Serum Cystatin C, Renal Filtration Function, and Left Ventricular Remodeling
| Autor: | Peter A. McCullough, Justin E. Trivax, Mark D. McMurray |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Creatinine
Kidney medicine.medical_specialty biology Heart disease business.industry Renal function medicine.disease chemistry.chemical_compound medicine.anatomical_structure Endocrinology chemistry Cystatin C Heart failure Internal medicine medicine biology.protein Cardiology Cardiology and Cardiovascular Medicine business Ventricular remodeling Kidney disease |
| Zdroj: | Circulation: Heart Failure. 2:86-89 |
| ISSN: | 1941-3297 1941-3289 |
| DOI: | 10.1161/circheartfailure.109.856393 |
| Popis: | It is estimated that heart failure (HF) affects 5.7 million Americans and will have an estimated cost of $34.8 billion in 2009.1 However, definitions of HF are mainly symptom based and, therefore, may lead to a gross underestimation of the actual prevalence. One study has shown that only 50% of people with echocardiographic evidence of left ventricular (LV) dysfunction are symptomatic.2 Article see p 98 It is now accepted that there is a link between renal dysfunction and heart disease, although physiological mechanisms remain unclear. The incidence and prevalence of chronic kidney disease are increasing, and it is estimated that 26 million Americans now have chronic kidney disease.1 From a public health standpoint, HF and chronic kidney disease are similar in that the underlying pathology is underway long before symptoms are manifested, thereby causing them to be largely underdiagnosed in their early stages. Any advance or improvement in early detection of HF or chronic kidney disease could have enormous potential to reduce the morbidity and mortality from these treatable diseases. The Dallas Heart Study showed that serum levels of cystatin C were independently associated with LV mass, concentricity, and wall thickness as measured by MRI.3 Male gender, hypertension, and use of antihypertensive medications were all associated with elevations of cystatin C. However, even after adjustment for these and other traditional risk factors, including estimated glomerular filtration rate (eGFR), the associations of cystatin C with a pathological cardiac phenotype persisted. These findings show that the risk of HF predicted by elevations of cystatin C is more than can be explained by its surrogacy as a predictor of impaired renal function. Clinical inferences concerning renal filtration function have been fundamental to medical evaluation of patients for over half a century. Serum creatinine has been the laboratory mainstay measure, … |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|