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Impact of myocardial function on cystatin C measurements in chronic systolic heart failure

W H Wilson Tang1, Frederick Van Lente, Kevin Shrestha

  • 1Kaufman Center for Heart Failure, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland Ohio 44195, USA.

Journal of Cardiac Failure
|June 3, 2008
PubMed

Insights

Plasma cystatin C (CysC) levels are elevated in chronic systolic heart failure (HF) patients and predict adverse outcomes. CysC is linked to diastolic and right ventricular dysfunction, independent of renal function.

Area of Science:

  • Cardiology
  • Nephrology
  • Biomarkers

Background:

  • The relationship between myocardial function and cystatin C (CysC) levels in chronic systolic heart failure (HF) is not well understood.
  • CysC is a recognized marker for renal function.

Purpose of the Study:

  • To investigate the association between plasma CysC levels and myocardial function in chronic systolic HF.
  • To determine if CysC is an independent predictor of long-term adverse clinical outcomes in this patient population.

Main Methods:

  • 139 patients with stable chronic systolic HF (left ventricular ejection fraction ≤ 35%) were prospectively enrolled.
  • Plasma CysC levels were measured.
  • Long-term adverse clinical outcomes (death, cardiac transplantation, HF hospitalizations) were tracked.

Main Results:

  • Elevated CysC levels were observed in 41% of patients with preserved renal function.
  • CysC correlated with N-terminal prohormone brain natriuretic peptide, diastolic dysfunction (mitral E/septal E'), right ventricular systolic dysfunction, and mitral regurgitation severity.
  • CysC was an independent predictor of adverse clinical outcomes (HR 1.88, P = .012) after adjusting for renal function, left ventricular ejection fraction, and diastolic dysfunction.

Conclusions:

  • Cystatin C is associated with more severe left ventricular diastolic and right ventricular systolic dysfunction in chronic systolic HF.
  • CysC serves as an independent predictor of long-term prognosis in chronic systolic HF, even after accounting for myocardial factors.
Abstract

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