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Clinical Impact of Hemorheology on Subclinical Myocardial Injury in Patients with Hypertension

BACKGROUND: The blood concentration of high-sensitivity cardiac troponin T (hs-cTnT) is a useful biomarker for myocardial injury or the pathogenesis of hypertension. Little is known about the relationship between hemorheology and myocardial injury in patients with hypertension. This cross-sectional...

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Autor principal: Hitsumoto, Takashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6225855/
https://www.ncbi.nlm.nih.gov/pubmed/30425766
http://dx.doi.org/10.14740/jocmr3652
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author Hitsumoto, Takashi
author_facet Hitsumoto, Takashi
author_sort Hitsumoto, Takashi
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description BACKGROUND: The blood concentration of high-sensitivity cardiac troponin T (hs-cTnT) is a useful biomarker for myocardial injury or the pathogenesis of hypertension. Little is known about the relationship between hemorheology and myocardial injury in patients with hypertension. This cross-sectional study aimed to clarify the clinical impact of hemorheology on subclinical myocardial injury assessed with a microchannel array flow analyzer (MC-FAN) and its impact on hs-cTnT in patients with hypertension. METHODS: A total of 447 outpatients (men: 181; women: 266; mean age: 65 ± 13 years), with no history of cardiovascular disease, including admission for heart failure, who were undergoing treatment for hypertension, were enrolled. Whole blood passage time (WBPT) as a marker of hemorheology was measured with a MC-FAN, and the relationship between hs-cTnT levels and various clinical parameters, including WBPT, was examined. RESULTS: hs-cTnT levels were detected in 400 patients (89.5%). WBPT was significantly higher in patients with detectable hs-cTnT levels than in those with undetectable hs-cTnT levels (60.5 ± 16.8 s versus 50.2 ± 14.2 s, P < 0.001). In patients with detectable hs-cTnT levels, there was a significant positive correlation between WBPT and hs-cTnT level (r = 0.33; P < 0.001). Multiple regression analysis revealed that WBPT was an independent variable when hs-cTnT was a subordinate factor (β = 0.15; P < 0.01). Receiver-operating characteristic curve analysis indicated that a cutoff value for WBPT of 55.6 s yielded the largest area under the curve (0.744; P < 0.001) for discriminating high hs-cTnT levels as ≥ 0.014 ng/mL. CONCLUSION: The results indicate that WBPT is independently associated with hs-cTnT in hypertensive patients with no history of cardiovascular events, suggesting that impairment of hemorheology in small cardiac vessels causes subclinical myocardial injury. In addition, the study suggests that progression of myocardial injury can be prevented by maintaining WBPT at approximately ≤ 55 s.
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spelling pubmed-62258552018-11-13 Clinical Impact of Hemorheology on Subclinical Myocardial Injury in Patients with Hypertension Hitsumoto, Takashi J Clin Med Res Original Article BACKGROUND: The blood concentration of high-sensitivity cardiac troponin T (hs-cTnT) is a useful biomarker for myocardial injury or the pathogenesis of hypertension. Little is known about the relationship between hemorheology and myocardial injury in patients with hypertension. This cross-sectional study aimed to clarify the clinical impact of hemorheology on subclinical myocardial injury assessed with a microchannel array flow analyzer (MC-FAN) and its impact on hs-cTnT in patients with hypertension. METHODS: A total of 447 outpatients (men: 181; women: 266; mean age: 65 ± 13 years), with no history of cardiovascular disease, including admission for heart failure, who were undergoing treatment for hypertension, were enrolled. Whole blood passage time (WBPT) as a marker of hemorheology was measured with a MC-FAN, and the relationship between hs-cTnT levels and various clinical parameters, including WBPT, was examined. RESULTS: hs-cTnT levels were detected in 400 patients (89.5%). WBPT was significantly higher in patients with detectable hs-cTnT levels than in those with undetectable hs-cTnT levels (60.5 ± 16.8 s versus 50.2 ± 14.2 s, P < 0.001). In patients with detectable hs-cTnT levels, there was a significant positive correlation between WBPT and hs-cTnT level (r = 0.33; P < 0.001). Multiple regression analysis revealed that WBPT was an independent variable when hs-cTnT was a subordinate factor (β = 0.15; P < 0.01). Receiver-operating characteristic curve analysis indicated that a cutoff value for WBPT of 55.6 s yielded the largest area under the curve (0.744; P < 0.001) for discriminating high hs-cTnT levels as ≥ 0.014 ng/mL. CONCLUSION: The results indicate that WBPT is independently associated with hs-cTnT in hypertensive patients with no history of cardiovascular events, suggesting that impairment of hemorheology in small cardiac vessels causes subclinical myocardial injury. In addition, the study suggests that progression of myocardial injury can be prevented by maintaining WBPT at approximately ≤ 55 s. Elmer Press 2018-12 2018-10-30 /pmc/articles/PMC6225855/ /pubmed/30425766 http://dx.doi.org/10.14740/jocmr3652 Text en Copyright 2018, Hitsumoto http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hitsumoto, Takashi
Clinical Impact of Hemorheology on Subclinical Myocardial Injury in Patients with Hypertension
title Clinical Impact of Hemorheology on Subclinical Myocardial Injury in Patients with Hypertension
title_full Clinical Impact of Hemorheology on Subclinical Myocardial Injury in Patients with Hypertension
title_fullStr Clinical Impact of Hemorheology on Subclinical Myocardial Injury in Patients with Hypertension
title_full_unstemmed Clinical Impact of Hemorheology on Subclinical Myocardial Injury in Patients with Hypertension
title_short Clinical Impact of Hemorheology on Subclinical Myocardial Injury in Patients with Hypertension
title_sort clinical impact of hemorheology on subclinical myocardial injury in patients with hypertension
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6225855/
https://www.ncbi.nlm.nih.gov/pubmed/30425766
http://dx.doi.org/10.14740/jocmr3652
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