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GW27-e0041 Relationship between Hyperuricemia and Renal Damage and Atherogenic Index of Plasma in the patients with Primary Hypertension
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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 68, NO. 16, SUPPL S, 2016
should be aged 18 years, prescribed with warfarin for at least 3 months. Demographic characteristics and clinical information were recorded. Follow-up visits were scheduled every 1 week in 3 months for bleeding complications monitoring, which assessed using the Fihn criteria. We genotyped eight tag SNPs (rs7251296, rs4808394, rs12610962, rs3093168, rs2074901, rs2018454, rs1558139 and rs3093200) in CYP4F2. CYP2C9*3, VKORC1-1639 G>A, and CYP4F2 V433M were also genotyped. The association of the tag SNPs and the risk of bleeding complications was evaluated using Cox proportional hazard regression with adjustment for potentially confounding variables. RESULTS Among the genotyped 459 patients (mean age, 57 15 years; 54.5% men), a total of 17 major and 79 minor bleeding complications occurred over 3 months. The incidence for major bleeding complications in this cohort was 3.7%, similar to those reported previously. Of all the tested CYP4F2 polymorphisms, only the SNP rs3093168 was statistically associated with major bleeding complications. The incidence rate of major bleeding complications was significantly higher among patients with CC alleles (7.02%) than those with the CG and GG alleles (2.61%) (HR：3.63; 95%CI: 1.23-10.72; P¼0.019). No significant correlation was found between any of the CYP4F2 genotypes and the minor bleeding events. All the major bleeding complications in the patients with rs3093168 CC genotype occurred after the stabilization of warfarin anticoagulation. CONCLUSIONS The patients with rs3093168 CC alleles have a significantly higher incidence rate of major bleeding complications, for these patients, more attention needed to achieve a more safe and effective anticoagulant effect.
HYPERTENSION GW27-e0040 The Relationship Between Blood Pressure Circadian Rhythm, Brain Natriuretic Peptide and Left Ventricular Hypertrophy in the Patients with Primary Hypertension Huijuan Kou, Dengfeng Gao, Rui Ma, Xin Dong Department of Cardiology, The Second Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China OBJECTIVES To investigate the relationship between blood pressure circadian rhythm, brain natriuretic peptide (BNP) and left ventricular hypertrophy (LVH) for patients with primary hypertension. METHODS Echocardiography was performed to determine left ventricular mass index (LVMI) due to the Devereux Formula. The nocturnal blood pressure decline rate, 24 h blood pressure (24h PP) and blood pressure index (PPI) were determined by 24h-ambulatory blood pressure monitoring. A total of 349 hypertensive patients were divided into four groups including supper-dipper group defined as 20% (n¼7), dipper group as 10-20% (n¼77), non-dipper group as 0-10% (n¼173) and anti-dipper group as <0% (n¼92). The baseline demographic characteristics of patients were collected. Fasting blood sugar, blood urea nitrogen, serum cretinine, cystatin C, uric acid, blood lipids and plasma BNP level were measured. All the data were analyzed by using the SPSS 13.0 software. For all tests, P<0.05 was considered to be statistically significant. RESULTS The patients with LVH (n¼74) had significantly higher percentage of grade 3 hypertension (85.1% v.s. 46.9%), 24h SBP (134 mmHg v.s. 129 mmHg), daytime-mean SBP (134 mmHg v.s. 130 mmHg), night-mean SBP (132 mmHgv.s. 121 mmHg), 24h PP (57 mmHg v.s. 52 mmHg) and PPI (0.43 v.s. 0.41), and lower nocturnal blood pressure decline rate [(1.308.02)% v.s. (5.687.25)%] than the non-LVH patients (n¼275) (P<0.05). The LVH hypertensive group had significantly higher BNP level (87.8 pg/mL v.s. 28.8 pg/mL, P<0.001) and LVMI (135.1 g/m2 v.s. 88.7 g/m2, P<0.001) than the control group. No significant difference was observed in the BNP level among the four groups including supper-dipper, dipper, non-dipper and antidipper. However, the difference was statistically significant in the LVMI (P<0.001). Additionally, patients in the anti-dipper group had remarkably higher LVMI than those in the dipper patients (100.3 g/m2 v.s.86.3 g/m2, P<0.001) and non-dipper (100.3 g/m2 v.s.93.7 g/m2, P¼0.007). Patients in the non-dipper group had significantly higher LVMI than those in the dipper group (93.7 g/m2 v.s. 86.3 g/m2, P¼0.003). The Logistic regressions analysis suggested a significant correlation of LVMI with BNP and the grade of hypertension. CONCLUSIONS With the increasing of plasma BNP level, the left ventricular hypertrophy is closely related to abnormal blood pressure circadian rhythm and the grade of hypertension in primary hypertensive patients.
