Background:Left ventricular hypertrophy (LVH) is a major risk factor for cardiovascular disease, including heart failure. Although linked to obesity and hypertension, its pathogenesis is multifactorial. Blunted postprandial sympathetic regulation of gut blood flow has been observed in overweight animals and suggested as a promotor of hypertension and LVH. We hypothesized that blunted postprandial superior mesenteric blood flow responses would be more common in overweight humans and associated with increased blood pressure and LVH.Methods:Left ventricular dimensions and hemodynamic responses to a standardized high-calorie liquid meal were measured in healthy adolescents (n=82; 39 overweight/obese) by magnetic resonance imaging. Covariates such as body mass index, blood pressure, Tanner score, and an index of insulin resistance were included in multiple regression models to examine the independent associations of mesenteric flow response with blood pressure status and LVH.Results:Food ingestion increased cardiac output (Δmean, 0.45 [SD, 0.62] L·min⁻¹; P=3.8×10⁻⁸) and superior mesenteric artery flow (Δmean, 0.76 [SD, 0.35] L·min⁻¹; P=4.2×10⁻³¹). A blunted mesenteric flow response was associated with increased left ventricular mass (B=−12.7 g·m^−2.7 per L·min⁻¹·m^−0.92; P=6×10⁻⁵) and concentric LVH (log likelihood, −9.9; P=0.001), independently of known determinants of LVH, including body mass index. It was also associated with elevated systolic blood pressure (B=−18.0 mm Hg per L·min⁻¹·m^−0.92; P=0.001), but this link did not explain the association with left ventricular mass.Conclusions:Postprandial mesenteric vascular dysfunction is associated with LVH and hypertension, independently of common risk factors for those conditions. These findings highlight a new, independent marker of cardiovascular risk in the young.

中文翻译：

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餐后血管功能障碍与血压升高和青少年肥胖的不良左心室重塑有关。

背景：左心室肥厚 (LVH) 是包括心力衰竭在内的心血管疾病的主要危险因素。虽然与肥胖和高血压有关，但其发病机制是多因素的。在超重动物中观察到餐后肠道血流的交感神经调节减弱，并被认为是高血压和 LVH 的促进剂。我们假设餐后肠系膜上血流反应迟钝在超重人群中更为常见，并且与血压升高和 LVH 相关。 82；39 超重/肥胖）通过磁共振成像。协变量，例如体重指数、血压、Tanner 评分、^-1 ; P =3.8×10 ^-8 )和肠系膜上动脉流量(Δmean, 0.76 [SD, 0.35] L·min ^-1；P =4.2×10 ^-31 )。肠系膜血流反应迟钝与左心室质量增加（B=-12.7 g·m ^-2.7 / L·min ^-1 ·m ^{- 0.92}；P =6×10 ^-5）和同心 LVH（对数似然，-9.9 ; P = 0.001)，独立于 LVH 的已知决定因素，包括体重指数。它还与升高的收缩压有关（B=−18.0 mm Hg/L·min ⁻¹ ·m ^{− 0.92}；P=0.001)，但此链接并未解释与左心室质量的关联。结论：餐后肠系膜血管功能障碍与 LVH 和高血压相关，与这些情况的常见危险因素无关。这些发现突出了年轻人心血管风险的一个新的、独立的标志。