Association between angiopoietin‐2 and functional cardiac remodeling in hemodialysis patients with normal left ventricular ejection

Abstract

Cardiac remodeling is the initial process in heart failure development. The aim of this study is to evaluate the association between endothelium-related biomarkers and cardiac remodeling in hemodialysis (HD) patients and how the presence of high blood pressure and diabetes mellitus modulates these associations. This was a crosssectional study with adult HD and normal left ventricular (LV) ejection fraction-LVEF-patients. The authors correlated several endothelium-related biomarkers with echocardiographic indices-LV mass index (LVMi), LVEF, global longitudinal strain, mitral E/e' , and aortic root diameter. Seventy-one patients were included, with 37 women (52.1%) and mean age of 54.3 ± 16.8 years. Angiopoietin-2 (AGPT2) was inversely correlated with global longitudinal strain (r = -.374, p = .001) and directly with E/e' (r = .265, p = .025). After adjustment, only AGPT2 was significantly associated with global longitudinal strain. blood pressure and diabetes mellitus were independent moderators for the AGPT2 and global longitudinal strain association. The conditional association was significant only when the mean pre-HD blood pressure was above 97.5 mmHg or in diabetes mellitus patients. Finally, there was an interaction between diabetes mellitus and blood pressure when moderating the conditional effect of AGPT2 on global longitudinal strain. While in non-diabetic patients, the association between AGPT2 with global longitudinal strain was significant only with pre-HD blood pressure levels as high as 110 mmHg, in diabetic patients, this association was significant with pre-HD blood pressure as low as 90 mmHg. Higher levels of AGPT2 were associated with worse cardiac function as determined by lower global longitudinal strain values. This association was moderated by blood pressure and diabetesThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Is atrial fibrillation in HFpEF a distinct phenotype? Insights from multiparametric MRI and circulating biomarkers

“…In keeping with our findings, Angiopoeitin-2 has also been associated with AF in other studies [ 43 ] and has been associated with adverse cardiac remodelling [ 44 ] as well as both systolic and diastolic dysfunction [ 45 ], albeit in non-AF patients. Angiopoeitin-2 plays an important role in angiogenesis and delivers its impact on vascular structure and function via vascular endothelial growth factor [ 44 ], potentially leading to arterial stiffness [ 46 ], which is known to be associated with HFpEF [ 47 ].…”

O Emprego do Strain do Átrio Esquerdo na Análise da Função Diastólica do VE: Pronto para o Uso?

“…Exemplos de sua aplicação são: determinação de doença miocárdica subclínica em ventrículos aparentemente normais, diagnóstico precoce da cardiotoxicidade por quimioterápicos, diferenciação entre as principais causas de aumento da espessura miocárdica, segmentação de risco em diferentes patologias cardíacas, e em uma série de outras condições clínicas que afetam o miocárdio. [5][6][7][8] As deformações circunferenciais e radiais do VE também podem ser medidas pelo mesmo método; além disso, também pode-se obter a velocidade com que essas deformações ocorrem, o chamado strain rate. Variáveis rotacionais medidas na base, segmentos médios e segmentos apicais também podem complementar a avaliação, bem como o twist, que é a diferença entre as rotações basais e apicais do VE.…”