GW27-e0041 Relationship between Hyperuricemia and Renal Damage and Atherogenic Index of Plasma in the patients with Primary Hypertension Huijuan Kou, Dengfeng Gao, Rui Ma, Zhenhua Han, Xin Dong Department of Cardiology, The Second Affiliated Hospital, Xi’an Jiao Tong University School of Medicine, Xi’an, Shaanxi OBJECTIVES To investigate the relationship between hyperuricemia and renal damage and atherogenic index of plasma (AIP) in patients with primary hypertension. METHODS A total of 231 hypertensive patients were divided into two groups according to the level of uric acid in plasma. Fasting plasma glucose, BUN, Scr, MA, Cys-C, TG, TC, LDL-C, HDL-C and UA and were dynamically monitored by the automatic biochemaical analyzer. The AIP was calculated by the formula (AIP¼lgTG/HDL-c). The estimated glomerular filtration rate (eGFR) was calculated by the Cockroff-Gault formula. All the data were analyzed by using the SPSS 13.0 software. For all tests, P<0.05 was considered to be statistically significant. RESULTS The hyperuricemia group (n¼67) has significantly higher BUN (6.9 v.s. 5.5 mmol/L, P¼0.015), Scr (88.9 v.s. 68.7 m mol/L, P<0.001), MA (33.3 v.s. 11.8 mg/L, P<0.001), Cys-C levels (1.26 v.s. 0.97 mg/L, P<0.001) and lower eGFR (65.8 v.s. 84.9 mL/min, P¼0.001) level than the control group (n¼164). The AIP in hyperuricemia patients was high than the control group, however, no significant differences was observed between the two groups (0.10 v.s. 0.08, P¼0.223). The level of blood uric acid was rising with the increase of the quartile of AIP (F¼0.976, P¼0.405). The level of uric acid in plasma was correlated to the AIP (r¼0.144, P¼0.032). CONCLUSIONS The hypertensive patients with hyperuricemia were inclined to suffer from the renal target organ damage. Dynamic observation on the AIP might be helpful to identify the risk of developing atherosclerosis in the hypertensive patients with hyperuricemia. GW27-e0048 A mitochondrial mutation A8701G is associated with maternally inherited hypertension and dilated cardiomyopathy in a Chinese pedigree of a consanguineous marriage Zhu Ye, Xiang Gu Northern People’s Hospital OBJECTIVES Cardiovascular diseases, including dilated cardiomyopathy (DCM) and hypertension, are the leading cause of death around the world. The role of mitochondrial DNA (mtDNA) in the pathogenesis of these diseases has not been completely clarified. In this study, we evaluate whether the A8701G mutation is associated with maternally inherited hypertension and DCM in a Chinese pedigree of a consanguineous marriage. METHODS Fourteen subjects in a three-generation Han Chinese family with hypertension and DCM, in which consanguineous marriage was present in the parental generation, were interviewed. We divided all the family members into case (7 maternal members) and control group (7 non-maternal members) for comparison. Clinical evaluations and sequence analysis of mtDNA were obtained from all participants. Frequency differences between maternal and non-maternal members were tested to locate the disease associated mutations. RESULTS The majority of family members presented with a maternal inheritance of hypertension and DCM. Sequence analysis of mtDNA in this pedigree identified eight mtDNA mutations. Among the mutations identified, there was only one significant (P¼0.005) mutation: A8701G, which is a homoplasmic mitochondrial missense mutation in all the matrilineal relatives. There was no clear evidence for any synergistic effects between A8701G and other mutations. CONCLUSIONS The A8701G mutation may act as an inherited risk factor for the matrilineal transmission of hypertension and DCM in conjunction with genetic disorders caused by consanguineous marriage. GW27-e0059 Dissipative energy loss within the left ventricle detected by vector flow mapping in hypertension Zhang Wen, He Huang Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China OBJECTIVES To explore the dissipative energy loss (EL) within the left ventricle in hypertension by using vector flow mapping(VFM), to
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 68, NO. 16, SUPPL S, 2016
