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Biomedical subjects

J R Nielsen

Publications and source records attributed to J R Nielsen.

At least 19 recordsLinked to original sources

[Glucagon-like peptide 2, a neurotransmitter with a newly discovered role in the regulation of food ingestion].

We report here that glucagon-like peptide 2(GLP-2) and its receptor constitute a distinct projection system connecting the nucleus of the solitary tract with the dorsomedial hypothalamic nucleus (DMH). The DMH contains a dense plexus of GLP-2 immunoreactive fibres and is the only hypothalamic nucleus expressing GLP-2 receptor mRNA. Consistent with this, central application of GLP-2 activates the expression of neurones solely in the DMH. Furthermore, central administration of GLP-2 causes a dose-related, a pharmacologically and behaviourally specific inhibition of food intake in rats. Surprisingly, the alleged GLP-1 receptor antagonist, Exending (9-39), proved a functional antagonist of centrally applied GLP-2. These data implicate GLP-2 as an important neurotransmitter in the regulation of food intake and likely bodyweight. Our data therefore point to the DMH as a crossroad for endocrine and visceral information affecting feeding behaviour.

Animals↗

Guppy sexual behavior as an effect biomarker of estrogen mimics.

There is widespread concern that some environmental chemicals can reduce the reproductive capability of humans and wildlife by mimicking natural estrogens and disrupting endocrine function. This potential threat to animal populations posed by xenoestrogens has, hardly surprisingly, been met by an intensive global effort to identify and develop biomarkers suitable for screening chemicals for estrogen mimicking capacity. Despite this effort, there are few biomarkers capable of linking exposure to xenoestrogens to impaired reproductive capability. The reproductive success of most animals depends strongly on the ability to perform the appropriate sexual behavior. The sexual display of the male guppy is strongly linked to reproductive success and is readily quantified under laboratory conditions. This preliminary study demonstrates that exposure of adult male guppies to water weakly contaminated with either natural estrogen (17beta-estradiol) or the xenoestrogen (4-tert-octylphenol) causes a dramatic decrease in the rate and intensity of sexual display. It is concluded that quantitative analysis of the sexual display of male guppies holds great promise as a biomarker at the organismal level for the effects of estrogen mimicking xenobiotics.

Animals↗

Serial changes in atrial natriuretic peptide and endothelin-1 concentrations. Their relationships to the cardiac performance of patients hospitalized for acute myocardial infarction.

AIM: The study was designed to assess temporal changes in atrial natriuretic peptide (ANP) and endothelin-1 (ET) concentrations in patients hospitalized for acute myocardial infarction (AMI) and their relationships to cardiac performance determined by radionuclide ventriculography. PATIENTS AND METHODS: 20 patients with first AMI were studied. Blood samples were drawn within the first 4-18 h, after 18-24 h, and on days 2, 3 and 6. Plasma concentrations of ANP and ET were measured in blood samples taken simultaneously. Radionuclide ventriculography was performed on the day of discharge to determine left-ventricular ejection fraction (LVEF), left-ventricular end-diastolic volume index, end-systolic volume index and left-ventricular stroke volume index. RESULTS: Median concentrations of ET decreased from 2.15 pmol/l on admission to 1.45 pmol/l at discharge (32%, p < 0.001). Median ANP rose from 29 to 79 pg/ml (172%, p < 0.001). The increment in ANP and the decrease in ET concentrations from admission to discharge was inversely correlated (r = -0.81, p < 0.005). ANP was inversely correlated to LVEF (r = -0.82, p < 0.001) and to the end-systolic volume index at discharge (r = -0.73, p < 0.003). CONCLUSION: Dynamic and inverse fluctuations in ET and ANP occur within the 1st week of AMI. The magnitude of endocrine activation in the ANP-ET system seems to reflect an impairment in the left-ventricular systolic performance.

Atrial Natriuretic Factor↗

Serial Holter ST-segment monitoring after first acute myocardial infarction. Prevalence, variability, and long-term prognostic importance of transient myocardial ischemia.

