BACKGROUND: In hemodialysis patients, left ventricular hypertrophy (LVH) contributes to high cardiovascular mortality. We examined cardiovascular mortality prediction by the recently proposed Peguero-Lo Presti voltage since it identifies more patients with electrocardiographic (ECG) LVH than Cornell or Sokolow-Lyon voltages. METHODS: A total of 308 patients on hemodialysis underwent 24 h ECG recordings. LVH parameters were measured before and after dialysis. The primary endpoint of cardiovascular mortality was recorded during a median 3-year follow up. Risk prediction was assessed by Cox regression, both unadjusted and adjusted for the Charlson Comorbidity Index and the Cardiovascular Mortality Risk Score. RESULTS: The Peguero-Lo Presti voltage identified with 21% the most patients with positive LVH criteria. All voltages significantly increased during dialysis. Factors such as ultrafiltration rate, Kt/V, body mass index, sex, and phosphate were the most relevant for these changes. During follow-up, 26 cardiovascular deaths occurred. Post-dialysis Peguero-Lo Presti cut-off as well as the Peguero-Lo Presti and Cornell voltages were independently associated with cardiovascular mortality in unadjusted and adjusted analysis. The Sokolow-Lyon voltage was not significantly associated with mortality. An optimal cut-off for the prediction of cardiovascular mortality was estimated at 1.38 mV for the Peguero-Lo Presti. CONCLUSIONS: The post-dialysis Peguero-Lo Presti cut-off as well as the Peguero-Lo Presti and Cornell voltages allowed independent risk prediction of cardiovascular mortality in hemodialysis patients. Measuring the ECG LVH parameters after dialysis might allow a standardized interpretation as dialysis-specific factors influence the voltages.

• Klíčová slova
• Cardiovascular mortality, Hemodialysis, Left ventricular hypertrophy, Peguero-Lo presti,
• MeSH
• dialýza ledvin škodlivé účinky   MeSH
• elektrokardiografie MeSH
• hypertenze * MeSH
• hypertrofie levé komory srdeční * diagnóza   etiologie   MeSH
• index tělesné hmotnosti MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

In Uganda, hypertension is an escalating health issue, but there is limited specific data regarding the prevalence of left ventricular hypertrophy (LVH) among hypertensive patients in eastern Uganda. This study aimed to establish the prevalence of LVH among hypertensive patients at Jinja Regional Referral Hospital. A cross-sectional study conducted at the hospital enrolled 323 participants using convenience sampling. The results revealed a prevalence rate of 19.50 % for LVH, primarily observed in male participants and younger age groups (25-35 years). Furthermore, the study found a low incidence of associated cardiac arrhythmia, with only 1.59 % of participants having atrial fibrillation. These findings indicate a relatively low burden of LVH and arrhythmia in this population, emphasizing the importance of continued efforts in hypertension management and LVH prevention. Further research and interventions are necessary to mitigate the impact of hypertension-related complications in the eastern region of Uganda.

• Klíčová slova
• Burden, Cardiac arrhythmia, Hypertension, Left ventricular hypertrophy,
• MeSH
• dospělí MeSH
• hypertenze * epidemiologie   MeSH
• hypertrofie levé komory srdeční * epidemiologie   MeSH
• incidence MeSH
• konziliární vyšetření a konzultace statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• prevalence MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• srdeční arytmie * epidemiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Uganda epidemiologie   MeSH

One hundred and forty-seven patients with essential hypertension (EH) and 126 patients with secondary arterial hypertension (AH) on the basis of chronic pyelonephritis were studied by means of radiocardiography with 131I-albumin and M-mode echocardiography. The importance of the haemodynamic type of circulation for the development of left ventricular hypertrophy (LVH) was established. Correlative analysis revealed that the influence of arterial pressure (AP) on LVH is increased by stabilization of AH, especially in patients with the normo- and hypokinetic types of circulation; interestingly, the relation between LVH and systolic pressure was closer than that between LVH and diastolic pressure, especially in patients with secondary AH. Moreover, it was shown that the development of LVH is due to a preferential increase in posterior wall thickness in essential hypertensives and in ventricular septal thickness in secondary hypertensives, although all patients with LVH had dilatation of the left ventricular cavity.

