Tehran University Medical Journal

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Background: Microalbuminuria (MA) is associated with increased cardiovascular risk in hypertensive patients, but not many studies have specifically examined the effects of MA-lowering on regression of left ventricular hypertrophy (LVH) among pediatric patients with hypertension.
Methods: Fifty-five patients with essential hypertension, 11 to 19 years old were prospectively studied. All patients received concomitant therapy of hydrochlorothiazide and angiotensin-converting-enzyme inhibitor. Five patients also required angiotensin-receptor blocker to achieve the blood pressure goal. Baseline and 12-month follow-up measures of left ventricular mass index (LVMI) determined by echocardiography and urine microalbumin/creatinine ratio (MA/Cr) were collected. MA was defined as MA/Cr>30. LVH was defined as LVMI>38.6 g/m2. The primary end points were 25% or more reductions in MA and the LVMI.
Results: Weight (r=0.83), body surface area (r=0.85), body mass index (BMI) (r=0.86), systolic blood pressure (SBP) (r=0.57), diastolic blood pressure (DBP) (r=0.49), mean arterial pressure (r=0.53) and MA (r=0.87) were all univariate correlates of LVMI. In a multiple regression analysis, MA, BMI and SBP were significant correlates of LVMI. MA alone explained 76% of the variance of LVMI, whereas BMI and SBP explained only 1.6% and 0.4% of the variance, respectively. MA was the most significant correlate of follow-up LVMI after BMI and SBP were included in the overall multiple regression models.
Conclusion: MA is a strong predictor of LVH in hypertensive children and adolescents. MA-lowering halts the progression of LVH or induces its regression.

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Background: Persistence of left ventricular hypertrophy (LVH) in renal transplant recipients is associated with unfavorable outcomes. Calcineurin-inhibitor (CNI) nephrotoxicity is a major cause of morbidity and mortality after kidney transplantation. In this study we compared sirolimus (SRL) with calcineurin-inhibitor as primary immunosuppressants for the attenuation of left ventricular hypertrophy in renal transplantation recipients.

Methods: In this prospective cohort study done in Shariati Hospital in 2010, we evaluated the effects of sirolimus and CNI on LVH of 55 renal transplant recipients. The cases (19) received sirolimus while the controls (36) received CNI while being matched for age and duration of transplantation. Data regarding blood pressure (BP), hemoglobin, serum creatinine, uric acid and lipid concentrations were assessed and changes in left ventricular (LV) mass were evaluated by echocardiography over a one-year follow-up.

Results: Left ventricular mass significantly decreased (P=0.0001) in the SRL group but blood pressure did not differ between the two groups. LV mass and LV mass index both decreased significantly (P≤0.05) but the difference was not associated with changes in BP. The difference in interventricular septal thickness at end diastole (IVSD) and posterior wall diameter (PWD) were significant (P≤0.05) in the SRL group but the difference in end diastolic diameter (EDD) was not significant.

Conclusion: Conversion from CNI to SRL-based immunosuppressive therapy in RTRs is safe and SRL may decrease LVH. SRL seems to be safe and improve renal function without cardiac compromise in kidney transplant recipients.

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Results: The results showed that MDA and The relative wall thickness (RWT) decreased after 8 weeks in HIIT+ supplement and HIIT+placebo groups and TAC level and LVEDd increased significantly (P<0.05). PWd decreased significantly only in the exercise+supplement group (P<0.05). No significant difference between groups in any other variables was detected (P>0.05). Conclusion: Eight weeks of high-intensity interval training alone or with quercetin by reducing oxidative stress(increasing total antioxidant capacity (TAC) and reducing malondialdehyde (MDA) reduces level of concentric pathologic hypertrophy in men with hypertension and coronary heart disease after angioplasty. So that high-intensity interval training with quercetin supplementation has relatively more effects.