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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Connection between Cardiac Fibrosis Biomarkers and Echocardiography Parameters in Advanced Chronic Kidney Disease
Carina Ureche1,2, Gianina Dodi3, Alexandra Covic1
1Department of Internal Medicine, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 University Street, 700115 Iasi, Romania.
Insights
Procollagen type I carboxy-terminal propeptide (PICP) is linked to echocardiographic markers of cardiac dysfunction in end-stage renal disease (ESRD) patients. This collagen biomarker may indicate subclinical heart problems in advanced chronic kidney disease (CKD).
Area of Science:
- Cardiology
- Nephrology
- Biomarker Research
Background:
- Myocardial fibrosis is central to uremic cardiomyopathy, causing heart structure and function changes detectable by echocardiography.
- End-stage renal disease (ESRD) patients often develop cardiac fibrosis, impacting heart health.
- Echocardiography and specific biomarkers are crucial for assessing cardiac status in ESRD.
Purpose of the Study:
- To investigate the association between echocardiographic parameters (EF, GLS, E/e', LAVI) and cardiac fibrosis biomarkers (PICP, P3NP, Gal-3) in ESRD patients.
- To determine if biomarkers of cardiac fibrosis correlate with systolic and diastolic dysfunction.
- To explore the utility of PICP, P3NP, and Gal-3 in identifying cardiac changes in advanced chronic kidney disease (CKD).
Main Methods:
- 140 ESRD patients underwent echocardiography at baseline.
- Serum levels of procollagen type I carboxy-terminal propeptide (PICP), procollagen type III N-terminal peptide (P3NP), and galectin-3 (Gal-3) were measured.
- Regression analysis was used to assess associations between echocardiographic parameters and biomarker levels.
Main Results:
- PICP showed strong associations with ejection fraction (EF), global longitudinal strain (GLS), mean E/e' ratio, and left atrial volume index (LAVI).
- P3NP and Gal-3 were significantly associated only with EF.
- Regression analysis revealed strong correlations between PICP and all assessed echocardiographic parameters, with high R-squared values.
Conclusions:
- Procollagen type I carboxy-terminal propeptide (PICP) is significantly associated with key echocardiographic indicators of cardiac dysfunction in ESRD.
- PICP may serve as a valuable biomarker for detecting subclinical systolic and diastolic dysfunction in patients with advanced CKD.
- Further research can explore PICP's role in managing uremic cardiomyopathy and related cardiac complications.
Background:
Myocardial fibrosis represents a mainstay pathway in the pathophysiology of uremic cardiomyopathy. This process leads to structural and functional changes in the heart, which can be detected by echocardiography. The purpose of our study was to determine the association between four echocardiographic parameters (ejection fraction (EF), global longitudinal strain (GLS), mean E/e' ratio, and left atrial volume indexed) and biomarkers associated with cardiac fibrosis, such as procollagen type I carboxy-terminal propeptide (PICP), procollagen type III N-terminal peptide (P3NP), and galectin-3 (Gal-3) in patients with end-stage renal disease (ESRD).
Methods:
140 patients with ESRD were enrolled and investigated by echocardiography and the serum levels of the aforementioned biomarkers were determined at baseline.
Results:
The mean EF was 53.63 ± 8%, the mean GLS was -10.2 ± 5.3%, the mean E/e' ratio was 9.8 ± 4.3, and the mean left atrial volume indexed (LAVI) was 45.8 ± 14.2 mL/m2. The average levels for PICP, P3NP, and Gal-3 were 457.2 ± 240 µg/L, 242 ± 199.9 µg/L, and 10.7 ± 3.7 ng/mL, respectively. In regression analysis, PICP was strongly associated with all four echocardiographic parameters (EF: p = 0.0002, R2 = 0.69; GLS: p = 0.00001, R2 = 0.81; mean E/e': p = 0.00002; R2 = 0.89; LAVI: p = 0.003; R2 = 0.73). P3NP and Gal-3 were only associated with the EF (p = 0.01, R2 = 0.31 and p = 0.02; R2 = 0.35, respectively).
Conclusion:
Our study evidenced that PICP, a collagen-derived biomarker, is associated with important echocardiography parameters, suggesting that it can serve as an indicator of the presence of subclinical systolic and diastolic dysfunction in patients with advanced CKD.
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