Based on serial Holter monitoring performed 7 times within 3 years after a first acute myocardial infarction, we assessed the prevalence, variability and long-term clinical importance of transient myocardial ischemia (TMI) defined as episodes of ambulatory ST-segment depression. In all, 121 consecutive male patients <70 years old were studied. The prevalence of TMI on different Holter recordings varied around 20% ranging between 18 and 27%. Fifty-five of the patients (46%) had TMI on at least 1 of the 7 Holter recordings. Considerable variability was found within and between patients for the presence of TMI. No high-risk group for cardiac death, nonfatal reinfarction or coronary revascularization during up to 10 years of follow-up could be identified by the detection of TMI. From these results we conclude that a routine search for TMI on serial Holter monitoring cannot be recommended in male survivors of an uncomplicated first acute myocardial infarction.

Aged↗

[Pathogenesis of schizophrenia. Illustrated by anatomical, physiological and neuropsychological aspects of the brain].

Research into schizophrenia over the latest years has led to many new investigations and results, and a new hypothesis has suggested a defect in the neurointegrative function of the central nervous system. Changes in the cytoarchitecture of the hippocampus and the entorhinal cortex points towards a dysfunction of temporo-limbic structures, probably a result of embryogenesis, and as a consequence dysfunction of the prefrontal cortex arises. The hypothesis of the defect filter function, which has been placed in the thalamus, explains how the schizophrenic person cannot protect himself against various bombardments of stimuli. This leads to a deficiency in information processing, known as defective automatic categorisation. The long-term memory, especially the semantic memory with common knowledge about the world, is affected, which can be of importance to the schizophrenic delusions. The discoveries suggest a dysfunction of the cortico-striato-thalamo-cortical circuit.

Brain↗

Characteristics and prognostic importance of ST-segment elevation on Holter monitoring early after acute myocardial infarction.

The correlation between episodes of ST-segment elevation on Holter monitoring, clinical characteristics, left ventricular function, exercise testing, and long-term prognosis was determined in 123 consecutive patients 55 +/- 8 years old (mean +/- SD) with a first acute myocardial infarction (AMI). During 36 hours of Holter recording 11 +/- 5 days after AMI, 11 patients (9%) had 91 episodes of ST-segment elevation (group 1), whereas 112 patients had no such episodes (group 2). Most episodes of ST-segment elevation occurred in leads with pathologic Q waves or small, indistinct R waves. Large, anterior Q-wave AMIs were more prevalent in group 1 than in group 2, and in-hospital heart failure also occurred more frequently in group 1 patients (82% vs 23%; p < 0.0005). Regional and global left ventricular function was reduced in group 1 compared with group 2: ejection fraction 33 +/- 11% vs 50 +/- 11% (p = 0.0001). All episodes of ST-segment elevation were asymptomatic and did not correlate with different indicators of myocardial ischemia. Indeed, exercise-induced ST-segment depression was more prevalent in group 2 than in group 1: 57 vs 18% (p < 0.035). Over a mean of 5 years (range 4 to 6) of follow-up, an association between episodes of ST-segment elevation on Holter monitoring and (1) cardiac death (Kaplan-Meier analysis; p < 0.005), and (2) cardiac death and nonfatal reinfarction (Kaplan-Meier analysis; p < 0.025) was found.(ABSTRACT TRUNCATED AT 250 WORDS)

Echocardiography↗

Changes in left and right ventricular performance and volumes in seven-year survivors of acute myocardial infarction.

We describe the spontaneous long-term changes in right (RV) and left (LV) ventricular performance during a 7-year period after acute myocardial infarction (AMI). Radionuclide ventriculography was performed in the second week after AMI in 201 patients. RV and LV ejection fractions, and LV end-diastolic and end-systolic volumes were determined. A follow-up after 7 years was performed in 55 survivors. Of these, 16 patients were also examined after 1 year. During the 7-year follow-up period, LV ejection fraction decreased from 0.49 to 0.45 (p < 0.01). LV end-diastolic volume increased from 161 to 210 ml (30%) (p < 0.01), and LV end-systolic volume from 83 to 123 ml (48%) (p < 0.01). In patients without recurrent AMI, coronary artery bypass grafting surgery, or angiotensin-converting enzyme inhibitor therapy (n = 37) during follow-up, no change in average LV ejection fraction was observed. Nevertheless, this subgroup had substantial increases in LV end-diastolic volume, from 157 to 190 ml (21%) (p = 0.002) and in LV end-systolic volume, from 80 to 105 ml (31%) (p < 0.001). In a subgroup of patients also reinvestigated after 1 year (n = 16), there was a 15% increase in LV end-diastolic volume the first year after AMI with an additional 10% increase in LV end-diastolic volume between years 1 and 7. Corresponding figures for LV end-systolic volume were 20% and 12%, respectively. Hardly any association was apparent between LV ejection fraction, LV end-diastolic volume, and LV stroke volume at discharge for subsequent LV dilatation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Prognostic significance of transient myocardial ischaemia after first acute myocardial infarction: five year follow up study.

