Blood pressure-independent relations of left ventricular geometry to the metabolic syndrome and insulin resistance: a population-based study

Sundström, Johan; Ärnlöv, Johan; Stolare, Karin; Lind, Lars

doi:10.1136/hrt.2007.121020

Cited by 45 publications

(43 citation statements)

References 32 publications

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“…3,4,38 We actually found, in agreement with the data from the literature, 3,4,11 that HIV þ patients had higher insulin resistance, defined by higher HOMA index, and greater prevalence of metabolic syndrome than HIVÀ subjects. As reported above, [13][14][15][16] in subjects without HIV infection insulin resistance and metabolic syndrome have been linked per se to LV hypertrophy and diastolic dysfunction, through multiple mechanisms which are still not completely elucidated, including increased sympathetic activity, trophic effects of insulin on cardiomyocytes, chronic subclinical inflammation, activation of renin-angiotensin-aldosterone system; all these mechanisms are as well potential causes of myocardial hypertrophy and increased interstitial and perivascular fibrosis. 15,39 The main limitation of our study is the lack of naive HIV þ patients.…”

Section: Left Ventricular Remodelling In Hiv Infection Am Grandi Et Almentioning

confidence: 99%

“…As reported above, [13][14][15][16] in subjects without HIV infection insulin resistance and metabolic syndrome have been linked per se to LV hypertrophy and diastolic dysfunction, through multiple mechanisms which are still not completely elucidated, including increased sympathetic activity, trophic effects of insulin on cardiomyocytes, chronic subclinical inflammation, activation of renin-angiotensin-aldosterone system; all these mechanisms are as well potential causes of myocardial hypertrophy and increased interstitial and perivascular fibrosis. 15,39 The main limitation of our study is the lack of naive HIV þ patients. The very small number of naive subjects examined at our clinic prevented us from selecting such a group as to be consistent with the others.…”

Section: Left Ventricular Remodelling In Hiv Infection Am Grandi Et Almentioning

confidence: 99%

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Left ventricular remodelling in asymptomatic HIV infection on chronic HAART: comparison between hypertensive and normotensive subjects with and without HIV infection

et al. 2011

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The high cardiovascular risk of HIV infected (HIV þ ) patients is still partly unexplained. We aimed to evaluate if HIV infection and highly active antiretroviral therapy (HAART) are linked per se to left ventricular (LV) remodelling, independently of blood pressure (BP) values. We enrolled 4 groups of patients matched by gender, age, body mass index and smoking habit: 30 HIV þ hypertensives, 30 HIV þ normotensives, 30 notinfected (HIVÀ) hypertensives and 30 HIVÀ normotensives. HIV þ patients were on chronic HAART. Hypertension was newly diagnosed (p6 months) and never treated. Each patient underwent blood tests, 24-h BP monitoring and LV echocardiogram. The 4 groups had similar fasting glucose and cholesterol; triglycerides, HOMA index and prevalence of metabolic syndrome were higher in the HIV þ groups. Despite similar 24-h BP values, HIV þ hypertensives had greater LV mass and higher prevalence of preclinical diastolic dysfunction than HIVÀ hypertensives. Compared to HIVÀ normotensives, HIV þ normotensives had similar 24-h BP values, but greater LV mass and lower LV diastolic indices, similar to HIVÀ hypertensives, whose 24-h BP values were higher. Asymptomatic HIV infection and chronic HAART are associated with myocardial hypertrophy and preclinical diastolic dysfunction, independently of BP values.

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Section: Left Ventricular Remodelling In Hiv Infection Am Grandi Et Almentioning

confidence: 99%

Section: Left Ventricular Remodelling In Hiv Infection Am Grandi Et Almentioning

confidence: 99%

Left ventricular remodelling in asymptomatic HIV infection on chronic HAART: comparison between hypertensive and normotensive subjects with and without HIV infection

et al. 2011

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“…Echocardiography was performed by an experienced examiner (L. Lind) blinded to clinical data and using an Acuson XP124 cardiac ultrasound unit, as described previously (16 ). LV volumes were determined according to the Teichholz method and from that, the LV ejection fraction (LVEF) was determined.…”

Section: Laboratory Analysis and Other Investigationsmentioning

confidence: 99%

Factors Influencing the 99th Percentile of Cardiac Troponin I Evaluated in Community-Dwelling Individuals at 70 and 75 Years of Age

