Dataset Information

Relationship Between Vascular Aging and Left Ventricular Concentric Geometry in Community-Dwelling Elderly: The Northern Shanghai Study.

ABSTRACT: Purpose:There have been few recent studies regarding vascular aging and its relationship with left ventricular (LV) geometry. Moreover, the association of abnormal LV geometry with various kinds of vascular aging has not yet been systematically analyzed. Thus, this study aimed to further elucidate this relationship. Materials and Methods:In this study, 3363 older participants (43.6% male, aged 71.1±5.9 years; 56.4% female, aged 71.1±6.1 years) derived from the Northern Shanghai Study were enrolled. Vascular aging criteria included arteriosclerosis, defined as carotid-femoral pulse wave velocity >10 m/s or brachial-ankle pulse wave velocity >1800 cm/s, and peripheral atherosclerosis, defined as ankle-brachial index <0.9, carotid artery intima-media thickness (cIMT) greater than 0.9 mm, or carotid plaque indicating carotid artery abnormality. Micro-albuminuria was defined as urinary albumin-to-creatinine ratio >30 mg/g. Decreased estimated glomerular filtration rate (eGFR) was defined as eGFR <60 mL/min/1.73 m2. Results:When vascular aging parameters were respectively adjusted for age and sex, arteriosclerosis, micro-albuminuria, and peripheral atherosclerosis were significantly associated with concentric remodeling, eccentric LV hypertrophy (LVH), and concentric LVH (P<0.045) but not with decreased eGFR or abnormal cIMT and presence of plaque. Peripheral atherosclerosis was strongly associated with LV concentric geometry (LVCG) when considering other covariates (risk factors, diseases, and treatments) (P<0.012). Conclusion:Vascular aging parameters such as arteriosclerosis, micro-albuminuria, and peripheral atherosclerosis are significantly and independently associated with LVCG in community-dwelling older Chinese population, suggesting the importance of vascular aging during early clinical assessment of abnormal LV geometry change and serious cardiovascular events.

SUBMITTER: Maimaitiaili R

PROVIDER: S-EPMC7283487 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Relationship Between Vascular Aging and Left Ventricular Concentric Geometry in Community-Dwelling Elderly: The Northern Shanghai Study.

Maimaitiaili Rusitanmujiang R Teliewubai Jiadela J Zhao Song S Tang Jiamin J Chi Chen C Zhang Yi Y Xu Yawei Y

Clinical interventions in aging 20200604

<h4>Purpose</h4>There have been few recent studies regarding vascular aging and its relationship with left ventricular (LV) geometry. Moreover, the association of abnormal LV geometry with various kinds of vascular aging has not yet been systematically analyzed. Thus, this study aimed to further elucidate this relationship.<h4>Materials and methods</h4>In this study, 3363 older participants (43.6% male, aged 71.1±5.9 years; 56.4% female, aged 71.1±6.1 years) derived from the Northern Shanghai St ...[more]

PMID: 32606625

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Project description:Background: Walking, as the most common campaign in older people, is recommended to improve their cardiovascular health. However, the direct association between weekly walking activity and asymptomatic hypertensive mediated organ damage (HMOD) remains unclear. Methods: 2,830 community-dwelling elderly subjects (over 65 years) in northern Shanghai were recruited from 2014 to 2018. Weekly walking activity was assessed by International Physical Activity Questionnaires (IPAQ). Within the framework of comprehensive cardiovascular examinations, HMOD, including left ventricular mass index, peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity, creatinine clearance rate, urinary albumin-creatinine ratio, carotid-femoral pulse wave velocity (cf-PWV), carotid intima-media thickness (CIMT), arterial plaque, and ankle-brachial index (ABI), were all evaluated. Results: 1,862 (65.8%) participants with weekly walking activity showed lower CIMT, lower cf-PWV, fewer abnormal ABI, and lower prevalence of hypertension and coronary heart disease (p < 0.05). Walking activity was negatively correlated with age and smokers (correlation coefficient: -0.066, -0.042; both p < 0.05). After adjusting for cardiovascular risk factors and concomitant diseases, walking activity was significantly associated with better indicator of most vascular HMOD in multivariate logistic regressions, including arterial stiffness [odds ratio (OR) = 0.75, p = 0.01], increased CIMT (OR = 0.70, p = 0.03), and peripheral artery disease (OR = 0.72, p = 0.005), but not cardiac or renal HMOD. Subgroup analysis further showed that walking duration ≥1 h/day was significantly associated with decreased risk of most vascular HMOD after adjustment for confounders and moderate-to-vigorous physical activity based on IPAQ (all p < 0.05). Conclusions: In the community-dwelling elderly Chinese, there was a significant negative association of weekly walking activity with vascular HMOD, but not cardiac or renal HMOD. Increased daily walking duration, but not walking frequency, was significantly associated with improved vascular HMOD. Hence, increasing daily walking duration seems to encourage a healthy lifestyle in terms of vascular protection. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT02368938.

