Abstract
Brachial flow-mediated dilation (FMD) is a measure of endothelial nitric oxide bioavailability. Endothelial nitric oxide controls vascular tone and is likely to modify the ventricular muscle coupling mechanism. The association between left ventricular mass and FMD is not well understood. We assessed the association between left ventricular mass index (LVMI) and FMD in participants of the Multi-Ethnic Study of Atherosclerosis (MESA). MESA is a population-based study of 6814 adults free of clinical cardiovascular disease at baseline who were recruited from six US clinics. LVMI (left ventricular mass per body surface area) and FMD were measured in 2447 subjects. Linear regression analysis was used to evaluate the association. The subjects had a mean age of 61.2±9.9 years, 51.2% females with 34.3% Caucasians, 21.6% Chinese, 19.4% African Americans and 24.7% Hispanics. The mean body mass index (BMI) was 27.4±4.8 kg m−2, 9.4% had diabetes, 11% were current smokers and 38% hypertensives. The mean±s.d. LVMI was 78.1±15.9 g m−2 and mean±s.d. FMD was 4.4%±2.8%. In univariate analysis, LVMI was inversely correlated with FMD (r= −0.20, P<0.0001). In the multivariable analysis, LVMI was associated with FMD (β coefficient (se) = −0.50 (0.11), P<0.001 (0.5 g m−2 reduction in LVMI per 1% increase in FMD)) after adjusting for age, gender, race/ethnicity, systolic blood pressure, diabetes mellitus, smoking, weight, statin use, antihypertensive medication use, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol. The association between brachial flow mediated dilation and LVMI maybe independent of traditional CV risk factors in population based adults.
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References
Cotton JM, Kearney MT, MacCarthy PA, Grocott-Mason RM, McClean DR, Heymes C et al. Effects of nitric oxide synthase inhibition on basal function and the force-frequency relationship in the normal and the failing human heart in vivo. Circulation 2001; 104: 2318–2323.
Piacentino III V, Weber CR, Chen X, Weisser-Thomas J, Margulies KB, Bers DM et al. Cellular basis of abnormal calcium transients of the failing human ventricular myocytes. Circ Res 2003; 92: 651–658.
Calderone A, Thaik CM, Takahashi N, Chang DL, Colucci WS . Nitric oxide, atrial natruiretic peptide, and cyclic GMP inhibits the growth-promoting effects of norepinephrine in cardiac myocytes and fibroblasts. J Clin Invest 1998; 101: 812–818.
Joannides R, Haefeli WE, Linder L, Richard V, Bakkali EH, Thuillez C et al. Nitric oxide is responsible for flow-dependent dilation of human peripheral conduit arteries in vivo. Circulation 1995; 91: 1314–1319.
Furchgott RF, Vanhoutte PM . Endothelium derived relaxing and contracting factors. FASEB J 1989; 3: 2007–2018.
Gardin JM, Wagenknecht LE, Anton- Culver H, Flack J, Gidding S, Kurosaki T et al. Relationship of cardiovascular risk factors to echocardiographic left ventricular mass in healthy young black and white adults men and women. The CARDIA study. Circulation 1995; 92: 381–387.
Haider AW, Larson MG, Benjamin EJ, Levy D . Increased left ventricular mass and hypertrophy are associated with increased risk for sudden death. J Am Coll Cardiol 1998; 32: 1454–1459.
Koren MJ, Devereux RB, Casale PN, Savage DD, Laragh JH . Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med 1991; 114: 345–352.
Bikkina M, Levy D, Evans JC, Larson MG, Benjamin EJ, Wolf PA et al. Left ventricular mass and risk of stroke in an elderly cohort. The Framingham Heart Study. JAMA 1994; 272: 33–36.
Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP . Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 1990; 322: 1561–1566.
Hoffman U, Globits S, Stefenelli T, Loewe C, Kostner K, Frank H . The effects of ACE inhibitor therapy on left ventricular myocardial mass and diastolic filling in previously untreated hypertensive patients: a cine MRI study. J Magn Reson Imaging 2001; 14: 16–22.
Su SF, Hsiao CL, Chu CW, Lee BC, Lee TM . Effects of pravastatin on left ventricular mass in patients with hyperlipidemia and essential hypertension. Am J Cardiol 2000; 86: 514–518.
Gokce N, Keaney Jr JF, Hunter LM . Predictive value of noninvasively determined endothelial dysfunction for long term cardiovascular events in patients with peripheral vascular disease. J Am Coll Cardiol 2003; 41: 1769–1775.