should be aged 18 years, prescribed with warfarin for at least 3 months. Demographic characteristics and clinical information were recorded. Follow-up visits were scheduled every 1 week in 3 months for bleeding complications monitoring, which assessed using the Fihn criteria. We genotyped eight tag SNPs (rs7251296, rs4808394, rs12610962, rs3093168, rs2074901, rs2018454, rs1558139 and rs3093200) in CYP4F2. CYP2C9*3, VKORC1-1639 G>A, and CYP4F2 V433M were also genotyped. The association of the tag SNPs and the risk of bleeding complications was evaluated using Cox proportional hazard regression with adjustment for potentially confounding variables. RESULTS Among the genotyped 459 patients (mean age, 57 15 years; 54.5% men), a total of 17 major and 79 minor bleeding complications occurred over 3 months. The incidence for major bleeding complications in this cohort was 3.7%, similar to those reported previously. Of all the tested CYP4F2 polymorphisms, only the SNP rs3093168 was statistically associated with major bleeding complications. The incidence rate of major bleeding complications was significantly higher among patients with CC alleles (7.02%) than those with the CG and GG alleles (2.61%) (HR：3.63; 95%CI: 1.23-10.72; P¼0.019). No significant correlation was found between any of the CYP4F2 genotypes and the minor bleeding events. All the major bleeding complications in the patients with rs3093168 CC genotype occurred after the stabilization of warfarin anticoagulation. CONCLUSIONS The patients with rs3093168 CC alleles have a significantly higher incidence rate of major bleeding complications, for these patients, more attention needed to achieve a more safe and effective anticoagulant effect.
HYPERTENSION GW27-e0040 The Relationship Between Blood Pressure Circadian Rhythm, Brain Natriuretic Peptide and Left Ventricular Hypertrophy in the Patients with Primary Hypertension Huijuan Kou, Dengfeng Gao, Rui Ma, Xin Dong Department of Cardiology, The Second Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China OBJECTIVES To investigate the relationship between blood pressure circadian rhythm, brain natriuretic peptide (BNP) and left ventricular hypertrophy (LVH) for patients with primary hypertension. METHODS Echocardiography was performed to determine left ventricular mass index (LVMI) due to the Devereux Formula. The nocturnal blood pressure decline rate, 24 h blood pressure (24h PP) and blood pressure index (PPI) were determined by 24h-ambulatory blood pressure monitoring. A total of 349 hypertensive patients were divided into four groups including supper-dipper group defined as 20% (n¼7), dipper group as 10-20% (n¼77), non-dipper group as 0-10% (n¼173) and anti-dipper group as <0% (n¼92). The baseline demographic characteristics of patients were collected. Fasting blood sugar, blood urea nitrogen, serum cretinine, cystatin C, uric acid, blood lipids and plasma BNP level were measured. All the data were analyzed by using the SPSS 13.0 software. For all tests, P<0.05 was considered to be statistically significant. RESULTS The patients with LVH (n¼74) had significantly higher percentage of grade 3 hypertension (85.1% v.s. 46.9%), 24h SBP (134 mmHg v.s. 129 mmHg), daytime-mean SBP (134 mmHg v.s. 130 mmHg), night-mean SBP (132 mmHgv.s. 121 mmHg), 24h PP (57 mmHg v.s. 52 mmHg) and PPI (0.43 v.s. 0.41), and lower nocturnal blood pressure decline rate [(1.308.02)% v.s. (5.687.25)%] than the non-LVH patients (n¼275) (P<0.05). The LVH hypertensive group had significantly higher BNP level (87.8 pg/mL v.s. 28.8 pg/mL, P<0.001) and LVMI (135.1 g/m2 v.s. 88.7 g/m2, P<0.001) than the control group. No significant difference was observed in the BNP level among the four groups including supper-dipper, dipper, non-dipper and antidipper. However, the difference was statistically significant in the LVMI (P<0.001). Additionally, patients in the anti-dipper group had remarkably higher LVMI than those in the dipper patients (100.3 g/m2 v.s.86.3 g/m2, P<0.001) and non-dipper (100.3 g/m2 v.s.93.7 g/m2, P¼0.007). Patients in the non-dipper group had significantly higher LVMI than those in the dipper group (93.7 g/m2 v.s. 86.3 g/m2, P¼0.003). The Logistic regressions analysis suggested a significant correlation of LVMI with BNP and the grade of hypertension. CONCLUSIONS With the increasing of plasma BNP level, the left ventricular hypertrophy is closely related to abnormal blood pressure circadian rhythm and the grade of hypertension in primary hypertensive patients.