OBJECTIVE: To assess the five year prognostic significance of transient myocardial ischaemia on ambulatory monitoring after a first acute myocardial infarction, and to compare the diagnostic and long term prognostic value of ambulatory ST segment monitoring, maximal exercise testing, and echocardiography in patients with documented ischaemic heart disease. DESIGN: Prospective study. SETTING: Cardiology department of a teaching hospital. PATIENTS: 123 consecutive men aged under 70 who were able to perform predischarge maximal exercise testing. INTERVENTIONS: Echocardiography two days before discharge (left ventricular ejection fraction), maximal bicycle ergometric testing one day before discharge (ST segment depression, angina, blood pressure, heart rate), and ambulatory ST segment monitoring (transient myocardial ischaemia) started at hospital discharge a mean of 11 (SD 5) days after infarction. MAIN OUTCOME MEASURES: Relation of ambulatory ST segment depression, exercise test variables, and left ventricular ejection fraction to subsequent objective (cardiac death or myocardial infarction) or subjective (need for coronary revascularisation) events. RESULTS: 23 of the 123 patients had episodes of transient ST segment depression, of which 98% were silent. Over a mean of 5 (range 4 to 6) years of follow up, patients with ambulatory ischaemia were no more likely to have objective end points than patients without ischaemic episodes. If, however, subjective events were included an association between transient ST segment depression and an adverse long term outcome was found (Kaplan-Meier analysis; P = 0.004). The presence of exercise induced angina identified a similar proportion of patients with a poor prognosis (Kaplan-Meier analysis; P < 0.004). Both exertional angina and ambulatory ST segment depression had high specificity but poor sensitivity. The presence of exercise induced ST segment depression was of no value in predicting combined cardiac events. Indeed, patients without exertional ST segment depression were at increased risk of future objective end points (Kaplan-Meier analysis; P < 0.0045). These findings may be explained in part by a higher prevalence of left ventricular dysfunction in patients without ischaemic changes in the exercise electrocardiogram (P < 0.05). CONCLUSION: There seem to be limited reasons to perform ambulatory ST segment monitoring in survivors of a first myocardial infarction who can perform exercise tests before discharge. Patients at high risk of future myocardial infarction or death from cardiac causes are not identified. Ambulatory monitoring and exertional angina distinguish a small subset of patients who will develop severe angina pectoris demanding coronary revascularisation during follow up. Patients without exercise induced ST segment depression comprise a high risk subgroup in terms of subsequent objective end points. The role of ambulatory ST segment monitoring performed in unselected patients immediately after infarction when risk is maximal remains to be clarified.

Echocardiography↗

[Thrombolysis and acute myocardial infarction. Reduced residual ischemia in first acute myocardial infarction].

In order to assess the effect of thrombolysis on residual myocardial ischaemia, we prospectively performed maximal exercise testing and ambulatory ST-segment monitoring in a consecutive series of 123 men recovering from a first acute myocardial infarction (AMI). Seventy-four patients fulfilled our criteria for thrombolysis, but only 35 patients received thrombolytic agents, whereas 39 were conservatively treated (controls). In 49 patients thrombolytic therapy was not indicated. Thrombolysis resulted in a non-significant reduction in the prevalence of exercise-induced ST-segment depression: 43% in reperfused patients versus 62% in controls. During 36-hour ambulatory ST-segment monitoring, however, the duration of myocardial ischaemia was significantly reduced in thrombolyzed patients: 322 minutes versus 1144 minutes in controls (p < 0.05). Exercise testing revealed a higher maximal work capacity in thrombolyzed patients compared with controls: 160 +/- 41 versus 139 +/- 34 W (p < 0.02). No difference was found in left ventricular ejection fraction between the two subgroups. We conclude, that thrombolysis given for a first AMI reduces residual myocardial ischaemia. The reduced ischaemic burden is assumed to be the pathophysiologic mechanism underlying the also observed improvement in exercise tolerance.