Project description:BACKGROUND:It has been reported that the triglyceride-glucose (TyG) index may serve as a simple and credible surrogate marker of insulin resistance (IR). However, its association with macrovascular and microvascular damage is unclear. Accordingly, the objective of the present study is to investigate the association of macrovascular and microvascular damage with the TyG index. METHODS:A total of 2830 elderly participants from the Northern Shanghai Study (NSS) were enrolled. The TyG index was calculated as ln[fasting triglycerides (mg/dL)?×?fasting glucose (mg/dL)/2]. Parameters of vascular damage, including carotid-femoral pulse wave velocity (cf-PWV), brachial-ankle pulse wave velocity (ba-PWV), ankle-brachial index (ABI), carotid intima-media thickness (CMT), carotid plaque, estimated glomerular filtration rate (eGFR) and the urine albumin-to-creatinine ratio (UACR), were measured and calculated. RESULTS:In univariate logistic regression, an increased TyG index was associated with a higher risk of cf-PWV?>?10 m/s, ba-PWV?>?1800 cm/s, ABI?<?0.9, microalbuminuria (MAU) and chronic kidney disease (CKD). In multivariable logistic regression, there was a significant increase in the risk of cf-PWV?>?10 m/s (OR?=?1.86, 95% confidence interval [95% CI] 1.37-2.53, Pfor trend?<?0.001), ba-PWV?>?1800 cm/s (OR?=?1.39, [95% CI] 1.05-1.84, Pfor trend=?0.02), MAU (OR?=?1.61, [95% CI] 1.22-2.13, Pfor trend?<?0.001) and CKD (OR?=?1.67, [95% CI] 1.10-1.50, Pfor trend=?0.02) after adjustment for age, sex, BMI, waist circumference, smoking habit, hypertension, family history of premature CVD, diabetes, HDL-C, LDL-C, insulin therapy and statin therapy. However, no significant relationship was observed between the TyG index and lower extremity atherosclerosis, carotid hypertrophy or carotid plaque. CONCLUSION:An elevated TyG index was significantly associated with a higher risk of arterial stiffness and nephric microvascular damage. This conclusion lends support to the clinical significance of the TyG index for the assessment of vascular damage.

