Associations Between Cardiac Biomarkers and Cardiac Structure and Function in CKD

Kidney International Reports

Leila R. Zelnick¹  Nisha Bansal²  Raymond R. Townsend⁴  Jiang He⁴  James P. Lash⁴  Mahboob Rahman⁴  John W. Kusek⁴  Panduranga S. Rao⁴  Lawrence J. Appel⁵  Stephen L. Seliger⁶  Nathan R. Stein⁷  Harold I. Feldman⁷  Elsayed Z. Soliman⁸  Michael G. Shlipak⁹  Amanda H. Anderson^1,10  Alan S. Go^1,10  Christopher R. deFilippi^1,11  Bonnie Ky^1,12  Rajat Deo^1,13  Robert H. Christenson^1,14 

[1] Correspondence: Nathan R. Stein, University of California, San Francisco, 505 Parnassus Ave, Rm M1480, San Francisco, California 94143, USA.;Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA;USA;;Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA;Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA;Department of Medicine, University of California, San Francisco, San Francisco, California, USA;Department of Medicine, University of Illinois College of Medicine, Chicago, Illinois, USA;Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA;Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA;Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA;Division of Research, Kaiser Permanente, Oakland, California, USA;Inova Heart and Vascular Institute, Falls Church, Virginia;Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA;

关键词: biomarkers;    chronic renal insufficiency;    echocardiography;    growth differentiation factor 15;    heart failure;    NT-proBNP;   

DOI  :  

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown