1. HIT Poster session 1
- Author
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Gevaert, AB, Van Craenenbroeck, AH, Shivalkar, B, Lemmens, K, Vrints, CJ, Van Craenenbroeck, EM, Borizanova, A, Somleva, D, Zlatareva- Gronkova, N, Kinova, E, Goudev, A, Graziani, F, Camporeale, A, Pieroni, M, Pedicino, D, Laurito, MP, Verrecchia, E, Lanza, GA, Manna, R, Crea, F, Galuszka, O M, Reinthaler, M, Rutschow, S, Gross, M, Landmesser, U, Kasner, M, Stathogiannis, K, Toutouzas, K, Drakopoulou, M, Latsios, G, Synetos, A, Kaitozis, O, Trantalis, G, Mastrokostopoulos, A, Kotronias, R, Tousoulis, D, Lervik Nilsen, L C, Brekke, BB, Aase, SA, Lonnebakken, MT, Stensvag, D, Amundsen, B, Torp, H, Stoylen, A, Nishino, S, Watanabe, N, Kimura, T, Nakama, T, Furugen, M, Koiwaya, H, Ashikaga, K, Kuriyama, N, Shibata, Y, Willis, J, Augustine, DX, Knight, D, Sparey, J, Coghlan, G, Easaw, J, Venner, C, Huttin, O, Voilliot, D, Mercy, M, Villemin, T, Olivier, A, Mandry, D, Chaouat, A, Juilliere, Y, Selton-Suty, C, Luo, XX, Fang, F, Li, S, Zhang, ZH, Yu, CM, Van De Heyning, C M, Bertrand, PB, De Maeyer, C, De Bock, D, Paelinck, BP, Vrints, CJ, Claeys, MJ, Castaldi, B, Reffo, E, Balzarin, M, Zulian, F, Milanesi, O, Michalski, BW, Miskowiec, D, Kupczynska, K, Peczek, L, Nawrot, B, Lipiec, P, Kasprzak, JD, Wang, TL, Li, H, Jin, XY, Aktemur, T, Poci, N, Kaymaz, C, Dorlet, S, Huttin, O, Voilliot, D, Venner, C, Villemin, T, Manenti, V, Carillo, S, Chabot, F, Juilliere, Y, Selton-Suty, C, Verseckaite, R, Mizariene, V, Rimkeviciute, D, Bieseviciene, M, Jonkaitiene, R, Jurkevicius, R, Amzulescu, MS, Roy, C, Slimani, A, Boileau, L, De Meester, C, Vancraeynest, D, Pasquet, A, Vanoverschelde, JL, Pouleur, AC, Gerber, BL, Brecht, A, Oertelt-Prigione, S, Seeland, U, Ruecke, M, Regitz-Zagrosek, V, Stangl, V, Knebel, F, Brand, M, Laux, D, Roeing, J, Butz, T, Christ, M, Grett, M, Wennemann, R, Trappe, H- J, Galli, E, Fournet, M, Leclercq, C, Samset, E, Daubert, J-C, Donal, E, Murzilli, R, Leo, LA, Pasotti, E, Klersy, C, Moccetti, T, Faletra, FF, Bica, R, Dobre, D, Darmon, S, Dumitrescu, S, Calistru, P, Teixeira, R, Monteiro, R, Ribeiro, M, Garcia, J, Cardim, N, Goncalves, L, Schmid, J, Kaufmann, R, Grubler, MR, Verheyen, N, Weidemann, F, Binder, JS, Miglioranza, MH, Santanna, RT, Rover, MM, Leiria, T, Kalil, R, Picano, E, Gargani, L, Cherneva, ZH, Kuneva, ZK, Vasilev, DV, Gheghici, S, Ianula, R, Dasoveanu, M, Calin, C, Homentcovsci, C, Siliste, R, Pernigo, M, Bergamini, C, Mantovani, A, Bonapace, S, Lipari, P, Barbieri, E, Bonora, E, Targher, G, Rafael, D, Camarozano, AC, Pereira Da Cunha, CL, Padilha, SL, Souza, AM, and Freitas, AKE
- Abstract
Background: Preclinical diastolic dysfunction is highly prevalent in the aging population, but mechanisms for progression into heart failure with preserved ejection fraction (HFpEF) are still obscure. Recently, microvascular endothelial inflammation and endothelial dysfunction (ED) were advocated as primum movens in the development of HFpEF. Purpose: We aimed to evaluate whether ED and arterial stiffness relate to diastolic and other structural and functional cardiac parameters. This was studied in patients with chronic kidney disease (CKD), known to be prone to diastolic dysfunction and left ventricular hypertrophy. Methods: Consecutive CKD patients, without concomitant cardiovascular disease, were included. Diastolic parameters were assessed by cardiac ultrasound using E/
e ´ ratio and left atrial volume index (LAVi). Also, left ventricular mass index (LVMi) and interventricular septum thickness (IVSd) were included. Endothelial function was evaluated by flow-mediated dilation (FMD) of the brachial artery induced by hyperaemia. Arterial stiffness was assessed by measuring carotid-femoral pulsed wave velocity (PWV). Results: After exclusion of patients with normal diastolic function (n=11), 52 patients (age 53.9 ± 12.8 years, 53.2% male) were assessed, of whom 36 underwent a second analysis after 3 months (total measurements 88). Mean creatinin clearance (eGFR) was 42.9 ± 23.2 ml/min/1.73m2. Comorbidities included arterial hypertension (90.4%) and diabetes mellitus (9.6%). Mean Framingham Heart score was 18.9% ± 18.7. Endothelial function was impaired (FMD 4.64% ± 2.61), and patients showed increased arterial stiffness (PWV 8.96 m/s ± 2.18). Ratio of E/e ´ was elevated (>12) in 36.4% of measurements. LVMi was raised in 28.4%, and LAVi was elevated in 45.1%. Patients with E/e ´ >12 had impaired FMD (p=0.005) and elevated PWV (p=0.047). In bivariate correlation analysis, FMD correlated with E/e ´ (r=-0.289, p=0.010) and with IVSd (r=-0.315, p=0.005). PWV did not show a relation with any of the diastolic indices (all p>0.05). In a multiple linear regression model, accounting for age, sex, smoking, eGFR, and PWV, FMD remained independently associated to E/e ´ (ß=-0.279, p=0.011) and IVSd (ß=-0.232, p=0.026). Conclusions: In CKD patients with preclinical diastolic dysfunction, impaired endothelial function correlates with higher filling pressures and structural cardiac changes. This observation supports the paradigm that ED plays a role in the pathophysiology of diastolic dysfunction, even in an asymptomatic stage.- Published
- 2015
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