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Short Communication

Free Access

Noninvasive Detection of Early Metabolic Left Ventricular Remodeling in Systemic Hypertension

Hamirani Y.S.a · Kundu B.K.b · Zhong M.b · McBride A.a · Li Y.b · Davogustto G.E.c · Taegtmeyer H.c · Bourque J.M.a, b

Author affiliations

aCardiovascular Division, Department of Medicine, and bDepartment of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Va., and cDivision of Cardiology, Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, Tex., USA

Corresponding Author

Bijoy K. Kundu, PhD

Department of Radiology and Medical Imaging

University of Virginia

Charlottesville, VA 22908 (USA)

E-Mail bkk5a@virginia.edu

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Cardiology 2016;133:157-162

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Abstract

Objectives: Hypertension (HTN) is a common cause of left ventricular hypertrophy (LVH). Sustained pressure overload induces a permanent myocardial switch from fatty-acid to glucose metabolism. In this study, we tested the hypothesis that metabolic remodeling, characterized by increased myocardial glucose uptake, precedes structural and functional remodeling in HTN-induced LVH. Methods: We recruited 31 patients: 11 with HTN only, 9 with HTN and LVH and 11 normotensive controls without LVH. Transthoracic echocardiography was performed to assess the function, mass, wall thickness and diastolic function of the left ventricle. Positron emission tomography imaging was performed, and the rate of myocardial 2-deoxy-2-[18F]fluoro-D-glucose uptake, Ki, was determined using a 3-compartment kinetic model. Results: The mean Ki values were significantly higher in HTN patients than in those with HTN and LVH (p < 0.001) and in controls (p = 0.003). The unexpected decrease in Ki with LVH may be secondary to a decreased Ki with diastolic dysfunction (DD), 0.039 ± 0.032 versus 0.072 ± 0.013 (p = 0.004). There was also a significant stepwise decrease in Ki with increasing DD grade (p = 0.04). Conclusion: Glucose metabolic remodeling is detectable in hypertensive patients before the development of LVH. Furthermore, lower glucose uptake rates are observed in patients with DD. The mechanism for this last finding requires further investigation.

© 2015 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Short Communication

Received: March 31, 2015
Accepted: September 23, 2015
Published online: November 24, 2015
Issue release date: February 2016

Number of Print Pages: 6
Number of Figures: 4
Number of Tables: 1

ISSN: 0008-6312 (Print)
eISSN: 1421-9751 (Online)

For additional information: http://www.karger.com/CRD


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