Project description:AimsNatriuretic peptides have reportedly been associated with cardiac hypertrophy and insulin resistance; however, it has not been established if B-type natriuretic peptide (BNP) is associated with either insulin resistance or cardiac remodelling in a population with normal plasma BNP levels. We investigated the relationship among plasma BNP levels, insulin resistance, and left ventricular (LV) remodelling in a population with normal physiological plasma BNP levels.Methods and resultsAmong 1632 individuals who participated in annual health checks between 2005 and 2008 in Arita-cho, Saga, Japan, 675 individuals [median (interquartile range) for age 62 (51-69) years; 227 men (34%)] with LV ejection fraction 50% and BNP level <35 pg/mL were enrolled in this study. Insulin resistance was assessed using homeostatic model assessment of insulin resistance (HOMA-IR). LV geometry, including LV concentric remodelling, was classified based on relative wall thickness (RWT) and LV mass index values derived from echocardiographic findings. Factors associated with insulin resistance and LV geometry were investigated using multiple logistic regression analysis. Tertiles of BNP were inversely associated with HOMA-IR [1st tertile, 1.33 (0.76-1.74); 2nd tertile, 1.05 (0.72-1.59); 3rd tertile, 0.95 (0.66-1.58), P = 0.005]. Lower BNP was associated with the prevalence of insulin resistance, defined as HOMA-IR ≥1.37, even after full multivariate adjustment [1 SD increment in BNP = adjusted odds ratio (aOR) 0.740; 95% confidence interval (CI) 0.601-0.912; P = 0.005]. LV concentric remodelling (RWT >0.42; LV mass index ≤115 g/m2 in men and ≤95 g/m2 in women) was observed in 107 (16%) participants, while normal LV geometry (RWT ≤0.42; LV mass index ≤115 g/m2 in men and ≤95 g/m2 in women) was seen in 423 (63%), and LV hypertrophy (LV mass index >115 g/m2 in men and >95 g/m2 in women) in 145 (21%). Both low BNP level and higher insulin resistance were independently linked to LV concentric remodelling after multivariate adjustment (1 SD increment in BNP = aOR 0.714, 95% CI 0.544-0.938, P = 0.015; HOMA-IR ≥ 1.37 vs. <1.37: aOR 1.694, 95% CI 1.004-2.857, P = 0.048, respectively).ConclusionsLower BNP levels are linked to either insulin resistance or LV concentric remodelling in a population with normal plasma BNP levels, suggesting that participants with lower natriuretic peptide level might be vulnerable to the development of metabolic disorders and LV morphological abnormalities.

Project description:Several biological pathways are activated concomitantly during left ventricular (LV) remodeling. However, the relative contribution of circulating biomarkers representing these distinct pathways to LV geometry is unclear.We evaluated 2119 Framingham Offspring Study participants (mean age, 57 years; 57% women) who underwent measurements of biomarkers of inflammation (C-reactive protein), hemostasis (fibrinogen and plasminogen activator inhibitor-1), neurohormonal activation (B-type natriuretic peptide), and renin-angiotensin-aldosterone system (aldosterone and renin modeled as a ratio [ARR]) and echocardiography at a routine examination. LV geometry was defined on the basis of sex-specific distributions of LV mass (LVM) and relative wall thickness (RWT): normal (LVM and RWT <80th percentile), concentric remodeling (LVM <80th percentile but RWT >or=80th percentile), eccentric hypertrophy (LVM >or=80th percentile but RWT <80th percentile), and concentric hypertrophy (LVM and RWT >or=80th percentile). We related the biomarker panel to LV geometry using polytomous logistic regression adjusting for clinical covariates and used backwards elimination to identify a parsimonious set of biomarkers associated with LV geometry. Modeled individually, C-reactive protein, fibrinogen, plasminogen activator inhibitor-1, and ARR were related to LV geometry (P<0.01). In multivariable analyses, the biomarker panel was significantly related to altered LV geometry (P<0.0001). On backwards elimination, logARR alone was significantly and positively associated with eccentric (odds ratio per SD increment, 1.20; 95% confidence interval, 1.05 to 1.37) and concentric LV hypertrophy (odds ratio per SD increment, 1.29; 95% confidence interval, 1.06 to 1.58).Our cross-sectional observations on a large community-based sample identified ARR as a key correlate of concentric and eccentric LV hypertrophy, consistent with a major role for the renin-angiotensin-aldosterone system in LV remodeling.

Dataset Information

Relationship Between Vascular Aging and Left Ventricular Concentric Geometry in Community-Dwelling Elderly: The Northern Shanghai Study.

Publications

Relationship Between Vascular Aging and Left Ventricular Concentric Geometry in Community-Dwelling Elderly: The Northern Shanghai Study.

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