Associations Between Cardiac Biomarkers and Cardiac Structure and Function in CKD

Nathan R. Stein; Leila R. Zelnick; Amanda H. Anderson; Robert H. Christenson; Christopher R. deFilippi; Rajat Deo; Alan S. Go; Jiang He; Bonnie Ky; James P. Lash; Stephen L. Seliger; Elsayed Z. Soliman; Michael G. Shlipak; Nisha Bansal; Lawrence J. Appel; Harold I. Feldman; Alan S. Go; Jiang He; John W. Kusek; James P. Lash; Panduranga S. Rao; Mahboob Rahman; Raymond R. Townsend

Kidney International Reports (Jul 2020)

Associations Between Cardiac Biomarkers and Cardiac Structure and Function in CKD

Nathan R. Stein,
Leila R. Zelnick,
Amanda H. Anderson,
Robert H. Christenson,
Christopher R. deFilippi,
Rajat Deo,
Alan S. Go,
Jiang He,
Bonnie Ky,
James P. Lash,
Stephen L. Seliger,
Elsayed Z. Soliman,
Michael G. Shlipak,
Nisha Bansal,
Lawrence J. Appel,
Harold I. Feldman,
Alan S. Go,
Jiang He,
John W. Kusek,
James P. Lash,
Panduranga S. Rao,
Mahboob Rahman,
Raymond R. Townsend

Affiliations

Nathan R. Stein: Department of Medicine, University of California, San Francisco, San Francisco, California, USA; Correspondence: Nathan R. Stein, University of California, San Francisco, 505 Parnassus Ave, Rm M1480, San Francisco, California 94143, USA.
Leila R. Zelnick: Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
Amanda H. Anderson: Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
Robert H. Christenson: Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
Christopher R. deFilippi: Inova Heart and Vascular Institute, Falls Church, Virginia; USA
Rajat Deo: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Alan S. Go: Division of Research, Kaiser Permanente, Oakland, California, USA
Jiang He: Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
Bonnie Ky: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
James P. Lash: Department of Medicine, University of Illinois College of Medicine, Chicago, Illinois, USA
Stephen L. Seliger: Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
Elsayed Z. Soliman: Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
Michael G. Shlipak: Department of Medicine, University of California, San Francisco, San Francisco, California, USA
Nisha Bansal: Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
Lawrence J. Appel
Harold I. Feldman
Alan S. Go
Jiang He
John W. Kusek
James P. Lash
Panduranga S. Rao
Mahboob Rahman
Raymond R. Townsend

Journal volume & issue: Vol. 5, no. 7
pp. 1052 – 1060

Abstract

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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.

Published in Kidney International Reports

ISSN: 2468-0249 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the genitourinary system. Urology
Website: http://www.journals.elsevier.com/kidney-international-reports/

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