AJH–April 2001–VOL. 14, NO. 4, PART 2
Increased 24 hr pulse pressure in untreated essential hypertension is associated with classic poor prognostic indicators (age, diabetes, coronary disease, cerebrovascular disease, non-dipping and left ventricular hypertrophy), potentially explaining the poorer prognosis seen in these patients. Interestingly, we found that it is also associated with a higher left atrial diameter, increased plasma sodium, bicarbonate and aldosterone suggesting that salt and fluid loading may be involved in the pathophysiology of an increased pulse pressure. This could explain the excellent efficacy of diuretics in the treatment of isolated systolic hypertension. Key Words: 24 hour pulse pressure, left ventricular mass, aldosterone
P-388 EFFECTS OF FIBRONECTIN ON PROLIFERATION AND COLLAGEN SYNTHESIS OF CARDIAC FIBROBLASTS FROM SPONTANEOUSLY HYPERTENSIVE RATS Liangdi Xie, Kegui Wu, Shuilong Chen, Ming Sun, Hongyan Zhou. 1 Hypertension Division, First Affiliated Hospital,Fujian Medical College, Fuzhou, Fujian, China, 2Department of Cardiology, Xiangya Hospital,Hunan Medical College, Changsha, Hunan, China This study was to investigate the effects of fibronectin (FN) on the proliferation and collagen synthesis in cultured rat cardiac fibroblasts (CFb) derived from SHR (CFbSHR) and WKY (CFbWKY). CFb derived from 12-week-old SHR and WKY was cultured by outgrowth of tissue block. Proliferation of CFb was measured by cell number counting and 3 H-TdR incoperation using 24-well plates pre-coated with 5g/cm2 FN. Collagen synthesis was determined by 3H-proline incorporation. Data expressed as mean⫾SD of 5-6 experiments performed in triplicate. It was showed that cell number was significantly increased after 72 hr incubation with FN in the presence of 10% FCS from a initial cell density of 1*104 cells/ml (CFbSHR:3.75⫾0.57 vs 2.29⫾0.29*104 cells/ml. P⬍0.01. CFb WKY : 2.42⫾0.44 vs 1.42⫾0.2*104 cells/ml.n⫽6. P⬍0.01 respectively). DNA synthesis of CFb was markedly promoted by FN(CFbSHR : 44734⫾8981 vs 29233⫾6746 cpm P⬍0.05. CFbWKY : 31461⫾6224 vs 22976⫾4782 cpm.P⬍0.05 respectively). FN induced an increase in 3 H-proline incorporation in bith CFbSHR and CFbWKY(CFbSHR: 3424⫾1145 vs 1936⫾763 cpm P⬍0.05. CFbWKY:2127⫾415 vs 1532⫾407cpm P⬍0.05 respectively).The proliferative and synthetic response to FN in CFb SHR was more significant than in CFbWKY.It is thus concluded that Fn is able to promote cell proliferation and collagen synthesis of CFb derived both from SHR and WKY. Key Words: Cardiac fibroblasts, Collagen synthesis, Fibronectin
P-389 PERICARDIAL EFFUSION AFTER FIRST ACUTE MYOCARDIAL INFARCTION M. Alam, M. Gunda, S. Borzak, F. Khaja, G. Divine, H. N. Sabbah, L. Graham, S. Goldstein. 1Henry Ford Hospital, Detroit, MI, United States The purpose of the study was to evaluate the incidence of post acute myocardial infarction pericardial effusion in the present thrombolytic/ Heparin era. Between the years 1996-1998 we prospectively performed Echocardiographic and Doppler studies in 511 patients with first acute myocardial infarction (AMI). All patients were evaluated for the presence of both anterior and posterior pericardial effusion (PE). An echocardiogram was obtained within 48 hours of AMI and also before hospital discharge. Of the 511 patients 29 (5.7%) had PE by echo. The echo and clinical variables were compared between PE and non-PE groups. The incidence of age, gender, race, Q-wave AMI, hypertension, diabetes, smoking thrombolytic and Heparin therapy were not significantly different between the 2 groups.
