Increased procollagen type i C-terminal peptide levels indicate diastolic dysfunction in end-stage renal disease patients undergoing maintenance dialysis therapy
Journal
Journal of the American Society of Echocardiography
Journal Volume
25
Journal Issue
8
Pages
895-901
Date Issued
2012
Author(s)
Yen-Wen Liu
Shih-I Chen
Chun-Shin Yang
Jyh-Hong Chen
Wei-Chuan Tsai
Abstract
Background: Cardiac dysfunction is common among patients with end-stage renal disease. The aim of this study was to explore the determinants of diastolic dysfunction in patients with end-stage renal disease on maintenance hemodialysis. Methods: Patients with asymptomatic end-stage renal disease undergoing hemodialysis underwent Doppler tissue imaging analysis and two-dimensional speckle-tracking echocardiography with strain analysis. Blood studies included albumin, cardiac troponin T, and procollagen type I C-terminal peptide (PICP). Results: All enrolled patients had left ventricular (LV) diastolic dysfunction and were stratified into two groups by a cutoff value of 13 for the ratio of early transmitral flow velocity to the average early diastolic annular velocity (E/e′). Seventy-two of the enrolled patients (87%) had grade 1 diastolic dysfunction, and 11 patients (13%) had higher grades of diastolic dysfunction. The study population did not include a representative sample of patients with the pseudonormal or restrictive filling patterns of diastolic dysfunction. There were no significant differences in gender, age, LV geometric change, ejection fraction, global systolic longitudinal strain and strain rate, and prevalence of comorbidities between groups. Patients with average E/e′ ? 13 had higher PICP, which was significantly correlated with cardiac troponin T, average E/e′, and systolic circumferential strain rate. By multivariate regression analysis, average E/e′ level was an independent factor of PICP level (P =.047). Conclusions: Hemodialysis patients with high average E/e′ ratios showed increased levels of LV filling pressure and higher severity levels of cardiac fibrosis, which occurred before the development of systolic dysfunction. PICP was a potential indicator of diastolic dysfunction and increased LV filling pressure. ? 2012 American Society of Echocardiography.
SDGs
Other Subjects
procollagen; procollagen type 1c terminal peptide; troponin T; unclassified drug; adult; aged; article; controlled study; diastolic dysfunction; disease severity; Doppler echocardiography; female; hemodialysis; human; kidney failure; major clinical study; male; protein blood level; Aged; Biological Markers; Female; Humans; Kidney Failure, Chronic; Male; Peptide Fragments; Procollagen; Renal Dialysis; Reproducibility of Results; Sensitivity and Specificity; Stroke Volume; Ventricular Dysfunction, Left
Type
journal article