title: Early hypertension is associated with reduced regional cardiac function, insulin resistance, epicardial, and visceral fat.
abstract: Mild-to-moderate hypertension is often associated with insulin resistance and visceral adiposity. Whether these metabolic abnormalities have an independent impact on regional cardiac function is not known. The goal of this study was to investigate the effects of increased blood pressure, insulin resistance, and ectopic fat accumulation on the changes in peak systolic circumferential strain. Thirty-five male subjects (age: 47+/-1 years; body mass index: 28.4+/-0.6 kg m(-2); mean+/-SEM) included 13 with normal blood pressure (BP: 113+/-5/67+/-2 mm Hg), 13 with prehypertension (BP: 130+/-1/76+/-2 mm Hg), and 9 newly diagnosed with essential hypertension (BP: 150+/-2/94+/-2 mm Hg) who underwent cardiac magnetic resonance tissue tagging (MRI) and MRI quantitation of abdominal visceral and epicardial fat. Glucose tolerance, on oral glucose tolerance test, and insulin resistance were assessed along with the serum lipid profile. All of the subjects had normal glucose tolerance, left- and right-ventricular volumes, and ejection fraction. Across the BP groups, left ventricular mass tended to increase, and circumferential shortening was progressively reduced at basal, midheart, and apical segments (on average, from -17.0+/-0.5% in normal blood pressure to -15.2+/-0.7% in prehypertension to -13.6+/-0.8% in those newly diagnosed with essential hypertension; P=0.004). Reduced circumferential strain was significantly associated with raised BP independent of age (r=0.41; P=0.01) and with epicardial and visceral fat, serum triglycerides, and insulin resistance independent of age and BP. In conclusion, regional left ventricular function is already reduced at the early stages of hypertension despite the normal global cardiac function. Insulin resistance, dyslipidemia, and ectopic fat accumulation are associated with reduced regional systolic function.
authors.affiliation: Metabolism and MRI Laboratory, Consiglio Nazionale delle Ricerche Institute of Clinical Physiology, Via Moruzzi, 1-S Cataldo, 56124 Pisa, Italy. sironi@ifc.cnr.it
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Sironi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pingitore
authors.forename: Sergio
authors.initials: S
authors.lastname: Ghione
authors.forename: Daniele
authors.initials: D
authors.lastname: De Marchi
authors.forename: Barbara
authors.initials: B
authors.lastname: Scattini
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Positano
authors.forename: Elza
authors.initials: E
authors.lastname: Muscelli
authors.forename: Demetrio
authors.initials: D
authors.lastname: Ciociaro
authors.forename: Massimo
authors.initials: M
authors.lastname: Lombardi
authors.forename: Ele
authors.initials: E
authors.lastname: Ferrannini
authors.forename: Amalia
authors.initials: A
authors.lastname: Gastaldelli
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D001794:Blood Pressure; D005951:Glucose Tolerance Test; D006352:Heart Ventricles; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D010496:Pericardium; D013314:Stress, Mechanical; D013599:Systole; D016277:Ventricular Function, Left; D014781:Viscera
chemical_list: D008055:Lipids