POSTERS: Cardiac Structure and Function
161A
Left Ventricle Variables
PE nⴝ29
No PE nⴝ482
P Value
Score Index Ejection Fraction %
1.8 ⫾ .4 48 ⫾ 7
1.6 ⫾ .4 51 ⫾ 9.7
0.03 0.01
Patients with first AMI who develop pericardial effusion have a large infarction size. Key Words: Pericardial Effusion, Acute Myocardial Infarction
P-390 PULSE PRESSURE (PP) AND EARLY SIGNS OF TARGET ORGAN DAMAGE (TOD) IN ESSENTIAL HYPERTENSION (EH) Francesca Viazzi, Giovanna Leoncini, Denise Parodi, Maura Ravera, Elena Ratto, Simone Vettoretti, Massimo Del Sette, Gianpaolo Bezante, Giacomo Deferrari, Roberto Pontremoli. 1Dept of Internal Medicine, University of Genoa, Genoa, Italy High values of PP have recently been implicated in the development and progression of large vessel atherosclerosis, small vessel disease and in the occurrence of cardiovascular (CV) events. Furthermore the ratio of stroke volume (SV) to PP, a measure of conduit vessel stiffness, has been proposed as a predictor of CV morbidity. The aim of the present study is to investigate the link between PP and subclinical organ damage in a cohort of patient (163 m, 107 f) with EH. PP was calculated as the difference between systolic and diastolic blood pressure (BP). Left ventricular mass index (LVMI), relative wall thickness (RWT) and SV were assessed by M-B mode echocardiography (LVH⫽ LVMI ⱖ51g/m2.7). Carotid intima-media thickness (IMT) was evaluated by high resolution US scan. Albuminuria was measured as albumin to creatinine ratio (ACR) in three first morning urine samples. PP was positively correlated with early signs of TOD (namely LVMI P⫽0.001, IMT P⬍0.0001 and ACR P⫽0.03) and with selected clinical variables (gender P⫽0.01, duration of disease P⫽0.001, age P⬍0.0001, total cholesterol P⬍0.0001 and LDL cholesterol P⫽0.04). Multiple linear regression analysis showed that PP and ACR independently influence LVMI (F⫽11.1229, r2 0.16, P⬍0.0001) and IMT (F⫽17.155, r2 0.28, P⬍0.0001).When data were analyzed on the basis of PP values, patients in the upper quartile showed higher LVMI (F⫽4.596, P⫽0.004), higher ACR (F⫽2.841, P⬍0.05) as well as thicker carotid walls (F⫽6.265, P⬍0.001). Furthermore patients with LVH and those with IMT values above the median showed higher values of PP (57.07⫾1.3, LVH⫹ vs 53.9⫾1.07 mmHg, LVH-; P⫽0.06; 60⫾2.3, IMT⫹ vs 54.5⫾1.2 mmHg, IMT-; P⬍0.0001). Reduced SV/PP was associated with concentric LV geometry either with or without an increase in LVMI (Remodeling, 1.25⫾0.006; Normal, 1.55⫾0.006; Concentric LVH, 1.48⫾0.006; Eccentric LVH, 1.66⫾0.006 ml; P⬍0.0001). Moreover RWT was inversely correlated with SV/PP (P⬍0.0001) suggesting a link between arterial stiffness and unfavorable cardiac geometry. In conclusion, PP is an independent marker of preclinical CV damage in EH and therefore can be useful to identify patients at higher risk of CV events. Key Words: pulse pressure, target organ damage, microalbuminuria
P-391 DIFFERENTIAL GENE EXPRESSIONS OF NATRIURETIC PEPTIDES IN LEFT VENTRICULAR HYPERTROPHY MODELS IN CONSCIOUS RATS Gabor Foldes, Istvan Szokodi, Zoltan Lako-Futo, Rudolf deChatel, Heikki Ruskoaho, Miklos Toth. 1Dept. of Pharmacology and Toxicology, University of Oulu, Oulu, Finland, 2Ist Dept. of Internal Medicine, Semmelweis University, Budapest, Hungary Increased ventricular expression of several genes, including a newly identified vasorelaxant peptide, adrenomedullin (AM), atrial- and B-type natriuretic peptide (ANP, BNP) has been documented in experimental models of cardiac hypertrophy (CH). Yet, it remained to be clarified if