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Open AccessArticle

The Cardiotonic Steroid Marinobufagenin Is a Predictor of Increased Left Ventricular Mass in Obesity: The African-PREDICT Study

1
Hypertension in Africa Research Team (HART), North-West University, Potchefstroom 2520, South Africa
2
MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom 2520, South Africa
3
National Institute on Aging, NIH, Baltimore, MD 212242, USA
4
School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney 2052, Australia
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(10), 3185; https://doi.org/10.3390/nu12103185
Received: 29 September 2020 / Revised: 14 October 2020 / Accepted: 15 October 2020 / Published: 18 October 2020
The endogenous Na+/K+-ATPase inhibitor, marinobufagenin (MBG), strongly associates with salt intake and a greater left ventricular mass index (LVMi) in humans and was shown to promote cardiac fibrosis and hypertrophy in animals. The adverse effects of MBG on cardiac remodeling may be exacerbated with obesity, due to an increased sensitivity of Na+/K+-ATPase to MBG. This study determined whether MBG is related to the change in LVMi over time in adults with a body mass index (BMI) ≥30 kg/m2 (obese) and <30 kg/m2 (non-obese). The study followed 275 healthy participants (aged 20–30 years) from the African-Prospective study on the Early Detection and Identification of Cardiovascular disease and Hypertension (African-PREDICT) study over 4.5 years. At baseline, we measured 24 h urine MBG excretion. MBG levels were positively associated with salt intake. LVMi was determined by two-dimensional echocardiography at baseline and after >4.5 years. With multivariate adjusted analyses in obese adults (N = 56), we found a positive association of follow-up LVMi (Adjusted (Adj.) R2 = 0.35; Std. β = 0.311; p = 0.007) and percentage change in LVMi (Adj. R2 = 0.40; Std. β = 0.336; p = 0.003) with baseline MBG excretion. No association of LVMi (Adj. R2 = 0.37; p = 0.85) or percentage change in LVMi (Adj. R2 = 0.19; p = 0.68) with MBG excretion was evident in normal weight adults (N = 123). These findings suggest that obese adults may be more sensitive to the adverse cardiac effects of MBG and provide new insight into the potential role of dietary salt, by way of MBG, in the pathogenesis of cardiac remodeling in obese individuals. View Full-Text
Keywords: body mass index; cardiotonic steroids; left ventricular mass; marinobufagenin; obesity; dietary salt intake; young adults body mass index; cardiotonic steroids; left ventricular mass; marinobufagenin; obesity; dietary salt intake; young adults
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Strauss-Kruger, M.; Kruger, R.; Smith, W.; Gafane-Matemane, L.F.; Mokwatsi, G.; Wei, W.; Fedorova, O.V.; Schutte, A.E. The Cardiotonic Steroid Marinobufagenin Is a Predictor of Increased Left Ventricular Mass in Obesity: The African-PREDICT Study. Nutrients 2020, 12, 3185.

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