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- Title
Cystatin C: A potential biomarker for pulmonary arterial hypertension.
- Authors
Fenster, Brett E.; Lasalvia, Luis; Schroeder, Joyce D.; Smyser, Jamey; Silveira, Lori J.; Buckner, J. Kern; Brown, Kevin K.
- Abstract
Background and Objective Cystatin C ( CysC), a novel marker of renal function, predicts left heart failure and cardiovascular mortality. The hypothesis that serum CysC levels correlate with right ventricular ( RV) morphology, function and pressure in pulmonary arterial hypertension ( PAH) was tested. Methods As part of a prospective study, 14 PAH subjects and 10 matched controls underwent same-day echocardiography, cardiac magnetic resonance imaging ( CMR), and phlebotomy for CysC, brain natriuretic peptide ( BNP), and N-terminal BNP ( NT- ProBNP). RV ejection fraction ( RVEF), end-diastolic volume, end-systolic volume and mass were calculated using CMR. RV systolic pressure ( RVSP), strain and diastolic function (including tricuspid valve ( TV) E velocity, A velocity, e′ velocity, E/A ratio and E/e′ ratio) were assessed using echocardiography. Results RVSP was significantly elevated in PAH subjects versus controls (57 ± 17 vs. 28 ± 8 mm Hg, P < 0.0001). CysC was abnormally elevated in the PAH cohort when compared with controls (1.00 ± 0.23 vs 0.78 ± 0.05 mg/L, P = 0.001). CysC positively correlated with RVSP (rho 0.61, P = 0.002), RV end-diastolic volume (rho 0.50, P = 0.01), RV end-systolic volume (rho 0.58, P = 0.003), mass index (rho 0.66, P = 0.0004), strain (rho 0.51, P = 0.01) and strain rate (rho 0.51, P = 0.01) and negatively correlated with RVEF (rho −0.58, P = 0.003) and TV e′ (rho −0.75, P < 0.0001). The same correlations with BNP and NT- ProBNP were comparable with CysC. Conclusions In a small cohort, CysC accurately correlates with RV pressure, function and morphology. CysC may represent a novel PAH biomarker.
- Subjects
CYSTATINS; HYPERTENSION; CARDIAC magnetic resonance imaging; CARDIOVASCULAR diseases; ECHOCARDIOGRAPHY; PHLEBOTOMY; SYSTOLIC blood pressure
- Publication
Respirology, 2014, Vol 19, Issue 4, p583
- ISSN
1323-7799
- Publication type
Article
- DOI
10.1111/resp.12259