• MeSH
• dospělí MeSH
• echokardiografie MeSH
• funkce levé komory srdeční fyziologie   MeSH
• hemodynamika fyziologie   MeSH
• hypertenze diagnostické zobrazování   patofyziologie   MeSH
• hypertrofie levé komory srdeční diagnostické zobrazování   patofyziologie   MeSH
• kontrakce myokardu fyziologie   MeSH
• krevní tlak fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pyelonefritida diagnostické zobrazování   patofyziologie   MeSH
• renální hypertenze diagnostické zobrazování   patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Left-ventricular hypertrophy (LVH) is a risk factor for cardiovascular morbidity. Antihypertensive treatment with angiotensin-converting enzyme inhibitors (ACEI) is able to induce the regression of LVH in adults. However, there has been no study of the ability of ACEI to induce the regression of LVH in children. Our aim was to investigate the effect of ramipril on left-ventricular mass and blood pressure (BP) in hypertensive children. METHODS: Twenty-one children (median age, 15 years) with renal (76%) or primary (24%) hypertension were prospectively treated with ramipril monotherapy for 6 months. Blood pressure was evaluated using ambulatory BP monitoring, with hypertension defined as mean BP >or=95th percentile. Left-ventricular hypertrophy was defined either as left-ventricular mass index (LVMI) >38.6 g/m(2.7) (pediatric definition) or as LVMI >51.0 g/m(2.7) (adult definition). RESULTS: Nineteen children completed the study. The median LVMI decreased from 36.8 g/m(2.7) (range, 18.9 to 55.8 g/m(2.7)) to 32.6 g/m(2.7) (range, 19.0 to 52.1 g/m(2.7); P < .05) after 6 months. The prevalence of LVH decreased from 42% to 11% using the pediatric definition (P < .05) and did not change using the adult definition (ie, it remained at 5%). The median ambulatory BP decreased by 11, 7, 8, and 7 mm Hg for daytime systolic, daytime diastolic, nighttime systolic, and nighttime diastolic BP (P < .05), respectively. A positive correlation was found between LVMI and nighttime systolic BP at the start of the study (r = 0.46, P < .05). CONCLUSIONS: Ramipril is an effective drug in children with hypertension, for its ability to reduce not only BP but also left-ventricular mass and induce regression of LVH.

• MeSH
• dítě MeSH
• hypertenze farmakoterapie   patofyziologie   MeSH
• hypertrofie levé komory srdeční diagnostické zobrazování   farmakoterapie   patofyziologie   MeSH
• index tělesné hmotnosti MeSH
• inhibitory ACE terapeutické užití   MeSH
• ledviny patofyziologie   MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• ramipril škodlivé účinky   terapeutické užití   MeSH
• ultrasonografie MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• inhibitory ACE MeSH
• ramipril MeSH

In Uganda, hypertension is a rapidly increasing non-communicable disease with high morbidity and mortality, leading to complications such as renal failure, heart failure, stroke, and myocardial infarctions. This study aimed to determine the factors associated with left ventricular hypertrophy (LVH) among hypertensive patients at Jinja Regional Referral Hospital. A cross-sectional study was conducted among 323 participants using convenience sampling, the study utilized structured questionnaires and data was analyzed using STATA. Results indicated that factors independently associated with LVH included alcohol consumption (aOR 0.26, 95%CI 0.10-0.70, P=0.007), lack of physical exercise (aOR 0.47, 95%CI 0.23-0.94, P=0.033), Low medication adherence (aOR 0.31, 95%CI 0.13-0.71, P=0.006)., female participants who had waist-hip-ratio >0.80 (aOR 3.70, 95%CI 1.18-11.64, P=0.025), diastolic blood pressure of 100 - 109 mmHg (aOR 4.58, 95%CI 1.65-12.74, P=0.004) and diastolic blood pressure of ≤89 mmHg (aOR 3.03, 95%CI 1.03-8.89, P=0.044). The study highlights the need for better management of hypertension and lifestyle modifications to reduce LVH prevalence.