GW27-e0041 Relationship between Hyperuricemia and Renal Damage and Atherogenic Index of Plasma in the patients with Primary Hypertension Huijuan Kou, Dengfeng Gao, Rui Ma, Zhenhua Han, Xin Dong Department of Cardiology, The Second Affiliated Hospital, Xi’an Jiao Tong University School of Medicine, Xi’an, Shaanxi OBJECTIVES To investigate the relationship between hyperuricemia and renal damage and atherogenic index of plasma (AIP) in patients with primary hypertension. METHODS A total of 231 hypertensive patients were divided into two groups according to the level of uric acid in plasma. Fasting plasma glucose, BUN, Scr, MA, Cys-C, TG, TC, LDL-C, HDL-C and UA and were dynamically monitored by the automatic biochemaical analyzer. The AIP was calculated by the formula (AIP¼lgTG/HDL-c). The estimated glomerular filtration rate (eGFR) was calculated by the Cockroff-Gault formula. All the data were analyzed by using the SPSS 13.0 software. For all tests, P<0.05 was considered to be statistically significant. RESULTS The hyperuricemia group (n¼67) has significantly higher BUN (6.9 v.s. 5.5 mmol/L, P¼0.015), Scr (88.9 v.s. 68.7 m mol/L, P<0.001), MA (33.3 v.s. 11.8 mg/L, P<0.001), Cys-C levels (1.26 v.s. 0.97 mg/L, P<0.001) and lower eGFR (65.8 v.s. 84.9 mL/min, P¼0.001) level than the control group (n¼164). The AIP in hyperuricemia patients was high than the control group, however, no significant differences was observed between the two groups (0.10 v.s. 0.08, P¼0.223). The level of blood uric acid was rising with the increase of the quartile of AIP (F¼0.976, P¼0.405). The level of uric acid in plasma was correlated to the AIP (r¼0.144, P¼0.032). CONCLUSIONS The hypertensive patients with hyperuricemia were inclined to suffer from the renal target organ damage. Dynamic observation on the AIP might be helpful to identify the risk of developing atherosclerosis in the hypertensive patients with hyperuricemia. GW27-e0048 A mitochondrial mutation A8701G is associated with maternally inherited hypertension and dilated cardiomyopathy in a Chinese pedigree of a consanguineous marriage Zhu Ye, Xiang Gu Northern People’s Hospital OBJECTIVES Cardiovascular diseases, including dilated cardiomyopathy (DCM) and hypertension, are the leading cause of death around the world. The role of mitochondrial DNA (mtDNA) in the pathogenesis of these diseases has not been completely clarified. In this study, we evaluate whether the A8701G mutation is associated with maternally inherited hypertension and DCM in a Chinese pedigree of a consanguineous marriage. METHODS Fourteen subjects in a three-generation Han Chinese family with hypertension and DCM, in which consanguineous marriage was present in the parental generation, were interviewed. We divided all the family members into case (7 maternal members) and control group (7 non-maternal members) for comparison. Clinical evaluations and sequence analysis of mtDNA were obtained from all participants. Frequency differences between maternal and non-maternal members were tested to locate the disease associated mutations. RESULTS The majority of family members presented with a maternal inheritance of hypertension and DCM. Sequence analysis of mtDNA in this pedigree identified eight mtDNA mutations. Among the mutations identified, there was only one significant (P¼0.005) mutation: A8701G, which is a homoplasmic mitochondrial missense mutation in all the matrilineal relatives. There was no clear evidence for any synergistic effects between A8701G and other mutations. CONCLUSIONS The A8701G mutation may act as an inherited risk factor for the matrilineal transmission of hypertension and DCM in conjunction with genetic disorders caused by consanguineous marriage. GW27-e0059 Dissipative energy loss within the left ventricle detected by vector flow mapping in hypertension Zhang Wen, He Huang Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China OBJECTIVES To explore the dissipative energy loss (EL) within the left ventricle in hypertension by using vector flow mapping(VFM), to