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Demonstration of a relation between urinary digoxin-like immunoreactive substance and cardiac performance
H S Friedman1, B Babb, I B Shim
1Section of Cardiology, Brooklyn Hospital Center.
Insights
Urinary digoxin-like immunoreactive substance (DLIS) correlates with cardiac performance, specifically left ventricular fractional shortening. This finding suggests DLIS may act as a ligand for cardiac glycoside receptors.
Area of Science:
- Cardiology
- Endocrinology
- Biochemistry
Background:
- Cardiac glycosides play a crucial role in regulating cardiac function.
- The existence and physiological role of endogenous digoxin-like immunoreactive substance (DLIS) remain under investigation.
- Understanding factors influencing DLIS levels is important for cardiac research.
Purpose of the Study:
- To investigate the relationship between urinary DLIS concentrations and cardiac performance in individuals not receiving cardiac glycosides.
- To identify potential physiological correlates of urinary DLIS.
Main Methods:
- A cohort study involving 34 individuals undergoing echocardiography was conducted.
- Echocardiographic parameters of cardiac dimensions and performance were assessed.
- Urinary DLIS, creatinine, and electrolyte concentrations were measured.
Main Results:
- Urinary DLIS levels varied, with a mean of 0.22 +/- 0.24 ng/ml.
- Bivariate analyses showed significant correlations between urinary DLIS and body weight, left ventricular end-diastolic dimension, left ventricular fractional shortening, and mitral inflow velocity.
- Multivariate analysis identified a significant independent association between urinary DLIS and left ventricular fractional shortening.
Conclusions:
- Urinary DLIS is related to cardiac performance under steady-state conditions.
- The findings suggest that DLIS may function as an endogenous ligand for cardiac glycoside receptors.
- Further research is warranted to elucidate the precise physiological role of DLIS in cardiovascular regulation.
Objective:
To determine the relation between urinary digoxin-like immunoreactive substance (DLIS) and cardiac performance.
Design:
Cohort study.
Setting:
Echocardiography laboratory of a university-affiliated teaching hospital.
Subjects:
Thirty-four individuals referred for echocardiographic studies who had never received cardiac glycosides or other substances known to cross-react with a digoxin radioimmunoassay and had no condition that has been associated with increased DLIS.
Measurements:
Cardiac dimensions and indices of cardiac performance derived from echocardiograms and cardiac Doppler flow studies and concentrations of urinary DLIS, creatinine, and electrolytes.
Results:
Urinary DLIS ranged from < 0.125 ng (digoxin equivalents) per milliliter (below the sensitivity of the assay) to 0.99 ng/ml, averaging 0.22 +/- 0.24 ng/ml. On bivariate analyses, UDLIS was found to correlate significantly with body weight, left ventricular (LV) end-diastolic dimension, LV fractional shortening, mitral transvalvular flow velocity following atrial systole, and urinary calcium. On multivariate analyses, the association between urinary DLIS (alone or adjusted for urinary creatinine) and LV fractional shortening emerged as the paramount independent relation.
Conclusion:
Urinary DLIS can be related to cardiac performance under steady-state conditions. This suggests that DLIS may be a ligand for a cardiac glycoside receptor.