• Klíčová slova
• Hypertension factors, Hypertrophy, Left ventricular,
• MeSH
• dospělí MeSH
• hypertenze * epidemiologie   MeSH
• hypertrofie levé komory srdeční * epidemiologie   MeSH
• konziliární vyšetření a konzultace MeSH
• lidé středního věku MeSH
• lidé MeSH
• prevalence MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• srdeční arytmie * epidemiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Uganda epidemiologie   MeSH

Central blood pressure (BP) has been shown to be a better predictor of target organ damage and cardiovascular events than brachial BP. Whether central BP is a better predictor of left ventricular hypertrophy (LVH) determined by electrocardiography (ECG) is not known. Radial applanation tonometry and ECG were performed in 728 subjects from the Czech Post-MONICA Study (a randomly selected 1% population sample). LVH was determined using the Sokolow-Lyon index and Cornell product; central pressure was derived from radial pulse. Of 657 subjects included in the analysis, 17 (9.4%) below 45 years and 43 (9%) over 45 years had LVH. In multiple linear regression analysis, the Sokolow-Lyon index in younger individuals was only associated with male sex and low BMI, with no association with BP found. In older individuals, LVH was associated with higher central and brachial BP. In separate binary logistic regression analyses adjusted for covariates, the odds ratio for central systolic pressure was higher than those for brachial systolic and pulse pressure in LVH prediction. Noninvasively determined central pressure in subjects over 45 years is more strongly related to ECG LVH than brachial pressure. This further supports a closer association of central pressure with target organ damage. Voltage criteria of LVH are not independently associated with central or brachial BP in younger individuals.

• MeSH
• dospělí MeSH
• hypertenze epidemiologie   patofyziologie   MeSH
• hypertrofie levé komory srdeční diagnóza   epidemiologie   patofyziologie   MeSH
• index tělesné hmotnosti MeSH
• krevní tlak fyziologie   MeSH
• lidé MeSH
• prevalence MeSH
• sexuální faktory MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

Left ventricular hypertrophy is an important risk factor of cardiovascular complications during the course of hypertension. Increased QT dispersion is associated with sudden cardiac death in congestive heart failure and in other cardiovascular diseases. Our aim was to compare QT dispersion from routine ECG in hypertensive patients with and without left ventricular hypertrophy defined by echocardiography. Authors examined 71 hypertensives treated in our medical department. Left ventricular hypertrophy was defined by echocardiography (Penn convention) as left ventricular mass index > 134 g/m2 in men and > 110 g/m2 in women. QT dispersion was defined from routine ECG (QTmax - QTmin). Presence of LVH was found in 26 patients (mean age 59.3 years), absence of LVH in 45 patients (mean age 57.8 years). Hypertensives with secondary hypertension, hypertrophic cardiomyopathy, sings of ischemia in ECG, arrhythmias, myocardial infarction, heart failure, diabetes mellitus and patients treated by antiarrhythmic drugs of the Ic and III groups were excluded. Both groups of hypertensives were matched by demographic parameters, and by the presence of hypertension, obesity, hyperlipidemia and smoking habites. There were statistically significant longer QT dispersion and QTc dispersion (59.0 +/- 20.1 ms, 64.0 +/- 23.7 ms) in LVH-positive patients than in LVH-negative once (43.2 +/- 9.5 ms, 48.4 +/- 11.1 ms). Left ventricular hypertrophy in patients with hypertension brings usually a complicated course of the disease. Authors recommend to look after left ventricular hypertrophy presence in hypertensives as it carries much more complicated course of the disease. Measurment of QT dispersion adds farther stratificational information to these patients.

