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Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery

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Systemic Angiotensinogen Concentrations Are Independently Associated With Left Ventricular Diastolic Function in a

Aletta M E Millen¹, Angela J Woodiwiss¹, Monica Gomes¹

¹Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

American Journal of Hypertension

|October 7, 2017

Summary

Systemic angiotensinogen (AGT) concentrations are linked to left ventricular (LV) diastolic dysfunction in Black Africans. This suggests the renin-angiotensin-aldosterone system (RAAS) may influence heart function in this population.

Keywords:

angiotensinogen blood pressure hypertension left ventricular diastolic function

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Area of Science:

Cardiology
Renal Physiology
Population Health

Background:

Left ventricular (LV) diastolic dysfunction is a key feature of heart failure with preserved ejection fraction.
The renin-angiotensin-aldosterone system (RAAS) is known to impair LV diastolic function.
The specific role of systemic angiotensinogen (AGT) in this process remains unclear.

Purpose of the Study:

To investigate the association between systemic AGT concentrations and LV diastolic function.
To explore the potential contribution of systemic AGT to diastolic dysfunction in an African population.

Main Methods:

LV diastolic function assessed using myocardial tissue Doppler imaging (average e') and mitral inflow velocity (E/e') in 445 Black African participants.
Multivariate regression models adjusted for multiple demographic, clinical, and lifestyle factors.

Main Results:

Serum AGT concentrations were independently associated with E/e' (P=0.04), a marker of diastolic dysfunction.
No significant association was found between AGT and average e', nor between plasma renin and diastolic function markers.
The association between AGT and E/e' persisted after adjusting for blood pressure and other confounders.

Conclusions:

Circulating AGT levels are associated with LV diastolic function in a Black African population, independent of blood pressure.
Systemic AGT, via the RAAS, may play a significant role in the development of LV diastolic dysfunction in this demographic.
Further research is warranted to elucidate the precise mechanisms.