Serum Uric Acid is Independently Associated with Diastolic Dysfunction in Apparently Healthy Subjects with Essential Hypertension

Georgiopoulos, Georgios; Tsioufis, Costas; Kalos, Theodoros; Magkas, Nikolaos; Roussos, Dimitris; Chrysοhoou, Christina; Sarri, G.; Syrmali, K.; Georgakopoulos, Panagiotis; Tousoulis, Dimitrios

doi:10.2174/1570161116666171226124959

Cited by 14 publications

(10 citation statements)

References 38 publications

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“…Increased diastolic dysfunction and aortic regurgitation were also observed in TAK patients ( Table 3 ). Consistent with the evidence that diastolic dysfunction is associated with increased uric acid levels ( 35 ), a marker of endothelial stress, we found that uric acid levels were significantly elevated in TAK patients with severe aortic regurgitation compared with TAK patients without dysfunction (5.06 ± 1.51/2.96 ± 0.79). Accordingly, TAK patients with moderate-severe aortic regurgitation had elevated uric acid levels compared with patients without regurgitation (6.03 ± 1.22/ 3.64 ± 1.21) or mild-to-moderate diastolic dysfunction (6.03 ± 1.22/3.18 ± 1.20) ( Figure 1A ).…”

Section: Resultssupporting

confidence: 90%

Cardiovascular Risk in Patients With Takayasu Arteritis Directly Correlates With Diastolic Dysfunction and Inflammatory Cell Infiltration in the Vessel Wall: A Clinical, ex vivo and in vitro Analysis

et al. 2022

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BackgroundTakayasu Arteritis (TAK) increases vascular stiffness and arterial resistance. Atherosclerosis leads to similar changes. We investigated possible differences in cardiovascular remodeling between these diseases and whether the differences are correlated with immune cell expression.MethodsPatients with active TAK arteritis were compared with age- and sex-matched atherosclerotic patients (Controls). In a subpopulation of TAK patients, Treg/Th17 cells were measured before (T0) and after 18 months (T18) of infliximab treatment. Echocardiogram, supraaortic Doppler ultrasound, and lymphocytogram were performed in all patients. Histological and immunohistochemical changes of the vessel wall were evaluated as well.ResultsTAK patients have increased aortic valve dysfunction and diastolic dysfunction. The degree of dysfunction appears associated with uric acid levels. A significant increase in aortic stiffness was also observed and associated with levels of peripheral T lymphocytes. CD3+ CD4+ cell infiltrates were detected in the vessel wall samples of TAK patients, whose mean percentage of Tregs was lower than Controls at T0, but increased significantly at T18. Opposite behavior was observed for Th17 cells. Finally, TAK patients were found to have an increased risk of atherosclerotic cardiovascular disease (ASCVD).ConclusionOur data suggest that different pathogenic mechanisms underlie vessel damage, including atherosclerosis, in TAK patients compared with Controls. The increased risk of ASCVD in TAK patients correlates directly with the degree of inflammatory cell infiltration in the vessel wall. Infliximab restores the normal frequency of Tregs/Th17 in TAK patients and allows a possible reduction of steroids and immunosuppressants.

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Section: Resultssupporting

confidence: 90%

Cardiovascular Risk in Patients With Takayasu Arteritis Directly Correlates With Diastolic Dysfunction and Inflammatory Cell Infiltration in the Vessel Wall: A Clinical, ex vivo and in vitro Analysis

et al. 2022

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“…Increased diastolic dysfunction and aortic regurgitation were also observed in TAK patients (Table 3). Consistent with the evidence that diastolic dysfunction is associated with increased uric acid levels [26], a marker of endothelial stress, we found that uric acid levels were significantly elevated in TAK patients with severe aortic regurgitation compared with TAK patients without dysfunction (5.06 ± 1.51/2.96 ± 0.79). Accordingly, TAK patients with moderate-severe aortic regurgitation had elevated uric acid levels compared with patients without regurgitation (6.03 ± 1.22/ 3.64 ± 1.21) or mild-to-moderate diastolic dysfunction (6.03 ± 1.22/3.18 ± 1.20) (Figure 1A).…”

Section: Baseline Features and Clinical Differencessupporting

confidence: 89%

Correlation Between Vascular Inflammation Markers, Diastolic Dysfunction and Cardiovascular Risk in Patients with Takayasu Arteritis

