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Risk factors for left ventricular hypertrophy: role of Na(+)-Li+ countertransport
1Nucleo de Estudos de Hipertensäo de Faro, UCEH da Universidade do Algarve, Faro, Portugal.
Insights
Essential hypertension (EH) patients with left ventricular hypertrophy (LVH) face increased cardiovascular death risk. Erythrocyte NaLi countertransport activity emerged as a significant independent predictor of LVH in this patient group.
Area of Science:
- Cardiology
- Hypertension Research
- Cellular Physiology
Background:
- Left ventricular hypertrophy (LVH) is a significant predictor of cardiovascular mortality in patients with essential hypertension (EH).
- The underlying mechanisms and risk factors contributing to LVH development in EH are complex and not fully elucidated.
- Identifying novel markers for LVH could improve risk stratification and patient management.
Purpose of the Study:
- To investigate potential risk factors for LVH in a cohort of nonobese patients with essential hypertension.
- To assess the association between erythrocyte ion transport activity, intracellular sodium levels, and insulin sensitivity with left ventricular mass index (LVMI).
- To identify independent predictors of LVH in essential hypertension.
Main Methods:
- A cross-sectional study involving 28 nonobese patients with essential hypertension.
- Analysis of erythrocyte ion transport parameters: Vmax of NaLi countertransport, NaKCl cotransport, NaK-pump, and Na-leak Kp Na.
- Measurement of intracellular sodium and insulin sensitivity index, with LVMI as the dependent variable.
Main Results:
- Age, duration of EH, and Vmax of NaLi countertransport were significantly associated with LVMI in univariate analysis.
- Stepwise multiple regression identified age, duration of EH, and Vmax of NaLi countertransport as independent predictors of LVMI (R2 = 0.581, P = 0.0001).
- Specifically, Vmax of NaLi countertransport showed a significant independent association with LVMI (P = 0.032).
Conclusions:
- The NaLi countertransport, a mode of NaH exchanger activity, may serve as a valuable biomarker for LVH in essential hypertension.
- This finding suggests that NaLi countertransport activity could indicate increased cardiovascular risk in hypertensive individuals.
- Further research into the role of NaLi countertransport in cellular growth and LVH is warranted.
Abstract:
Left ventricular hypertrophy (LVH) is associated with an increase in cardiovascular death in essential hypertension (EH). The factors involved in LVH are multiple and complex. We looked for risk factors of LVH in a group of 28 nonobese patients with EH (mean age = 45.3 years). We analyzed the activity of several erythrocyte ion transports (Vmax of NaLi countertransport, NaKCl cotransport and NaK-pump, and the Na-leak Kp Na), the intracellular Na and the insulin sensitivity index. All these parameters were used as independent variables whereas the left ventricular mass index (LVMI) was used as the dependent variable. Variables showing a significant univariate correlation (age, time of EH, mean blood pressure and Vmax of NaLi countertransport) were introduced in a stepwise multiple regression model. Only age (P = 0.014), time of EH (P = 0.038) and Vmax of NaLi countertransport (P = 0.032) were independently associated with LVMI (R2 = 0.581, P = 0.0001). The NaLi CT, an operating mode of the NaH exchanger that facilitates cellular growth, may be a marker of LVH, and consequently a marker of increased cardiovascular risk.