Association between Cystatin C and MRI Measures of Left Ventricular Structure and Function: Multi-Ethnic Study of AtherosclerosisReportar como inadecuado




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International Journal of NephrologyVolume20112011, Article ID153868, 7 pages

Research Article

Department of Cardiology, Wake Forest University, Winston-Salem, NC 27157, USA

University of California, San Francisco, CA 94143, USA

Division of Cardiology, John Hopkins University, Baltimore, MD 410-516-8000, USA

Division of Cardiology, John Hopkins University and Imaging Sciences Training Program, National Institutes of Health and National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD 20892, USA

Cardiovascular Health Research Unit, University of Washington, Seattle, WA 98195-5502, USA

UCLA David Geffen School of Medicine, CA 90095, USA

Received 15 June 2011; Revised 23 July 2011; Accepted 26 July 2011

Academic Editor: Kazunari I.Kaneko

Copyright 2011 Subhashish Agarwal et al.
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction.
Reduced kidney function, approximated by elevated cystatin C, is associated with diastolic dysfunction, heart failure, and cardiovascular mortality; however, the precise mechanisms that account for these relationships remains unclear.
Understanding the relationship between cystatin C and subclinical left ventricular LV remodeling, across ethnically diverse populations, may help explain the mechanisms underlying the association of kidney dysfunction with heart failure and cardiovascular mortality.
Methods.
Measures of cystatin C and LV parameters were obtained from the multi-ethnic study of atherosclerosis MESA cohort at baseline with complete data on cystatin C and LV parameters.
LV parameters; LV end-diastolic LVEDV and end-systolic volumes LVESV, LV mass LVM, concentricity LV mass-LV end-diastolic volume, and LV ejection fraction LVEF were measured using magnetic resonance imaging.
Nested linear models were used to examine the relationship between higher quartiles of cystatin C and LV parameters, with and without adjustment for demographics, height, and weight, and traditional cardiovascular risk factors.
Similar analyses were performed stratified by ethnicity and gender.
Results.
A fully adjusted model demonstrated a linear relationship between higher quartiles of cystatin C and lower LVEDV, MeanSE, 1280.7, 1280.7, 1260.7, 1240.8mL; .
Associations were also observed between higher quartiles of cystatin C and lower LVESV and concentricity .
In contrast, no association was detected between cystatin C and LVM or LVEF.
In analyses stratified by race and gender, the patterns of association between cystatin C quartiles and LV parameters were qualitatively similar to the overall association.
Conclusion.
Cystatin C levels were inversely associated with LVEDV and LVESV with a disproportionate decrease in LVEDV compared to LVM in a multi-ethnic population.
This morphometric pattern of concentric left ventricular remodeling, may in part explain the process by which kidney dysfunction leads to diastolic dysfunction, heart failure and cardiovascular mortality.





Autor: Subhashish Agarwal,Vinay Thohan,Michael G.
Shlipak,Joao Lima,David A.
Bluemke,David Siscovick,Antoinette Gomes,and David M.
Herrin


Fuente: https://www.hindawi.com/



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