Association between Cystatin C and MRI Measures of Left Ventricular Structure and Function: Multi-Ethnic Study of Atherosclerosis
Introduction. Reduced kidney function, approximated by elevated cystatin C, is associated with diastolic dysfunction, heart failure, and cardiovascular mortality; however, the precise mechanism(s) that account for these relationships remains unclear. Understanding the relationship between cystatin C...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.4061/2011/153868 |
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| author | Subhashish Agarwal Vinay Thohan Michael G. Shlipak Joao Lima David A. Bluemke David Siscovick Antoinette Gomes David M. Herrington |
| author_facet | Subhashish Agarwal Vinay Thohan Michael G. Shlipak Joao Lima David A. Bluemke David Siscovick Antoinette Gomes David M. Herrington |
| author_sort | Subhashish Agarwal |
| collection | DOAJ |
| description | Introduction. Reduced kidney function, approximated by elevated cystatin C, is associated with diastolic dysfunction, heart failure, and cardiovascular mortality; however, the precise mechanism(s) 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 (N=4,970 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, (Mean ± SE, 128 ± 0.7, 128 ± 0.7, 126 ± 0.7, 124 ± 0.8 mL; P=0.0001). Associations were also observed between higher quartiles of cystatin C and lower LVESV (P=0.04) and concentricity (P=0.0001). 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. |
| format | Article |
| id | doaj-art-7d1dbe86f3234665977f2fa69a98bb3b |
| institution | OA Journals |
| issn | 2090-214X 2090-2158 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-7d1dbe86f3234665977f2fa69a98bb3b2025-08-20T02:07:12ZengWileyInternational Journal of Nephrology2090-214X2090-21582011-01-01201110.4061/2011/153868153868Association between Cystatin C and MRI Measures of Left Ventricular Structure and Function: Multi-Ethnic Study of AtherosclerosisSubhashish Agarwal0Vinay Thohan1Michael G. Shlipak2Joao Lima3David A. Bluemke4David Siscovick5Antoinette Gomes6David M. Herrington7Department of Cardiology, Wake Forest University, Winston-Salem, NC 27157, USADepartment of Cardiology, Wake Forest University, Winston-Salem, NC 27157, USAUniversity of California, San Francisco, CA 94143, USADivision of Cardiology, John Hopkins University, Baltimore, MD 410-516-8000, USADivision 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, USACardiovascular Health Research Unit, University of Washington, Seattle, WA 98195-5502, USAUCLA David Geffen School of Medicine, CA 90095, USADepartment of Cardiology, Wake Forest University, Winston-Salem, NC 27157, USAIntroduction. Reduced kidney function, approximated by elevated cystatin C, is associated with diastolic dysfunction, heart failure, and cardiovascular mortality; however, the precise mechanism(s) 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 (N=4,970 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, (Mean ± SE, 128 ± 0.7, 128 ± 0.7, 126 ± 0.7, 124 ± 0.8 mL; P=0.0001). Associations were also observed between higher quartiles of cystatin C and lower LVESV (P=0.04) and concentricity (P=0.0001). 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.http://dx.doi.org/10.4061/2011/153868 |
| spellingShingle | Subhashish Agarwal Vinay Thohan Michael G. Shlipak Joao Lima David A. Bluemke David Siscovick Antoinette Gomes David M. Herrington Association between Cystatin C and MRI Measures of Left Ventricular Structure and Function: Multi-Ethnic Study of Atherosclerosis International Journal of Nephrology |
| title | Association between Cystatin C and MRI Measures of Left Ventricular Structure and Function: Multi-Ethnic Study of Atherosclerosis |
| title_full | Association between Cystatin C and MRI Measures of Left Ventricular Structure and Function: Multi-Ethnic Study of Atherosclerosis |
| title_fullStr | Association between Cystatin C and MRI Measures of Left Ventricular Structure and Function: Multi-Ethnic Study of Atherosclerosis |
| title_full_unstemmed | Association between Cystatin C and MRI Measures of Left Ventricular Structure and Function: Multi-Ethnic Study of Atherosclerosis |
| title_short | Association between Cystatin C and MRI Measures of Left Ventricular Structure and Function: Multi-Ethnic Study of Atherosclerosis |
| title_sort | association between cystatin c and mri measures of left ventricular structure and function multi ethnic study of atherosclerosis |
| url | http://dx.doi.org/10.4061/2011/153868 |
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