Eggers¹,

Lind²,

Venge³

et al. 2013

Clinical Chemistry

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BACKGROUND We aimed to investigate the effects of sex, prevalent cardiovascular disease (CVD), and aging on the 99th percentile of cardiac troponin I (cTnI). METHODS cTnI was measured using a high-sensitivity assay (Abbott Diagnostics) in 814 community-dwelling individuals at both 70 and 75 years of age. We determined the cTnI 99th percentiles separately using nonparametric methods in the total sample, in men and women, and in individuals with and without CVD. RESULTS The cTnI 99th percentile at baseline was 55.2 ng/L for the total cohort. Higher 99th percentiles were noted in men (69.3 ng/L) and individuals with CVD (74.5 ng/L). The cTnI 99th percentile in individuals free from CVD at baseline (n = 498) increased by 51% from 38.4 to 58.0 ng/L during the 5-year observation period. Relative increases ranging from 44% to 83% were noted across all subgroups. Male sex [odds ratio, 5.3 (95% CI, 1.5–18.3)], log-transformed N-terminal pro-B-type natriuretic peptide [odds ratio, 1.9 (95% CI, 1.2–3.0)], and left-ventricular mass index [odds ratio, 1.3 (95% CI, 1.1–1.5)] predicted increases in cTnI concentrations from below the 99th percentile (i.e., 38.4 ng/L) at baseline to concentrations above the 99th percentile at the age of 75 years. CONCLUSIONS cTnI concentration and its 99th percentile threshold depend strongly on the characteristics of the population being assessed. Among elderly community dwellers, higher concentrations were seen in men and individuals with prevalent CVD. Aging contributes to increasing concentrations, given the pronounced changes seen with increasing age across all subgroups. These findings should be taken into consideration when applying cTnI decision thresholds in clinical settings.

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“…Echocardiographic parameters were measured with a comprehensive two-dimensional and Doppler echocardiography, which was performed with an Acuson XP124 cardiac ultrasound unit (Acuson, Mountain View, CA, USA) w1 week after the main examination by Dr Lind who was blinded to the clinical data (17). The echocardiographic measures included LVEDD, left atrial diameter, ejection fraction, LV isovolumic relaxation time, E/A ratio, interventricular septal thickness (IVST), and LV posterior wall thickness (PWT).…”

Section: Assessment and Definitions Of Clinical Covariatesmentioning

confidence: 99%

Adiponectin and cardiac geometry and function in elderly: results from two community-based cohort studies

Gustafsson

Lind

Zethelius

et al. 2010

European Journal of Endocrinology

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Objective: Several smaller studies have indicated that adiponectin might be associated with left ventricular (LV) mass and function, but community-based studies with adequate sample size and adjustment for potential confounders are lacking. Our objective was to investigate such associations in two large community-based studies of elderly. Design: Cross-sectional. Methods: We evaluated cross-sectional relations between serum adiponectin and echocardiographic measures of cardiac geometry and function (LV mass index, LV relative wall thickness, LV end-diastolic diameter, left atrial diameter, ejection fraction, LV isovolumic relaxation time, and E/A ratio) in 954 70-year-old participants (50% women) of the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS), and in 427 71-year-old men from the Uppsala Longitudinal Study of Adult Men (ULSAM). Results: In models adjusted for age, sex, body mass index, systolic blood pressure, antihypertensive treatment, antidiabetic treatment, lipid-lowering medication, fasting blood glucose, total cholesterol, high-density lipoprotein cholesterol, creatinine, and smoking, adiponectin was inversely associated with ejection fraction in men (b, K1.62; 95% confidence interval (CI), K2.50, K0.75 in PIVUS; b, K1.35; 95% CI, K2.41, K0.29 in ULSAM), but not in women. After additional adjustment for N-terminal pro-brain natriuretic peptide (NT-proBNP), the association between adiponectin and ejection fraction was attenuated (b, K0.98; 95% CI, K1.86, K0.10 in PIVUS; b, K0.75; 95% CI, K1.84, 0.35 in ULSAM). Conclusions: Serum adiponectin concentrations were associated with ejection fraction in men, and these associations were partially attenuated by NT-proBNP. Our results imply that adiponectin may be associated with systolic function through pathways that involve natriuretic peptides.

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Blood pressure-independent relations of left ventricular geometry to the metabolic syndrome and insulin resistance: a population-based study

Abstract: Left ventricular mass and relative wall thickness were increased in persons with the metabolic syndrome and were related to HOMA-IR in a large population-based sample of men and women of the same age, accounting for covariates including intra-arterial blood pressure levels.

Cited by 45 publications

References 32 publications

Left ventricular remodelling in asymptomatic HIV infection on chronic HAART: comparison between hypertensive and normotensive subjects with and without HIV infection

Left ventricular remodelling in asymptomatic HIV infection on chronic HAART: comparison between hypertensive and normotensive subjects with and without HIV infection

Factors Influencing the 99th Percentile of Cardiac Troponin I Evaluated in Community-Dwelling Individuals at 70 and 75 Years of Age

Adiponectin and cardiac geometry and function in elderly: results from two community-based cohort studies

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