vendex and Hypertension

Left ventricular (LV) twist may be a compensatory mechanism to preserve ejection fraction (EF). In patients with hypertension, twist varies depending on the left ventricle's degree of remodeling and systolic function; it is increased in those with hypertension with normal EF (HTNEF) and diminished in those with hypertension with low EF (HTLEF). The ratio of collagen-degradation biomarkers in patients with hypertension is higher in those with low EFs than those with preserved EFs and may contribute to remodeling and systolic dysfunction.. The aim of this study was to evaluate the relationship between these biomarkers and LV twist in 82 patients with hypertension, 41 with EFs < 50% (HTLEF group) and 41 with EFs ≥ 50% (HTNEF group). Net LV twist was measured using speckle-tracking echocardiography. Markers of collagen turnover, including serum concentrations of matrix metalloproteinase-1 (MMP1), tissue inhibitor of MMP1 (TIMP1), and the ratio of MMP1 to TIMP1, were measured.. Log TIMP1, log MMP1, and log MMP1/TIMP1 ratio levels were higher in the HTLEF group than the HTNEF group (12.3 ± 0.3 vs 11.8 ± 0.1 [P < .0001], 9.1 ± 0.3 vs 8.0 ± 0.2 [P < .0001], and -3.3 ± 0.3 vs -3.8 ± 0.2 [P < .0001], respectively). Net LV twist was lower in the HTLEF group than the HTNEF group (3.3 ± 1.1 vs 11.7 ± 0.7, P < .0001). An inverse correlation existed between log MMP1/TIMP1 and net LV twist after adjusting for age, EF, duration of heart failure, systolic blood pressure, LV mass index, and LV sphericity index at end-diastole (r = -0.43, P < .0001).. This inverse correlation between twist and loss of myocardial collagen scaffolding in patients with hypertension with heart failure suggests that the integrity of the extracellular matrix may play an important role in preserving myocardial deformation.

Topics: Collagen; Echocardiography; Female; Heart Failure; Humans; Hypertension; Male; Matrix Metalloproteinase 1; Middle Aged; Reproducibility of Results; Sensitivity and Specificity; Tissue Inhibitor of Metalloproteinase-1; Torque; Ventricular Dysfunction, Left

The aim of the study was to determine the effect of comorbidities on physical function and quality of life of patients at 3 mos after total knee arthroplasty.. Data from 140 patients who underwent a primary unilateral total knee arthroplasty were examined retrospectively. Comorbidities were osteoporosis, presarcopenia, degenerative spine disease, diabetes, and hypertension. All patients completed the following: range of motion, stair climbing test, 6-min walk test, Timed Up and Go Test, peak torque of the knee extensor and flexor, instrumental gait analysis, Western Ontario McMaster Universities Osteoarthritis Index, and EuroQoL five-dimension questionnaire.. Univariate analyses revealed that osteoporosis led to a significantly longer time to complete the stair climbing test-ascent, stair climbing test-descent, and Timed Up and Go Test and to lower scores for the 6-min walk test and peak torque of the knee extensor. Patients with degenerative spine disease showed significant negative scores for knee extension range of motion. Diabetes showed a negative correlation with peak torque of the knee extensor and knee flexion range of motion, as well as a higher Western Ontario McMaster Universities Osteoarthritis Index-stiffness score. Multivariable linear regression analysis showed that Western Ontario McMaster Universities Osteoarthritis Index-stiffness remained independently associated with diabetes. Six-minute walk test, Timed Up and Go Test, stair climbing test-ascent, and peak torque of the knee extensors showed a significant association with osteoporosis.. Comorbidities, particularly osteoporosis and diabetes, affect short-term functional outcomes 3 mos after total knee arthroplasty.

Topics: Aged; Arthroplasty, Replacement, Knee; Comorbidity; Diabetes Mellitus; Disability Evaluation; Female; Gait Analysis; Humans; Hypertension; Knee Joint; Linear Models; Male; Osteoarthritis, Knee; Osteoporosis; Postoperative Period; Quality of Life; Range of Motion, Articular; Recovery of Function; Retrospective Studies; Sarcopenia; Spinal Diseases; Stair Climbing; Time and Motion Studies; Torque; Treatment Outcome; Walk Test