Left Ventricular Function in Elderly Men: Metabolic, Hormonal, Genetic and Prognostic Implications

Heart failure and left ventricular dysfunction are major causes of morbidity and mortality. In this thesis, metabolic, hormonal, genetic and prognostic aspects of echocardiographically determined left ventricular function were investigated in a fairly large longitudinal population-based study of men. The participants were examined both at age 50 and 70 years and were followed for mortality using the national cause-of-death registry.Several factors associated with the insulin resistance syndrome predicted left ventricular systolic dysfunction independent of myocardial infarction, hypertension, diabetes and the use of cardiovascular medication after twenty years follow-up. Plasma levels of N-terminal atrial natriuretic peptide (N-ANP) were significantly increased in men with left ventricular dysfunction in comparison to healthy men. However, the diagnostic accuracy was poor due to the extensive overlapping between the groups. Relations between a haplotype of the novel hUNC-93B1 gene and the E/A-ratio were found and validated in separate samples of the cohort…


Echocardiography and left ventricular function
Insulin resistance and left ventricular function
N-ANP and left ventricular function
Genes and left ventricular functio
Aims of the study
Investigations at age 50 years
Investigations at age 70 years
Results and discussion, paper I-IV
Paper I
Paper II
Paper III
Paper IV
Future perspective Future perspective Future perspective Future perspective Future perspective
Is modulation of myocardial energy metabolism a future direction for heart failure treatment?
Future roles for the natriuretic peptides
Possibilities and pitfalls of genetic associations studies
What does the Myocardial Performance Index really reflect?
Conclusions Conclusions Conclusions Conclusions Conclusions

Author: Arnlov, Johan

Source: Uppsala University Library

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