Relations of Biomarkers Representing Distinct Biological Pathways to Left Ventricular Geometry

Article

关键词: C-REACTIVE PROTEIN;    CONVERTING ENZYME-INHIBITOR;    CORONARY HEART-DISEASE;    TARGET ORGAN DAMAGE;    BLOOD-PRESSURE;    ESSENTIAL-HYPERTENSION;    METABOLIC SYNDROME;    SERUM ALDOSTERONE;    HYPERTROPHY;    PLASMA;   

DOI  :  10.1161/CIRCULATIONAHA.108.817411

来源: SCIE

【 摘 要 】

Background-Several biological pathways are activated concomitantly during left ventricular (LV) remodeling. However, the relative contribution of circulating biomarkers representing these distinct pathways to LV geometry is unclear. Methods and Results-We evaluated 2119 Framingham Offspring Study participants (mean age, 57 years; 57% women) who underwent measurements of biomarkers of inflammation (C-reactive protein), hemostasis (fibrinogen and plasminogen activator inhibitor-1), neurohormonal activation (B-type natriuretic peptide), and renin-angiotensin-aldosterone system (aldosterone and renin modeled as a ratio [ARR]) and echocardiography at a routine examination. LV geometry was defined on the basis of sex-specific distributions of LV mass (LVM) and relative wall thickness (RWT): normal (LVM and RWT <80th percentile), concentric remodeling (LVM <80th percentile but RWT >= 80th percentile), eccentric hypertrophy (LVM >= 80th percentile but RWT <80th percentile), and concentric hypertrophy (LVM and RWT >80th percentile). We related the biomarker panel to LV geometry using polytomous logistic regression adjusting for clinical covariates and used backwards elimination to identify a parsimonious set of biomarkers associated with LV geometry. Modeled individually, C-reactive protein, fibrinogen, plasminogen activator inhibitor-1, and ARR were related to LV geometry (P<0.01). In multivariable analyses, the biomarker panel was significantly related to altered LV geometry (P<0.0001). On backwards elimination, logARR alone was significantly and positively associated with eccentric (odds ratio per SD increment, 1.20; 95% confidence interval, 1.05 to 1.37) and concentric LV hypertrophy (odds ratio per SD increment, 1.29; 95% confidence interval, 1.06 to 1.58). Conclusions-Our cross-sectional observations on a large community-based sample identified ARR as a key correlate of concentric and eccentric LV hypertrophy, consistent with a major role for the renin-angiotensin-aldosterone system in LV remodeling. (Circulation. 2008; 118: 2252-2258.)

【 授权许可】

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