Aged↗

Endothelin release and enhanced regional myocardial ischemia induced by cold-air inhalation in patients with stable angina.

This study was designed to determine the influence of cold-air inhalation on regional myocardial perfusion in patients with ischemic heart disease. A selected group of vasoactive hormones was measured to investigate their possible roles as ischemic agents. Ten men who had recently had a myocardial infarction and anginal symptoms and with verified pathologic ST deviations during a preceding exercise test volunteered to participate in this randomized cross-over study. Two identical exercise tests were performed on different days; one with inhalation of cold (-22 degrees C) air and the other one with inhalation of thermoneutral air (22 degrees C). Scintigraphic imaging (single-photon emission computed tomography) of regional myocardial blood flow was performed with technetium 99m isonitrile flowtracer and a Bull's eye visual display with calculation of the scintigraphic ischemic severity score. The score was significantly higher during exercise with inhalation of cold air as compared to exercise with inhalation of thermoneutral air. Furthermore, only with cold-air inhalation did arterial plasma endothelin concentration increase significantly from rest to exercise and correlate with the change of ischemic severity score. In contrast, no change was observed under thermoneutral conditions. There was no significant difference between peak values of heart rate, systolic blood pressure, adrenaline, and noradrenaline concentrations in the two situations. We conclude that inhalation of cold air during exercise increases the degree of regional myocardial ischemia and that this is not caused by an increased myocardial oxygen demand. We suggest that cold air directly influences the vasomotor tone of the myocardial resistance vessels and that endothelin may be involved in the ischemic response.

Adult↗

Transient myocardial ischemia after a first acute myocardial infarction and its relation to clinical characteristics, predischarge exercise testing and cardiac events at one-year follow-up.

The relation between early out-of-hospital ambulatory ST-segment monitoring, clinical characteristics, predischarge maximal exercise testing and cardiac events was determined in 123 consecutive men (age 55 +/- 8 years) with a first acute myocardial infarction (AMI). During 36 hours of ambulatory recording 11 +/- 5 days after AMI 23 patients (19%) had 123 ischemic episodes (group 1), whereas 100 patients demonstrated no ischemia (group 2). Exercise-induced ST-segment depression was more prevalent in group 1 (83%) than in group 2 (47%) (p < 0.005). Group 1 patients also had more severe ischemia as judged from a shorter exercise duration before significant ST-segment depression (5.5 +/- 2.4 vs 7.7 +/- 4.1 minutes; p < 0.03) and more pronounced ST-segment depression on exercise testing (4.1 +/- 2.6 vs 2.6 +/- 1.6 mm; p < 0.03). Furthermore, exercise test results revealed an impaired hemodynamic response in group 1 compared with group 2: systolic blood pressure at maximal work load 160 +/- 31 vs 176 +/- 28 mm Hg (p < 0.025) and systolic blood pressure increase during exercise 41 +/- 24 vs 56 +/- 22 mm Hg (p < 0.01). With-in 368 +/- 8 days of follow-up the frequency of cardiac events (cardiac death, nonfatal reinfarction, and severe angina including the need of revascularization) was 52% in group 1 compared with 22% in group 2 (p < 0.01). Exercise-induced ischemia did not predict an adverse outcome: event rate 30 vs 25% in patients without residual ischemia (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Echocardiography↗

Sodium-potassium pump activity in white blood cells from children with an increased risk of developing hypertension--The Odense Schoolchild Study.

We have measured the capacity of the sodium-potassium pump, as assessed by 86rubidium uptake and the number of [3H]-ouabain binding sites on white blood cells, in children aged 9-11 years, partly cross-sectionally and partly longitudinally after a physical training programme. Children from a hypertensive subgroup comprising the upper 5% of the blood pressure distribution and children from a randomly selected normotensive subgroup were eligible for the study. In the cross-sectional study 40 children from the hypertensive subgroup and 40 children from the normotensive subgroup were evaluated. A significant increase in 86rubidium uptake was present in boys as compared to girls. After adjustment for differences in sexual maturation the observed significant difference disappeared. Important correlates of pump activity were height, plasma glucose, and physical fitness. In the training study 10 boys from the hypertensive subgroup and 10 boys from the normotensive subgroup were also evaluated after eight months of physical training. A significant fall in 86rubidium uptake was observed. No control group was examined and probably the changes reflect some effects of sexual maturation on cation handling of cells. These results indicate a significant effect of sexual maturation in capacity of sodium-potassium pump in children.

