Associations Between Cardiac Biomarkers and Cardiac Structure and Function in CKD
| Autor: | Nathan R. Stein, Leila R. Zelnick, Amanda H. Anderson, Robert H. Christenson, Christopher R. deFilippi, Rajat Deo, Alan S. Go, Jiang He, Bonnie Ky, James P. Lash, Stephen L. Seliger, Elsayed Z. Soliman, Michael G. Shlipak, Nisha Bansal, Lawrence J. Appel, Harold I. Feldman, John W. Kusek, Panduranga S. Rao, Mahboob Rahman, Raymond R. Townsend |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class 030232 urology & nephrology heart failure 030204 cardiovascular system & hematology lcsh:RC870-923 growth differentiation factor 15 03 medical and health sciences 0302 clinical medicine Clinical Research Internal medicine medicine Natriuretic peptide echocardiography cardiovascular diseases Subclinical infection Ejection fraction Troponin T chronic renal insufficiency business.industry biomarkers medicine.disease lcsh:Diseases of the genitourinary system. Urology Nephrology NT-proBNP Heart failure Cardiology Biomarker (medicine) GDF15 business Kidney disease |
| Zdroj: | Kidney International Reports Kidney International Reports, Vol 5, Iss 7, Pp 1052-1060 (2020) |
| ISSN: | 2468-0249 |
| Popis: | Introduction Subclinical changes to cardiac structure and function detected with echocardiography precede the development of clinical heart failure (HF) in persons with chronic kidney disease (CKD). Circulating cardiac biomarkers may reflect these pathophysiological changes. This study investigated associations between established biomarkers (N-terminal pro-B-type natriuretic peptide [NT-proBNP] and high-sensitivity troponin T [hsTnT]) and novel biomarkers (growth differentiation factor 15 [GDF-15], galectin-3 [Gal-3], and soluble ST-2 [sST-2]), using echocardiographic measurements in persons with CKD. Methods In cross-sectional analyses among 2101 participants with mild to moderate CKD in the Chronic Renal Insufficiency Cohort (CRIC), biomarker levels measured at baseline were evaluated with echocardiographic measurements 1 year later. These included left ventricular mass index (LVMI), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular ejection fraction (LVEF), and left atrial diameter (LAD). Multivariable linear regression analyses tested associations of each biomarker with echocardiographic measurements, adjusting for covariates. Results GDF-15 was significantly associated with higher LVMI (1.0 g/m2.7; 95% CI, 0.4–1.7), LVESV (0.4 ml/m2.7; 95% CI, 0.0–0.7), and LVEDV (0.6 ml/m2.7; 95% CI, 0.1–1.1), but not with LVEF or LAD. These findings were not significant when adjusting for NT-proBNP and hsTnT. Gal-3 and sST-2 had no significant associations. Higher levels of NT-proBNP and hsTnT were associated with all echocardiographic measurements. Conclusion In patients with CKD, the novel biomarker GDF-15, a marker of inflammation and tissue injury, and clinical biomarkers NT-proBNP and hsTnT, were associated with echocardiographic measurements of subclinical cardiovascular disease. Collectively, these biomarkers may highlight biological pathways that contribute to the development of clinical HF. |
| Databáze: | OpenAIRE |
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