease, such as hypertrophy and other types of left ventricular remodeling, ischemia/reperfusion injury, angiogenesis, and atherogenesis. Given their roles in such a wide variety of disease states, protein kinases are rapidly becoming extremely attractive targets for drug discovery, probably second only to heterotrimeric G protein-coupled receptors (eg, angiotensin II). Here, we will review the reasons for this explosion in interest in inhibitors of protein kinases and will describe the process of identifying novel drugs directed against kinases. We will specifically focus on disease states for which drug development has proceeded to the point of clinical or advanced preclinical studies.