Association between cardiovascular autonomic neuropathy and left ventricular hypertrophy in young patients with congenital generalized lipodystrophy

Ponte, Carlos Roger Sales da; Fernandes, Virgínia Oliveira; Liberato, Christiane Bezerra Rocha; Montenegro, Ana Paula Dias Rangel; Batista, Lívia Aline de Araújo; Gurgel, Maria Helane Costa; Karbage, Lia Beatriz de Azevedo Souza; Vasconcelos, Izabella Tamira Galdino Farias; d’Alva, Catarina Brasil; Júnior, Renan Magalhães Montenegro

doi:10.1186/s13098-019-0444-8

Cited by 9 publications

(12 citation statements)

References 43 publications

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“…Tadic et al [39][40][41] performed 3 studies indicating HRV indices were significantly associated with findings of 2-and 3-dimensional echocardiography. Ponte et al [42] found that HF was significantly lower in patients with left ventricular hypertrophy. However, a Portuguese study showed no correlation was found between HRV and echocardiographic measurements in hypertrophic cardiomyopathy patients [43].…”

Section: Hrv and Echocardiographic Aspectsmentioning

confidence: 97%

Heart Rate Variability and Prognosis in Hemodialysis Patients: A Meta-Analysis

et al. 2020

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Background: Heart rate variability (HRV) means the variation in time of beat-to-beat interval. Lower HRV has been shown to be related with death and cardiovascular events in previous studies. In the last few years, the number of patients with ESRD has increased steadily. Maintenance hemodialysis is the most prevalent renal replacement therapy in patients with ESRD. This study aims to investigate if decreased HRV is an independent predictor of mortality in maintenance hemodialysis patients. Methods: Pubmed/Medline, EMBASE, Ovid, the Web of Science, and the Cochrane Central Register of Controlled Trials databases were searched up to October 1, 2019, for full-text articles in English. Cohort studies reporting the association between HRV and prognosis in hemodialysis patients were selected. Data extraction was performed by 2 reviewers independently, with adjudication by a third reviewer. Extracted data included the study characteristics, HRV measurement and research outcomes. Hazard ratios (HRs) and 95% confidence interval (CI) were pooled in a random-effects model for outcomes of all-cause and cardiovascular mortality. Heterogeneity assessment, subgroup analyses, and sensitivity analysis were conducted. Results: A total of 7 studies were eligible. HRV metrics consist of SDNN, SDANN, RMSSD, pNN50, HRVTI, ULF, VLF, LF, HF, LF/HF ratio, HRT, DC, and scaling exponents α1 and α2. Decreased HRV was associated with higher all-cause mortality (HR: 1.63, 95% CI: 1.11–2.39, p = 0.014) and cardiovascular mortality (HR: 1.07, 95% CI: 1.00–1.15, p = 0.045). Among the different HRV metrics, decreased SDANN (p < 0.001) and decreased LF/HF ratio (p = 0.001) were identified as predictors of all-cause death. Decreased SDNN, SDANN, and LF/HF ratio were identified as predictors of cardiovascular death (p = 0.004, p = 0.001, and p = 0.002). Conclusions: Decreased HRV is associated with higher risk of all-cause and cardiovascular death in the hemodialysis population. Decreased SDANN and LF/HF were identified as predictors of both all-cause and cardiovascular mortality, while the utility of other HRV metrics requires further investigation. The protocol for this study was registered with PROSPERO (CRD42019141886).

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Section: Hrv and Echocardiographic Aspectsmentioning

confidence: 97%

Heart Rate Variability and Prognosis in Hemodialysis Patients: A Meta-Analysis

et al. 2020

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“…Moreover, these pathophysiological changes in cardiomyocytes determine the risk factors for development of IR and hyperinsulinemia, resulting in a potentially vicious cycle, which gives rise to the question: does HF cause T2D? [12] .…”

Section: Introductionmentioning

confidence: 99%

Association of arterial stiffness, N-terminal pro-brain natriuretic peptide, insulin resistance, and left ventricular diastolic dysfunction with diabetic cardiac autonomic neuropathy