Child↗

Residual myocardial ischaemia in first non-Q versus Q wave infarction: maximal exercise testing and ambulatory ST-segment monitoring.

In a prospective study of 123 consecutive survivors of a first myocardial infarction (43 non-Q wave, 80 Q wave), we determined the total residual ischaemic burden by use of pre-discharge maximal exercise testing and post-discharge 36 h ambulatory ST-segment monitoring initiated 11 +/- 5 days after the infarction. The prevalence of exercise-induced ischaemic manifestations in the infarct types was similar: chest pain 14% vs 16% and ST-segment depression 54% vs 54%. The ischaemic threshold did not differ either (heart rate at 1 mm of ST-segment depression 120 +/- 27 vs 119 +/- 25 beats.min-1). During early post-discharge daily activities, more patients with non-Q wave infarction demonstrated transient episodes of ST-segment depression: 28% vs 14% (ns). Furthermore, ischaemic episodes were significantly longer (42.5 +/- 50.1 vs 22.0 +/- 20.6 min; P < 0.001), and the ischaemic threshold was significantly lower in non-Q wave infarction (heart rate at onset of ST-segment depression 84 +/- 11 vs 88 +/- 9 beats.min-1; P < 0.05). During 3.5 +/- 0.9 years of follow-up the proportion of patients with > or = 1 ischaemic event (non-fatal reinfarction, angina pectoris, revascularization) was significantly higher in non-Q wave infarction (51%) as compared to Q wave infarction (31%) (P < 0.05). In both infarct types the presence of ST-segment depression on ambulatory recording and exercise testing significantly predicted the development of future angina pectoris, whereas patients at increased risk for subsequent non-fatal reinfarction or cardiac death were not identified.

Activities of Daily Living↗

Changing circadian variation of transient myocardial ischemia during the first year after a first acute myocardial infarction.

In a consecutive series of 123 men (aged 55 +/- 8 years) with a recent first acute myocardial infarction (AMI), 24-hour ambulatory ST-segment monitoring was performed early after discharge (day 11 +/- 5), 6 months (day 185 +/- 6) and 1 year (day 368 +/- 8) after AMI. No difference in the prevalence of transient myocardial ischemia was found between the 3 recordings (17, 17 and 20%), and most ischemic episodes were silent (98, 100 and 97%). In the early postinfarction period, a peak of ischemic activity was demonstrated between 6 P.M. and midnight (40 of 93 episodes [43%]). Over time, the maximal occurrence of ischemia gradually advanced toward the morning hours with a peak activity between 6 A.M. and noon at 1-year follow-up (32 of 73 episodes [44%]). Significantly more patients (16 of 21 [76%]) had ischemia from 6 P.M. to midnight at discharge compared with the findings 1 year later (9 of 23 patients [39%]) (p < 0.03). An opposite trend was found regarding patients who exhibited ischemic episodes in the hours from 6 A.M. to noon: 10 of 21 patients (48%) early after discharge versus 17 of 23 patients (74%) at 1-year follow-up (p = not significant). Results from the 6-month recording displayed characteristics between the findings from discharge and 1-year ambulatory monitoring. The pathophysiologic processes underlying the observations from this study are unknown. The change in circadian periodicity could not be explained from differences in heart rate variation patterns or medical antianginal treatment among the 3 recordings.(ABSTRACT TRUNCATED AT 250 WORDS)

Chi-Square Distribution↗

Lack of indication of myocardial cell damage after myocardial ischaemia in patients with severe stable angina.

To evaluate myocardial cell damage in relation to spontaneous and exercise-induced ischaemia, release of myoglobin, creatine kinase (CK) and its isoenzyme MB (CK-MB) into the serum was estimated in 10 patients with severe stable angina. All patients had a positive exercise test, significant stenosis of one or more of the main coronary arteries and more than five ischaemic attacks per week. ST-segment monitoring was performed for 36 h. During the last 24 h of that period (period A) serial blood samples were analysed for myoglobin, CK and CK-MB using sensitive assays. Three days later (period B) the patients performed an exercise test at 0815 h, with ST-segment monitoring and blood sampling carried out as described for period A. During period A, 47 ischaemic episodes (100% silent) with a total duration of 599 min were noted in four patients. Forty-seven ischaemic episodes (94% silent) with a total duration of 804 min, were observed in seven patients during period B. Release of myoglobin, CK, and CK-MB did not increase in relation either to spontaneous or exercise-induced ischaemia. Thus even frequent and prolonged episodes of transient myocardial ischaemia (symptomatic or asymptomatic) in patients with severe stable angina pectoris does not seem to cause irreversible myocardial damage.