• MeSH
• dospělí MeSH
• elektrokardiografie * MeSH
• hypertenze komplikace   patofyziologie   MeSH
• hypertrofie levé komory srdeční etiologie   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

BACKGROUND: Pediatric blood pressure (BP) assessment and management is increasingly important. Uncontrolled systolic and combined hypertension leads to hypertension-mediated organ damage. The impact of isolated diastolic hypertension is less clearly understood. METHODS: We analyzed the prevalence of ambulatory isolated diastolic hypertension (IDH) in primary (PH) and secondary (SH) hypertension, and associations with BMI Z-score (BMIz) and left ventricular mass index adjusted to the 95th percentile (aLVMI) in a large, multicenter cohort of hypertensive children. Hypertensive children were divided and analyzed in three ambulatory hypertension subgroups: 24-h, daytime, and nighttime. Specifically, we sought to determine the prevalence of ambulatory 24-h, daytime, or nighttime IDH. RESULTS: Prevalence of IDH varied based on ambulatory phenotypes, ranging from 6 to 12%, and was highest in children with SH. Children with IDH tended to be more likely female and, in some cases, were leaner than those with isolated systolic hypertension (ISH). Despite previous pediatric studies suggesting no strong association between diastolic blood pressure and left ventricular hypertrophy (LVH), we observed that children with IDH were equally likely to have LVH and had comparable aLVMI to those with ISH and combined systolic-diastolic hypertension. CONCLUSIONS: In summary, ambulatory IDH appears to be a unique phenotype with a female sex, and younger age predilection, but equal risk for LVH in children with either PH or SH.

• Klíčová slova
• Ambulatory blood pressure monitoring, Children, Diastolic blood pressure, Hypertension,
• MeSH
• ambulantní monitorování krevního tlaku * MeSH
• diastola MeSH
• dítě MeSH
• hypertenze * epidemiologie   diagnóza   etiologie   MeSH
• hypertrofie levé komory srdeční * epidemiologie   etiologie   diagnóza   MeSH
• krevní tlak * MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• prevalence MeSH
• rizikové faktory MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

BACKGROUND: The spontaneously hypertensive rat (SHR) is the most widely used model of essential hypertension and is susceptible to left ventricular hypertrophy (LVH) and myocardial fibrosis. Recently, a quantitative trait locus (QTL) that influences heart interstitial fibrosis was mapped to chromosome 8. Our aim was to dissect the genetic basis of this QTL(s) predisposing SHR to hypertension, LVH, and interstitial fibrosis. METHODS: Hemodynamic and histomorphometric analyses were performed in genetically defined SHR.PD-chr.8 minimal congenic strain (PD5 subline) rats. RESULTS: The differential segment, genetically isolated within the PD5 subline, spans 788kb and contains 7 genes, including the promyelocytic leukemia zinc finger (Plzf) gene that has been implicated in hypertrophy and cardiac fibrosis. Mutant Plzf allele contains a 2,964-bp deletion in intron 2. The PD5 congenic strain, when compared with the SHR, showed significantly reduced systolic blood pressure by approximately 15mm Hg (P = 0.002), amelioration of LVH (0.23±0.02 vs. 0.39±0.02g/100g body weight; P < 0.00001), and reduced interstitial fibrosis (17,478±1,035 vs. 41,530±3,499 μm(2); P < 0.0001). The extent of amelioration of LVH and interstitial fibrosis was disproportionate to blood pressure decrease in congenic rats, suggesting an important role for genetic factors. Cardiac expression of Plzf was significantly reduced in prehypertensive (8 and 21 days) congenic animals compared with controls. CONCLUSIONS: These results provide compelling evidence of a significant role for genetic factors in regulating blood pressure, LVH, and cardiac fibrosis and identify mutant Plzf as a prominent candidate gene.

