Association between indoxyl sulfate and cardiac dysfunction and prognosis in patients with dilated cardiomyopathy

Area of Science:

• Cardiology
• Nephrology
• Biochemistry

Background:

• Serum indoxyl sulfate (IS) is a known uremic toxin that exacerbates chronic kidney disease (CKD) progression.
• The association between serum IS and hemodynamic parameters or cardiac events in nonischemic dilated cardiomyopathy (DCM) remains unclear.

Purpose of the Study:

• To investigate the relationship between serum IS levels and hemodynamic parameters.
• To determine if serum IS is associated with cardiac events in DCM patients.

Main Methods:

• Serum IS and plasma brain natriuretic peptide (BNP) levels were measured in 76 DCM patients.
• Echocardiography was performed, and patients were stratified into low IS (<0.9 µg/ml) and high IS (≥ 0.9 µg/ml) groups.
• Statistical analyses were conducted to assess associations and predictive values.

Main Results:

• Patients with high IS levels exhibited significantly greater E/e' values compared to those with low IS levels.
• E/e' was identified as an independent determinant of serum IS levels.
• The high IS group showed a significantly higher risk of cardiac events, and IS predicted events independently of BNP.

Conclusions:

• Cardiac dysfunction in DCM patients is associated with elevated serum IS levels.
• Serum IS may function as a novel prognostic biomarker for DCM patients, including those with normal renal function or mild-to-moderate CKD.