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Increased mean aliphatic lipid chain length in left ventricular hypertrophy secondary to arterial hypertension

View Article: PubMed Central - PubMed

ABSTRACT

About 77.9 million (1 in 4) American adults have high blood pressure. High blood pressure is the primary cause of left ventricular hypertrophy (LVH), which represents a strong predictor of future heart failure and cardiovascular mortality. Previous studies have shown an altered metabolic profile in hypertensive patients with LVH. The goal of this study was to identify blood metabolomic LVH biomarkers by 1H NMR to provide novel diagnostic tools for rapid LVH detection in populations of hypertensive individuals. This cross-sectional study included 48 hypertensive patients with LVH matched with 48 hypertensive patients with normal LV size, and 24 healthy controls. Two-dimensional targeted M-mode echocardiography was performed to measure left ventricular mass index. Partial least squares discriminant analysis was used for the multivariate analysis of the 1H NMR spectral data. From the 1H NMR-based metabolomic profiling, signals coming from methylene (–CH2–) and methyl (–CH3) moieties of aliphatic chains from plasma lipids were identified as discriminant variables. The –CH2–/–CH3 ratio, an indicator of the mean length of the aliphatic lipid chains, was significantly higher (P < 0.001) in the LVH group than in the hypertensive group without LVH and controls. Receiver operating characteristic curve showed that a cutoff of 2.34 provided a 52.08% sensitivity and 85.42% specificity for discriminating LVH (AUC = 0.703, P-value < 0.001). We propose the –CH2–/–CH3 ratio from plasma aliphatic lipid chains as a biomarker for the diagnosis of left ventricular remodeling in hypertension.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of the study. The Identification Of Blood Markers For Asymptomatic Ventricular Dysfunction (IBLOMAVED) cohort was used for this study. HTN = arterial hypertension, LVH = left ventricular hypertrophy.
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Figure 1: Flow diagram of the study. The Identification Of Blood Markers For Asymptomatic Ventricular Dysfunction (IBLOMAVED) cohort was used for this study. HTN = arterial hypertension, LVH = left ventricular hypertrophy.

Mentions: The flowchart for patient inclusion is shown in Fig. 1. Patient's characteristics are shown in Table 1. Hypertensive patients were older, had a higher BMI, and were more likely to have diabetes and dyslipidemia. The sex distribution, renal function, and LV ejection fractions were similar across all cohorts. Control individuals had lower rates of diabetes, dyslipidemia, or obesity than the hypertensive cohort. However, within the hypertensive cohort the rates of these pathologies were similar. The hypertensive population had a systolic blood pressure (SBP) of 149 ± 20 mm Hg versus 125 ± 13 mm Hg for the control group. The hypertensive population with LVH received a higher total number of antihypertensive treatments in comparison to hypertensive patients with normal LV size, and, although not statistically significant, had 1 mm Hg of SBP and 4 mm Hg of diastolic blood pressure (DBP) lower than hypertensive patients with normal LV size. Patients with LV hypertrophy had greater LV mass and a LV thickness/radius ratio (h/r) of 52 ± 8, both significantly greater (P < 0.001) versus hypertensive patients without LV remodeling and compared to healthy controls. Lastly, hypertensive patients with and without LVH had higher deceleration time, early diastolic transmitral velocity to early mitral annular diastolic velocity ratio (E/Ea ratio), and left atrial area, but lower early/late ventricular filling velocities ratio (E/A ratio) compared to control. E/A ratio and LA area were not different between the 2 hypertensive groups, while LA diameter index tended to increase in the LVH group (P = 0.0567).


Increased mean aliphatic lipid chain length in left ventricular hypertrophy secondary to arterial hypertension
Flow diagram of the study. The Identification Of Blood Markers For Asymptomatic Ventricular Dysfunction (IBLOMAVED) cohort was used for this study. HTN = arterial hypertension, LVH = left ventricular hypertrophy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120887&req=5

Figure 1: Flow diagram of the study. The Identification Of Blood Markers For Asymptomatic Ventricular Dysfunction (IBLOMAVED) cohort was used for this study. HTN = arterial hypertension, LVH = left ventricular hypertrophy.
Mentions: The flowchart for patient inclusion is shown in Fig. 1. Patient's characteristics are shown in Table 1. Hypertensive patients were older, had a higher BMI, and were more likely to have diabetes and dyslipidemia. The sex distribution, renal function, and LV ejection fractions were similar across all cohorts. Control individuals had lower rates of diabetes, dyslipidemia, or obesity than the hypertensive cohort. However, within the hypertensive cohort the rates of these pathologies were similar. The hypertensive population had a systolic blood pressure (SBP) of 149 ± 20 mm Hg versus 125 ± 13 mm Hg for the control group. The hypertensive population with LVH received a higher total number of antihypertensive treatments in comparison to hypertensive patients with normal LV size, and, although not statistically significant, had 1 mm Hg of SBP and 4 mm Hg of diastolic blood pressure (DBP) lower than hypertensive patients with normal LV size. Patients with LV hypertrophy had greater LV mass and a LV thickness/radius ratio (h/r) of 52 ± 8, both significantly greater (P < 0.001) versus hypertensive patients without LV remodeling and compared to healthy controls. Lastly, hypertensive patients with and without LVH had higher deceleration time, early diastolic transmitral velocity to early mitral annular diastolic velocity ratio (E/Ea ratio), and left atrial area, but lower early/late ventricular filling velocities ratio (E/A ratio) compared to control. E/A ratio and LA area were not different between the 2 hypertensive groups, while LA diameter index tended to increase in the LVH group (P = 0.0567).

View Article: PubMed Central - PubMed

ABSTRACT

About 77.9 million (1 in 4) American adults have high blood pressure. High blood pressure is the primary cause of left ventricular hypertrophy (LVH), which represents a strong predictor of future heart failure and cardiovascular mortality. Previous studies have shown an altered metabolic profile in hypertensive patients with LVH. The goal of this study was to identify blood metabolomic LVH biomarkers by 1H NMR to provide novel diagnostic tools for rapid LVH detection in populations of hypertensive individuals. This cross-sectional study included 48 hypertensive patients with LVH matched with 48 hypertensive patients with normal LV size, and 24 healthy controls. Two-dimensional targeted M-mode echocardiography was performed to measure left ventricular mass index. Partial least squares discriminant analysis was used for the multivariate analysis of the 1H NMR spectral data. From the 1H NMR-based metabolomic profiling, signals coming from methylene (&ndash;CH2&ndash;) and methyl (&ndash;CH3) moieties of aliphatic chains from plasma lipids were identified as discriminant variables. The &ndash;CH2&ndash;/&ndash;CH3 ratio, an indicator of the mean length of the aliphatic lipid chains, was significantly higher (P&#8202;&lt;&#8202;0.001) in the LVH group than in the hypertensive group without LVH and controls. Receiver operating characteristic curve showed that a cutoff of 2.34 provided a 52.08% sensitivity and 85.42% specificity for discriminating LVH (AUC&#8202;=&#8202;0.703, P-value&#8202;&lt;&#8202;0.001). We propose the &ndash;CH2&ndash;/&ndash;CH3 ratio from plasma aliphatic lipid chains as a biomarker for the diagnosis of left ventricular remodeling in hypertension.

No MeSH data available.


Related in: MedlinePlus