• Klíčová slova
• Plzf (promyelocytic leukemia zinc finger) gene., blood pressure, hypertension, left ventricular hypertrophy, myocardial interstitial fibrosis, quantitative trait locus, spontaneously hypertensive rat,
• MeSH
• časové faktory MeSH
• DNA vazebné proteiny genetika   metabolismus   MeSH
• fenotyp MeSH
• fibróza MeSH
• genetická predispozice k nemoci MeSH
• genetické asociační studie MeSH
• hemodynamika genetika   MeSH
• hypertenze genetika   metabolismus   patofyziologie   MeSH
• hypertrofie levé komory srdeční genetika   metabolismus   patofyziologie   MeSH
• krysa rodu Rattus MeSH
• lokus kvantitativního znaku MeSH
• modely nemocí na zvířatech MeSH
• myokard patologie   MeSH
• potkani inbrední SHR MeSH
• protein promyelocytické leukemie s motivem zinkového prstu MeSH
• regulace genové exprese MeSH
• zvířata kongenní MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• DNA vazebné proteiny MeSH
• protein promyelocytické leukemie s motivem zinkového prstu MeSH
• ZBTB16 protein, rat MeSH Prohlížeč

BACKGROUND: In chronic kidney disease (CKD), serum concentrations of fibroblast growth factor 23 (FGF23) increase progressively as glomerular filtration rate declines, while renal expression of the FGF23 coreceptor Klotho decreases. Elevated circulating FGF23 levels are strongly associated with mortality and with left ventricular hypertrophy (LVH), which is a major cause of cardiovascular death in CKD patients. The cardiac FGF23/FGF receptor (FGFR) system and its role in the development of LVH in humans have not been addressed previously. METHODS: We conducted a retrospective case-control study in 24 deceased patients with childhood-onset end-stage renal disease (dialysis: n = 17; transplanted: n = 7), and 24 age- and sex-matched control subjects. Myocardial autopsy samples of the left ventricle were evaluated for expression of endogenous FGF23, FGFR isoforms, Klotho, calcineurin and nuclear factor of activated T-cells (NFAT) by immunohistochemistry, immunofluorescence microscopy, qRT-PCR and western blotting. RESULTS: The majority of patients presented with LVH (67%). Human cardiomyocytes express full-length FGF23, and cardiac FGF23 is excessively high in patients with CKD. Enhanced myocardial expression of FGF23 in concert with Klotho deficiency strongly correlates with the presence of LVH. Cardiac FGF23 levels associate with time-averaged serum phosphate levels, up-regulation of FGFR4 and activation of the calcineurin-NFAT signaling pathway, an established mediator of cardiac remodelling and LVH. These changes are detected in patients on dialysis but not in those with a functioning kidney transplant. CONCLUSIONS: Our results indicate a strong association between LVH and enhanced expression levels of FGF23, FGFR4 and calcineurin, activation of NFAT and reduced levels of soluble Klotho in the myocardium of patients with CKD. These alterations are not observed in kidney transplant patients.

• Klíčová slova
• Klotho, chronic kidney disease, fibroblast growth factor 23, fibroblast growth factor receptor 4, left ventricular hypertrophy,
• MeSH
• biologické markery metabolismus   MeSH
• chronická renální insuficience komplikace   MeSH
• dítě MeSH
• fibroblastové růstové faktory metabolismus   MeSH
• fibroblastový růstový faktor 23 MeSH
• hypertrofie levé komory srdeční etiologie   metabolismus   patologie   MeSH
• lidé MeSH
• receptor fibroblastových růstových faktorů, typ 4 metabolismus   MeSH
• retrospektivní studie MeSH
• studie případů a kontrol MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Názvy látek
• biologické markery MeSH
• FGF23 protein, human MeSH Prohlížeč
• FGFR4 protein, human MeSH Prohlížeč
• fibroblastové růstové faktory MeSH
• fibroblastový růstový faktor 23 MeSH
• receptor fibroblastových růstových faktorů, typ 4 MeSH