Urine Albumin to Creatinine Ratio and Echocardiographic Left Ventricular Structure and Function in Patients with Essential Hypertension

Abstract

Background:Appearance of microalbuminuria, particularly in patients with hypertension, might be associated with a higher prevalence of left ventricular (LV) dysfunction and geometric abnormalities. This study was undertaken to determine whether high urine albumin to creatinine ratio (UACR) as a sensitive marker for microalbuminuria can be associated with LV hypertrophy (LVH) and systolic and diastolic LV dysfunction.Methods:The study population consisted of 125 consecutive patients with essential uncomplicated hypertension. Urine albumin and creatinine concentration was determined by standard methods. LVH was defined as a LV mass index >100 g/m2 of body surface area in women and >130 g/m2 in men. Echocardiographic LV systolic and diastolic parameters were measured.Results:The prevalence of microalbuminuria in patients with essential hypertension was 5.6 %. UACR was significantly no different in patients with LVH than in patients with normal LV geometry (21.26 ± 31.55 versus 17.80 ± 24.52 mg/mmol). No significant correlation was found between UACR measurement and systolic and diastolic function parameters, including early to late diastolic peak velocity (E/A) ratio (R=-0.192, p=0.038), early diastolic peak velocity to early mitral annulus velocity (E/E') ratio (R=-0.025, p=0.794), LV ejection fraction (R=0.008, p=0.929), and LV mass (R=-0.132, p=0.154). According to the receiver operator characteristic (ROC) curve analysis, UACR measurement was not an acceptable indicator of LVH with areas under the ROC curves 0.514 (95 % confidence interval 0.394–0.634). The optimal cut-off value for UACR for predicting LVH was identified at 9.4, yielding a sensitivity of 51.6 % and a specificity of 48.3 %.Conclusion:In patients with uncomplicated essential hypertension, abnormal systolic and diastolic LV function and geometry cannot be effectively predicted by the appearance of microalbuminuria.

<p>Relationship Between Vascular Aging and Left Ventricular Concentric Geometry in Community-Dwelling Elderly: The Northern Shanghai Study</p>

“…12 Microvascular aging is common in hypertensive individuals, and people with micro-albuminuria showed higher prevalence of abnormal LV geometric patterns compared with those without micro-albuminuria. [13][14][15][16] A recent study showed that coronary artery atherosclerosis is associated with LV concentric geometry (LVCG), suggesting the greater cardiovascular risk associated with concentric remodeling and LVH. 17 A cohort study of 47,730 Koreans undergoing echocardiography revealed that mildly decreased estimated glomerular filtration rate (eGFR) had increased probability of LV geometry change represented by abnormal relative wall thickness (RWT).…”

Stem cell therapy for enhancement of bone consolidation in distraction osteogenesis

“…As shown in Table III, different cell sources were used: autologous or allogenic bone marrow MSCs from long bone 16,20,37,43,45,48,50–52 and iliac crest, 30,38,44,46,47 autologous adipose stem cells, 48,52 and location not specified. 15,49 The number of transplanted cells ranged from 1 to 30×10 6 .…”

“…15,49 The number of transplanted cells ranged from 1 to 30×10 6 . The cell injection timing included three different time points: in three studies, MSCs were injected during the distraction phase 15,37,49 or during the consolidation phase; 30,38,43,44,45,47,48,51 in three studies, the MSCs were injected on the day of the operation; 16,20,50 and in one study the time of injection was not stated 52 . The majority of the studies reported that MSC transplantation at the end of the lengthening phase with MSCs over 1 x 10 6 enhanced bone consolidation or formation in DO in animal models.…”

“…We know much more about the role of gender in medicine, such as the fact that women are more sensitive to cardiological medicine 38 and women who are lactating may have worsened symptoms. With the increasing demand to eliminate gender bias in animal studies, 39 future efforts are warranted to clarify gender-related differences of cell therapy in DO.…”