Association of Cystatin C With Left Ventricular Structure and Function The Dallas Heart Study

Division of Cardiology, Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, TX 75390-9047, USA.
Circulation Heart Failure (Impact Factor: 5.89). 03/2009; 2(2):98-104. DOI: 10.1161/CIRCHEARTFAILURE.108.807271
Source: PubMed


Cystatin C, a novel marker of renal function, has been associated with heart failure and cardiovascular mortality in older individuals. We tested the hypothesis that cystatin C is associated with preclinical cardiac structural and functional abnormalities in a younger population-based sample.
The study included participants in the Dallas Heart Study (ages 30 to 65 years) who had measurements of cystatin C and cardiac MRI. The associations of cystatin C with left ventricular (LV) mass, LV end-systolic and -diastolic volumes, concentricity (LV mass/LV end-diastolic volume), LV wall thickness, and LV ejection fraction were evaluated. Cystatin C levels ranged from 0.46 to 6.55 mg/L. In univariable analyses, increasing levels of cystatin C correlated with higher LV mass, concentricity, and wall thickness (P<0.001), but not with LV end-systolic volume, LV end-diastolic volume, or LV ejection fraction. After adjustment with traditional covariates and estimated glomerular filtration rate by the modification of diet in renal disease formula, log-transformed cystatin C remained independently associated with LV mass (P<0.001), concentricity (P=0.027), and wall thickness (P<0.001). These associations persisted when creatinine or estimated glomerular filtration rate by the Cockcroft-Gault formula were included in the models.
Higher levels of cystatin C were associated with increased LV mass and a concentric LV hypertrophy phenotype. These findings were independent of potential confounding variables including standard measurements of renal function, supporting the hypothesis that cystatin C may be useful to identify individuals with preclinical structural heart abnormalities.

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Available from: Jody A Rule, Sep 29, 2015
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    • "First, CyC seems to be a better measure of kidney function than sCr and GFR [16] [24] [28]. Second, CyC may provide prognostic information beyond its role as an index of kidney function and, also, may be a better overall measure of the spectrum of pathophysiologic abnormalities that accompany kidney disease [29] [30] [31]. Table 2: Ideal marker of contrast-induced acute kidney injury. "
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    ABSTRACT: Biomarkers of acute kidney injury (AKI) may be classified in 2 groups: (1) those representing changes in renal function (e.g., serum creatinine or cystatin C and urine flow rate) and (2) those reflecting kidney damage (e.g., kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18, etc.). According to these 2 fundamental criteria, 4 subgroups have been proposed: (1) no marker change; (2) damage alone; (3) functional change alone; and (4) combined damage and functional change. Therefore, a new category of patients with "subclinical AKI" (that is, an increase in damage markers alone without simultaneous loss of kidney function) has been identified. This condition has been associated with higher risk of adverse outcomes (including renal replacement therapy and mortality) at followup. The ability to measure these physiological variables may lead to identification of patients at risk for AKI and early diagnosis of AKI and may lead to variables, which may inform therapeutic decisions.
    Full-text · Article · May 2014 · BioMed Research International
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    • "Thus, Cys C was used to evaluate renal function in the study. Although Cys C is less dependent on factors such as age, sex, race and body mass index when compared to creatinine-based GFR estimation, it can be affected by other factors such as body composition (lean mass), thyroid dysfunction, cancer and left ventricular mass [35-38]. It is possible that GFR –independent factors could account for decreases in serum cystatin in some individuals, but these factors were not apparent during the follow-up of our patients and were unlikely to account for the changes in serum cystatin C in the group as a whole. "
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    • "CystC has been recognized as a sensitive marker for potential renal dysfunction and injury and as an independent predictor of cardiac outcomes in patients with heart failure.85,86 High serum CystC levels are associated with increased left ventricular hypertrophy and dysfunction.87 A comparison of the serum levels of patients with AAA to those of patients with normal aortas showed decreased levels of serum CystC in the patients with AAA.48 "
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