Reduced global longitudinal strain at rest and inadequate blood pressure response during exercise treadmill testing in male heterozygous familial hypercholesterolemia patients
Background: Heterozygous familial hypercholesterolemia (heFH) is a genetic disorder leading to premature coronary artery disease (CAD). We hypothesized that the subclinical pathophysiologic consequences of hypercholesterolemia may be detected before the occurrence of clinically overt CAD by stress t...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | International Journal of Cardiology. Hypertension |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590086221000082 |
| _version_ | 1819203850609885184 |
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| author | Vasiliki Vartela Iakovos Armenis Dimitra Leivadarou Konstantinos Toutouzas Konstantinos Makrilakis George D. Athanassopoulos George Karatasakis Genovefa Kolovou Sophia Mavrogeni Despina Perrea |
| author_facet | Vasiliki Vartela Iakovos Armenis Dimitra Leivadarou Konstantinos Toutouzas Konstantinos Makrilakis George D. Athanassopoulos George Karatasakis Genovefa Kolovou Sophia Mavrogeni Despina Perrea |
| author_sort | Vasiliki Vartela |
| collection | DOAJ |
| description | Background: Heterozygous familial hypercholesterolemia (heFH) is a genetic disorder leading to premature coronary artery disease (CAD). We hypothesized that the subclinical pathophysiologic consequences of hypercholesterolemia may be detected before the occurrence of clinically overt CAD by stress testing and myocardial strain imaging. Patients-methods: We evaluated the treadmill tests (ETTs) of 46 heFH men without known arterial hypertension/diabetes mellitus/vasculopathy like CAD and of 39 healthy men matched for age, baseline systolic/diastolic blood pressure (BP) and heart rate (HR), using Bruce protocol. Global longitudinal strain (GLS) of the left ventricle (LV) additionally to ejection fraction was obtained. Results: heFH men reached a significantly higher peak systolic and diastolic BP compared to controls (p = 0.002 and p < 0.001, respectively). Mean rate pressure product was significantly higher in heFH patients (p = 0.038). Both duration of the ETT and workload in metabolic equivalents was lower in the heFH group (p < 0.001 and p < 0.001, respectively). Baseline to peak rise of systolic and diastolic BP in heFH men was higher (p = 0.008 and p < 0.001 for systolic and diastolic BP, respectively). Furthermore, heFH men had higher rise of HR from baseline to peak, compared to controls; (p = 0.047). GLS in heHF men was slightly decreased (p = 0.014), although the ejection fraction was similar in both groups. Conclusion: heFH men have a higher rise in systolic/diastolic BP during ETT, which may reflect early, preclinical hypertension. Furthermore, slight impairment of LV GLS is present, despite the absence of apparent myocardial dysfunction in conventional 2D echocardiography. |
| first_indexed | 2024-12-23T04:26:28Z |
| format | Article |
| id | doaj.art-6598e750c9c74a1f911423b7b786fee1 |
| institution | Directory Open Access Journal |
| issn | 2590-0862 |
| language | English |
| last_indexed | 2024-12-23T04:26:28Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology. Hypertension |
| spelling | doaj.art-6598e750c9c74a1f911423b7b786fee12022-12-21T18:00:07ZengElsevierInternational Journal of Cardiology. Hypertension2590-08622021-06-019100083Reduced global longitudinal strain at rest and inadequate blood pressure response during exercise treadmill testing in male heterozygous familial hypercholesterolemia patientsVasiliki Vartela0Iakovos Armenis1Dimitra Leivadarou2Konstantinos Toutouzas3Konstantinos Makrilakis4George D. Athanassopoulos5George Karatasakis6Genovefa Kolovou7Sophia Mavrogeni8Despina Perrea9Onassis Cardiac Surgery Center, Department of Cardiology, Athens, Greece; Corresponding author. Onassis Cardiac Surgery Center, 356 Syngrou Ave, Kallithea, Athens, 17674, Greece.Onassis Cardiac Surgery Center, Department of Cardiology, Athens, GreeceHarokopio University, Athens, GreeceNational and Kapodistrian University of Athens, Medical School, Greece; Hippokration Hospital, First Department of Cardiology, National and Kapodistrian University of Athens, Medical School, GreeceInternal Medicine, National and Kapodistrian University of Athens Medical School, Greece; Hellenic Diabetes Association, Athens, Greece; Laikon