Serhiyenko¹,

Serhiyenko²,

Segin³

et al. 2022

Vessel Plus

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Aim: To investigate the changes of insulin resistance (IR), parameters of arterial stiffness, concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP), and echocardiographic parameters in patients with cardiac autonomic neuropathy (CAN) and type 2 diabetes mellitus (T2D). Methods: This study recruited 44 patients with T2D (19 patients without CAN and 25 patients with CAN) and 15 healthy volunteers. Arterial stiffness, immunoreactive insulin, homeostasis model assessment IR, NT-proBNP parameters, and echocardiographic examination were assessed. Results: Development of CAN is associated with increase in NT-proBNP levels, IR parameters, and arterial stiffening. Among patients with CAN, arterial stiffness parameters were considered as high. We found out that among patients of this group, the value of brachial augmentation index was normal in 52%, elevated in 40%, and pathological in 8%; pulse wave velocity was normal in 16%, elevated in 52%, and pathological in 32% of cases. Obtained results showed that development of CAN is accompanied by more pronounced left ventricular diastolic dysfunction and by formation of left ventricular hypertrophy (LVH), mostly by concentric type. Among patients of this group concentric LVH was diagnosed among 76 % and eccentric LVH among 16% of persons. Multiple regression analysis, after controlling for age, sex, diabetes duration, blood pressure, HbA1c, and left ventricular mass index, showed an independent association of heart rate response to deep breathing with pulse wave velocity (P < 0.001). Conclusion: Development of CAN is associated with increased IR parameters, increased levels of NT-proBNP, arterial stiffening, left ventricular diastolic dysfunction, and formation of LVH, mostly by concentric type.

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“…At the morphological level, they present prominent musculature, prognathism, umbilical protrusion, acanthosis nigricans, and phlebomegaly [4][5][6][7][8]. Cardiovascular (hypertrophic cardiomyopathy, arterial hypertension, cardiovascular autonomic neuropathy, and atherosclerosis) and respiratory disturbances (respiratory muscle weakness) have been currently described in patients with CGL [4,[9][10][11][12][13]. Lipodystrophic subjects may have muscle dysfunction and several pathophysiological mechanisms may be related, including increased endoplasmic reticulum stress [14].…”

Section: Introductionmentioning

confidence: 99%

Impaired functional exercise capacity and greater cardiovascular response to the 6-min walk test in congenital generalized lipodystrophy

Medeiros

Bezerra

Cruz

et al. 2022

BMC Cardiovasc Disord

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Background Congenital Generalized Lipodystrophy (CGL) is an ultra-rare disease characterized by metabolic disorders. However, the evaluation of functional exercise capacity, cardiovascular (CV) response to exercise, and peripheral arterial disease (PAD) in CGL is scarce. Here we evaluated the performance and CV response to exercise and their association with PAD in CGL compared to healthy individuals. Methods Twelve CGL and 12 healthy subjects matched for age and gender were included. Functional exercise capacity, CV response, and PAD were measured using the six-minute walk test (6MWT) and ankle-brachial index (ABI), respectively. Results At baseline, CGL subjects showed reduced predicted walked distance (6MWD) (p = 0.009) and increased heart rate (HR), systolic (SBP), and diastolic (DBP) pressures compared to healthy subjects (p < 0.05). Most CGL subjects presented normal ABI values (1.0 ≤ ABI ≤ 1.4). Only 25% (n = 3) had ABI ≤ 0.9. CGL subjects did not present changes in ABI and blood pressure 12 months after metreleptin (MLP) replacement, but they walked a greater 6MWD than baseline (p = 0.04). Further, 6MWD and right ABI measurements were positively correlated in CGL subjects (p = 0.03). Right ABI negatively correlated with glucose, triglycerides, and VLDL-c (p < 0.05). Conclusions We observed that CGL subjects had lower functional exercise capacity and higher cardiovascular effort for similar performance of 6MWT, suggesting that strategies for decreasing exercise effort in this population should be essential. Furthermore, better physical performance was associated with high ABI in CGL. Additional studies are needed to clarify leptin's role in preserving functional exercise capacity in CGL.

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Association between cardiovascular autonomic neuropathy and left ventricular hypertrophy in young patients with congenital generalized lipodystrophy

Cited by 9 publications

References 43 publications

Heart Rate Variability and Prognosis in Hemodialysis Patients: A Meta-Analysis

Heart Rate Variability and Prognosis in Hemodialysis Patients: A Meta-Analysis

Association of arterial stiffness, N-terminal pro-brain natriuretic peptide, insulin resistance, and left ventricular diastolic dysfunction with diabetic cardiac autonomic neuropathy

Impaired functional exercise capacity and greater cardiovascular response to the 6-min walk test in congenital generalized lipodystrophy

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