Yeboah J, Crouse JR, Hsu F, Burke GL, Herrington DM . Brachial Flow-mediated dilation predicts incident cardiovascular events in older adults: The Cardiovascular Health Study. Circulation 2007; 115 (18): 2390–2397.
Arcaro G, Zenere BM, Saggiani F, Zenti MG, Monauni T, Lechi A et al. ACE inhibitiors improve endothelial function in type 1 diabetic patients with normal arterial pressure and microalbuminuria. Diabetes Care 1999; 22: 1536–1542.
Taneva E, Borucki K, Weins L, Makarova R, Schmidt- Lucke C, Westphal S . Early effects on endothelial function of atorvastatin 40 mg twice daily and its withdrawal. Am J Cardiol 2006; 97: 1002–1006.
Perticone F, Maio R, Ceravolo R, Cosco C, Cloro C, Mattioli PL . Relationship between left ventricular mass and endothelial-dependent vasodilation in never treated hypertensive patients. Circulation 1999; 99: 1991–1996.
Sung J, Ouyang P, Bacher AC, Turner KL, DeRegis JR, Hees PS, et al., Stewart KJ Peripheral endothelium- dependent flow-mediated vasodilation is associated with left ventricular mass in older persons with hypertension. Am Heart J 2002; 144: 39–44.
Millgard J, Hagg A, Kahan T, Landelius J, Malmqvist K, Sarabi M et al. Left ventricular hypertrophy is associated with attenuated endothelium dependent vasodilation in hypertensive men. Blood Press 2000; 9: 309–314.
Muiesan ML, Salvetti M, Monteduro C, Corbellini C, Guelfi D, Rozzoni D et al. Flow-mediated dilatation of the brachial artery and left ventricular geometry in hypertensive patients. J Hypertens 2001; 19: 641–647.
Bild DE, Bluemke DA, Burke GL, Detrano R, Diez Roux AV, Folsom AR et al. Multi-Ethnic Study of Atherosclerosis: objectives and design. Am J Epidemiol 2002; 156: 871–881.
Friedewald WT, Levy RI, Fredrickson DS . Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18: 499–502.
Loehr LR, Espeland MA, Sutton-Tyrrell K, Burke GL, Crouse JR, Herrington DM . Racial differences in endothelial function in postmenopausal women. Am Heart J 2004; 48: 505–511.
Natori S, Lai S, Finn JP, Gomes AS, Hundley WG, Jerosch-Herold M et al. Cardiovascular function in Multi-Ethnic Study of Atherosclerosis: normal values by age, sex, and ethnicity. Am J Roentgenol 2006; 186: S357–S365.
Alfakih K, Plein S, Thiele H, Jones T, Ridgway JP, Sivananthan MU . Normal human left and right ventricular dimensions for MRI as assessed by turbo gradient echo and steady state free procession inaging sequences. J Magn Reson Imaging 2003; 17: 323–329.
Zhao J, Cheema FA, Reddy U, Bremmer JD, Su S, Goldberg J et al. Heritability of flow-mediated dilation: a twin study. J Thromb Haemost 2007; 5: 2386–2392.
Swan L, Birnie DH, Padmanabhan S, Inglis S, Connell JM, Hillis WS . The genetic determination of left ventricular mass in healthy adults. Eur Heart J 2003; 24: 577–582.
Levy D, Salomon M, D’Agostino RB, Belanger AJ, Kannel WB . Prognostic implications of baseline electrocardiographic features and their serial changes in subjects with left ventricular hypertrophy. Circulation 1994; 90: 1786–1793.
Vita JA, Keaney JF . Endothelial function abarometer for cardiovascular risk? Circulation 2002; 106: 640–664.
Khalili P, Nilsson PM, Nilsson JA, Berglund G . Smoking as a modifier of the systolic blood pressure-induced risk of cardiovascular events and mortality: a population-based prospeactive study of middle-aged men. J Hypertens 2002; 20: 1699–1701.
Jatoi NA, Jerrard-Dunne P, Feely J, Mahmud A . Impact of smoking and smoking cessation on arterial stiffness and aortic wave reflection in hypertension. Hypertension 2007; 49: 981–985.
Acknowledgements
This research was supported by contracts N01-HC-95159 through N01-HC-95166 and N01-HC-95169, and grants NHLBI T32 HL076132, all from the National Heart, Lung and Blood Institute, Bethesda, MD, USA.
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Yeboah, J., Crouse, J., Bluemke, D. et al. Endothelial dysfunction is associated with left ventricular mass (assessed using MRI) in an adult population (MESA). J Hum Hypertens 25, 25–31 (2011). https://doi.org/10.1038/jhh.2010.25
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DOI: https://doi.org/10.1038/jhh.2010.25
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