Ambulatory blood pressure, procolagen amino-terminal polypeptide (P-III-P) and hemorreologyc parameters
Abstract
The aim of this work is to study the relationships between blood pressure profile, cardiac manifestations of high blood pressure and P-III-P as an index of fibrosis. We studied hypertensives without other diseases using echocardiography (M and B mode, and Doppler), ABPM using a Spacelabs 9000, and plasma levels of P-III-P. The model ANOVA, one way, was used for the statistical analysis. The level of significance was accepted for p<0.01 (two-tailed probabilities). The 73 hypertensives studied were divided in two subgroups: dippers (49 subjects) and non-dippers (21 subjects). The non-dipper group had an higher degree of left ventricular hypertrophy obtained by the higher measurement of the inter-ventricular septum thickness (p<0.01), posterior wall thickness (p<0.01), and an higher index of left ventricular mass (p<0.01) then the dippers, they also had higher levels of fibrinogen (p<0,01) and higher plasma levels of P-III-P then dippers (p<0.01). It was found a correlation between the fibrinogen, P-III-P levels and index of left ventricular mass (p<0,01). In conclusion, P-III-P might be a marker of tissue lesion, and fibrinogen might be a plasma marker of gravity of hypertension. This gravity can be express by the degree of left ventricular hypertrophy.
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DECREASED MYOCARDIAL FATTY ACID UTILIZATION IN THE ELDERLY AND IN HYPERTENSIVE LVH G. Vedala, A.M. Kates, P. Herrero, R.J. Gropler, V.G. DavilaRoman*. Washington University School of Medicine, St. Louis, MO The clinical manifestations of LVH worsen with age. Experimental models of aging suggest that this may be mediated, at least in part, by abnormalities in myocardial blood flow (MBF) and intermediary metabolism (i.e. fatty acids). Furthermore, animal models of LVH have shown a reduction in myocardial fatty acid utilization (MFAU). To determine whether abnormalities in MFAU are present in the normal elderly (E) and in patients with hypertension and LVH, measurements of MBF (ml/g/min), myocardial oxygen consumption (MVO2, m mol/g/min), and fasting MFAU ( m mol/g/min) were measured at rest using positron emission tomography in 4 patients with hypertension and LVH (age 63 68; 3 male; LV mass index 106 613 g/m 2 ), 6 normal elderly subjects (age 64 64; 4 male), and 3 normal young (Y) subjects (age 24 61; 3 male). All groups had normal exercise stress echocardiograms, fasting lipid and glucose levels, and were nondiabetic and nonsmokers. Levels of MBF, MVO2, and plasma free fatty acids were similar for all groups (p5NS for all). The MFAU (corrected for MVO2) in the normal elderly was lower compared with normal young (3.2 310 22 65.3 310 23 vs. 4.1 310 22 6 7.1 310 23 ,p50.03, respectively), and was even lower in the hypertension and LVH patients (2.3 310 22 64.2 310 23 , p50.04 vs E and p,0.01 vs Y, see figure). These results demonstrate altered metabolic function in normal aging, and these alterations are even more marked in patients of similar age with hypertension and LVH. Thus, the myocardial metabolic response to aging may predispose to the clinical cardiovascular manifestations of LVH. Key Words: Left ventricular hypertrophy; fatty acid utilization; positron emission tomography AMBULATORY BLOOD PRESSURE, PROCOLAGEN AMINO-TERMINAL POLYPEPTIDE (P-III-P) AND HEMORREOLOGYC PARAMETERS C. Moreira, P. Alcaˆntara, F. Serejo, M. Gato-Varela, V. Ramalhinho, J. Braz-Nogueira, J. Martins e Silva. Medicine I Depar. / Instituto de Bioquimica fisiolo´gica—Hosp. St a Maria/ Faculdade de Medicina de Lisboa—Portugal The aim of this work is to study the relationships between blood pressure profile, cardiac manifestations of high blood pressure and P-III-P as an index of fibrosis. We studied hypertensives without other diseases using echocardiography (M and B mode, and Doppler), ABPM using a Spacelabs 9000, and plasma levels of P-III-P. The model ANOVA, one way, was used for the statistical analysis. The level of significance was accepted for p,0.01 (twotailed probabilities). The 73 hypertensives studied were divided in two subgroups: dippers (49 subjects) and non-dippers (21 subjects). The non-dipper group had an higher degree of left ventricular hypertrophy obtained by the higher measurement of the inter-ventricular septum thickness (p,0.01), posterior wall thickness (p,0.01), and an higher index of left ventricular mass (p,0.01) then the dippers, they also had higher levels of fibrinogen (p,0,01) and higher plasma levels of P-III-P then dippers (p,0.01). It was found a correlation between the fibrinogen, P-III-P levels and index of left ventricular mass (p,0,01). In conclusion, P-III-P might be a marker of tissue lesion, and fibrinogen might be a plasma marker of gravity of hypertension. This gravity can be express by the degree of left ventricular hypertrophy. Key Words: Hypertension; ABPM; P-III-P; Echocardiography CYCLIC VARIATION OF MYOCARDIAL INTEGRATED BACKSCATTER SIGNAL OF THE HYPERTENSIVE CARDIOPATHY. COMPARISON WITH THE ATHLETE’S HEART V. Di Bello, R. Pedrinelli*, D. Giorgi, A. Bertini, A. Cioppi, E. Talini, J. Khabirinejad, M. Pallini, S. Precisi, L. Moretti, M.T. Caputo, G. Dell’Omo*, C. Giusti. Department of Internal Medicine and *Cardiology, University of Pisa, Italy Aim of the study is to analyze the ultrasonic backscatter myocardial indexes both as peak signal intensity and as cyclic variation in these two models of left ventricular hypertrophy and in a group of sedentary healthy controls. We have studied three groups of 10 subjects, all males of mean age (31.663.5), with comparable weight and height: athlete’s group (A) (all cyclists); hypertensive group (I) and control group (C). Hypertensives are selected on the basis of ambulatory blood pressure monitoring results, according to ISHWHO guidelines. All subjects have performed 2D-color Doppler echocardiography with a digital echograph Hewlett-Packard Sonos 5500, for the conventional analysis of left ventricular mass and function. With “Acoustic Densitometry” module implemented on HP echograph, we have analyze the ultrasonic myocardial integrated backscatter (IB) signal, sampled with a R.O.I. placed at interventricular septum and at posterior left ventricular wall level. We also have considered the systo-diastolic variation of backscatter as Cyclic Variation Index (CVIbs): Left ventricular mass is comparable between the A and I groups, by inclusion criteria, and significantly higher in comparison with group C (LVMbs: A: 154.5618.7; I: 146.8625.5; C: 101.4612.4; AJH 2000;13:3A–4A ORALS: Theme II: Congestive Heart Failure and Hypertension © 2000 by the American Journal of Hypertension, Ltd. 0895-7061/00/$20.00 Published by Elsevier Science, Inc. Downloaded from https://academic.oup.com/ajh/article/13/S2/3A/190851 by Faculdade de Medicina de Lisboa user on 23 October 2020