Hospital, First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens Medical School, Athens, GreeceOnassis Cardiac Surgery Center, Department of Cardiology, Athens, GreeceOnassis Cardiac Surgery Center, Department of Cardiology, Athens, GreeceMetropolitan Hospital, Athens, GreeceOnassis Cardiac Surgery Center, Department of Cardiology, Athens, GreeceNational and Kapodistrian University of Athens, Division of Experimental Surgery, GreeceBackground: Heterozygous familial hypercholesterolemia (heFH) is a genetic disorder leading to premature coronary artery disease (CAD). We hypothesized that the subclinical pathophysiologic consequences of hypercholesterolemia may be detected before the occurrence of clinically overt CAD by stress testing and myocardial strain imaging. Patients-methods: We evaluated the treadmill tests (ETTs) of 46 heFH men without known arterial hypertension/diabetes mellitus/vasculopathy like CAD and of 39 healthy men matched for age, baseline systolic/diastolic blood pressure (BP) and heart rate (HR), using Bruce protocol. Global longitudinal strain (GLS) of the left ventricle (LV) additionally to ejection fraction was obtained. Results: heFH men reached a significantly higher peak systolic and diastolic BP compared to controls (p = 0.002 and p < 0.001, respectively). Mean rate pressure product was significantly higher in heFH patients (p = 0.038). Both duration of the ETT and workload in metabolic equivalents was lower in the heFH group (p < 0.001 and p < 0.001, respectively). Baseline to peak rise of systolic and diastolic BP in heFH men was higher (p = 0.008 and p < 0.001 for systolic and diastolic BP, respectively). Furthermore, heFH men had higher rise of HR from baseline to peak, compared to controls; (p = 0.047). GLS in heHF men was slightly decreased (p = 0.014), although the ejection fraction was similar in both groups. Conclusion: heFH men have a higher rise in systolic/diastolic BP during ETT, which may reflect early, preclinical hypertension. Furthermore, slight impairment of LV GLS is present, despite the absence of apparent myocardial dysfunction in conventional 2D echocardiography.http://www.sciencedirect.com/science/article/pii/S2590086221000082Heterozygous familial hypercholesterolemiaExercise treadmill testCoronary artery diseaseArterial blood pressureGlobal longitudinal strain |
| spellingShingle | Vasiliki Vartela Iakovos Armenis Dimitra Leivadarou Konstantinos Toutouzas Konstantinos Makrilakis George D. Athanassopoulos George Karatasakis Genovefa Kolovou Sophia Mavrogeni Despina Perrea Reduced global longitudinal strain at rest and inadequate blood pressure response during exercise treadmill testing in male heterozygous familial hypercholesterolemia patients International Journal of Cardiology. Hypertension Heterozygous familial hypercholesterolemia Exercise treadmill test Coronary artery disease Arterial blood pressure Global longitudinal strain |
| title | Reduced global longitudinal strain at rest and inadequate blood pressure response during exercise treadmill testing in male heterozygous familial hypercholesterolemia patients |
| title_full | Reduced global longitudinal strain at rest and inadequate blood pressure response during exercise treadmill testing in male heterozygous familial hypercholesterolemia patients |
| title_fullStr | Reduced global longitudinal strain at rest and inadequate blood pressure response during exercise treadmill testing in male heterozygous familial hypercholesterolemia patients |
| title_full_unstemmed | Reduced global longitudinal strain at rest and inadequate blood pressure response during exercise treadmill testing in male heterozygous familial hypercholesterolemia patients |
| title_short | Reduced global longitudinal strain at rest and inadequate blood pressure response during exercise treadmill testing in male heterozygous familial hypercholesterolemia patients |
| title_sort | reduced global longitudinal strain at rest and inadequate blood pressure response during exercise treadmill testing in male heterozygous familial hypercholesterolemia patients |
| topic | Heterozygous familial hypercholesterolemia Exercise treadmill test Coronary artery disease Arterial blood pressure Global longitudinal strain |
| url | http://www.sciencedirect.com/science/article/pii/S2590086221000082 |
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