Adult↗

Thrombolysis significantly reduces transient myocardial ischaemia following first acute myocardial infarction.

In order to investigate whether thrombolysis affects residual myocardial ischaemia, we prospectively performed a predischarge maximal exercise test and early out-of-hospital ambulatory ST segment monitoring in 123 consecutive men surviving a first acute myocardial infarction (AMI). Seventy-four patients fulfilled our criteria for thrombolysis, but only the last 35 patients included received thrombolytic therapy. As thrombolysis was not available in our Department at the start of the study, the first 39 patients included were conservatively treated (controls). No significant differences in baseline clinical characteristics were found between the two groups. In-hospital atrial fibrillation and digoxin therapy was more prevalent in controls (P less than 0.05). During exercise, thrombolysed patients reached a higher maximal work capacity compared with controls: 160 +/- 41 vs 139 +/- 34 W (P less than 0.02). Thrombolysis resulted in a non-significant reduction in exercise-induced ST segment depression: prevalence 43% vs 62% in controls. However, during ambulatory monitoring the duration of transient myocardial ischaemia was significantly reduced in thrombolysed patients: 322 min vs 1144 min in controls (P less than 0.05). Thrombolysed patients reached a higher heart rate during transient ischaemic episodes: 114 +/- 17 vs 93 +/- 11 b.min-1 in controls (P less than 0.001). In conclusion, thrombolytic therapy administered for a first AMI significantly reduces the burden of transient myocardial ischaemia. This may explain the improvement in myocardial function during physical activities, which was also observed in this study.

Coronary Circulation↗

Blood pressure and cardiac structure in children with a parental history of hypertension: the Odense Schoolchild Study.

OBJECTIVE: To examine the relation between a parental history of hypertension and blood pressure and cardiac structure in children aged 8-10 years. DESIGN: Cross-sectional study of a sample of children drawn from a population survey of coronary risk factors in children. SETTING: Odense, Denmark. SUBJECTS: Sixty-nine children of hypertensive parents (5.2% of the eligible population). MAIN OUTCOME MEASURES: Physical fitness assessed by calculation of maximum oxygen uptake, blood pressure recorded by one blind observer and left ventricular structure determined by echocardiography. RESULTS: Children with a parental history of hypertension displayed a significant decrease in physical fitness and a significant increase in obesity and systolic and diastolic blood pressure compared with the rest of the population. After controlling for differences in body size and physical fitness, they also showed significantly higher levels of systolic and diastolic blood pressure. Apart from a significant increase in thickness of the interventricular septum during systole, no significant differences in echocardiographic measures or indices could be demonstrated between children with a parental history of hypertension and a normotensive control group. CONCLUSION: Our results indicate that a higher level of blood pressure in children with a parental history of hypertension is apparent before the age of 10 years.

Blood Pressure↗

Left ventricular hypertrophy in children from the upper five percent of the blood pressure distribution--the Odense Schoolchild Study.

Left ventricular structural dimensions were assessed by echocardiography in a group of 64 children aged 9-11 years with a mean blood pressure at or above the 95th percentile (HC-group) and in a group of 66 children randomly selected from the rest of the population (NC-group). Children in the HC-group were heavier, more obese, and less fit. Parental history of hypertension was more frequent in the HC-group. Calculated left ventricular mass (LVM), and LVM corrected for body surface area (LVMI), were significantly greater in the HC-group and in boys. Repeated echocardiographic examination in 57 of the children following 8 months of physical training revealed significant increases in posterior wall thickness and the posterior-wall-thickness-to-radius ratio. LVM increased significantly in the NC-group. Neither physical fitness nor change in physical fitness contributed independently to the variability in LVM following the training period. In children aged 9-11 years at increased risk of developing essential hypertension left ventricular hypertrophy is present.

Blood Pressure↗