Cicco¹,

Desantis²,

Vacca³

et al. 2021

Preprint

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Background: Takayasu Arteritis (TAK) increases vascular stiffness and arterial resistance. Hypertension and atherosclerosis lead to similar changes. We investigated possible differences in cardiovascular remodeling between these diseases and whether the differences are correlated with immune cell expression. Methods: Patients with active TAK arteritis were compared with age- and sex-matched hypertensive and atherosclerotic patients. In a subpopulation of TAK patients, Treg/Th17 cells were measured before (T0) and after 18 months (T18) of infliximab treatment. Echocardiogram, supraaortic Doppler ultrasound, and lymphocytogram were performed in all patients. Histological and immunohistochemical evaluation of the vessel wall was performed to compare the in vivo results. Results: TAK patients have increased aortic valve dysfunction and diastolic dysfunction. These data have been associated with uric acid levels. A significant increase in aortic stiffness was also noted and associated with peripheral T lymphocyte levels. CD3+CD4+ cell infiltrates were detected in the vessel wall samples of these patients. They had a lower mean percentage of Tregs at T0 than controls, but levels increased significantly at T18. Opposite results were found in Th17 cells. Finally, TAK patients were found to have an increased risk of atherosclerotic cardiovascular disease (ASCVD). Conclusion: Our data suggest that different pathogenic mechanisms of vessel damage, including atherosclerosis, underlie TAK patients compared with control subjects. The increased risk of ASCVD in TAK patients correlates directly with the degree of inflammatory cell infiltration in the vessel wall. Infliximab restores the normal frequency of Tregs/Th17 in TAK patients and allows a possible reduction of steroids and immunosuppressants.

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“…At the same time, angiotensin receptors can also influence angiotensin type I receptors causing atrial muscle hypertrophy. The accumulation of extracellular matrix proteins leads to obvious fibrosis of the atria, which affects conduction function and triggers atrial remodeling (22,23).…”

Section: Discussionmentioning

confidence: 99%

Left heart function evaluation of patients with essential hypertension and paroxysmal atrial fibrillation by two-dimensional speckle tracking imaging combined with real-time three-dimensional ultrasound imaging

et al. 2021

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Background: This study aims to assess the value of two-dimensional speckle tracking imaging (2D-STI) combined with real-time 3-dimensional echocardiography (RT-3DE) in evaluating left heart function in patients with combined ETH and PAF. Methods: A prospective study was designed, and the research period was from January 2017 to January 2020. A PAF observation group comprised of patients with ETH and PAF, a PAF control group of patients with ETH but without PAF, and a healthy volunteer group referred to as the healthy group, each comprised of 50 patients was established. All patients underwent routine ultrasound imaging examination using 2D-STI and RT-3DE. The interventricular septum thickness (IVST), left and right atrioventricular diameter (LAD), left ventricular posterior wall thickness (PWT), left ventricular ejection fraction (LVEF), the mean left atrium peak strain (mSs, mSe, mSa), strain rate (mSRs, mSRe, mSRa), the left ventricular mass (LVM), left ventricular mass index (LVMI), and left atrial total emptying volume (LATEV), the left atrial volume index (LAVI), left atrial total emptying fraction (LATEF), left atrium expansion index (LAEI), left atrium passive ejection fraction (LAPEF), and left atrial active ejection fraction (LAAEF) were calculated. Patients in the PAF observation group received telmisartan combined with rosuvastatin after diagnosis and 12-and 24-month-follow up visits were conducted. During these visits, 2D-STI combined with RT-3DE was used to evaluate cardiac function and each patient's blood pressure was monitored. Results: Patients in the PAF observation group had a significantly longer course of ETH than patients in the PAF control group (13.5±4.4 vs. 10.32±5.6, P=0.002). The comparison of routine 2D-STI and RT-3DE ultrasound indexes among the three groups also showed significant differences (P<0.01). During the 2-year follow-up period, the IVST, LAD, PWT, and LVEF of remaining patients significantly improved as treatment progressed (P<0.05). The LAVI, LATEF, and LAEI also improved significantly as the treatment progressed (P<0.05). After 12 months of treatment, the recurrence rate of atrial fibrillation was 16.33% (8/45) and after 24 months this was 34.21% (13/38).Conclusions: Cardiac function could be evaluated comprehensively by 2D-STI combined with RT-3DE in patients with ETH combined with PAF at initial diagnosis and follow-up. Ethical approvalAll procedures performed in this study involving human participants were in accordance with the Declaration of Helsinki (as revised in 2013). The study was approved by the Clinical Ethics Committee of The Central Hospital of

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Serum Uric Acid is Independently Associated with Diastolic Dysfunction in Apparently Healthy Subjects with Essential Hypertension

Cited by 14 publications

References 38 publications

Cardiovascular Risk in Patients With Takayasu Arteritis Directly Correlates With Diastolic Dysfunction and Inflammatory Cell Infiltration in the Vessel Wall: A Clinical, ex vivo and in vitro Analysis

Cardiovascular Risk in Patients With Takayasu Arteritis Directly Correlates With Diastolic Dysfunction and Inflammatory Cell Infiltration in the Vessel Wall: A Clinical, ex vivo and in vitro Analysis

Correlation Between Vascular Inflammation Markers, Diastolic Dysfunction and Cardiovascular Risk in Patients with Takayasu Arteritis

Left heart function evaluation of patients with essential hypertension and paroxysmal atrial fibrillation by two-dimensional speckle tracking imaging combined with real-time three-dimensional ultrasound imaging

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