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Original Articles

Association of Cystatin C With Left Ventricular Structure and Function

The Dallas Heart Study

Parag C. Patel, MD; Colby R. Ayers, MS; Sabina A. Murphy, MPH; Ronald Peshock, MD; Amit Khera, MD, MSc; James A. de Lemos, MD; Jody A. Balko, MSc; Sachin Gupta, MD; Pradeep P.A. Mammen, MD; Mark H. Drazner, MD, MSc and David W. Markham, MD

From the Division of Cardiology (P.C.P., R.P., A.K., J.A.L., J.A.B., S.G., P.P.A.M., M.H.D., D.W.M.), Donald W. Reynolds Cardiovascular Clinical Research Center (C.R.A., R.P., A.K., J.A.L., M.H.D. D.W.M.), University of Texas Southwestern Medical Center, Dallas, Tex; and Brigham and Women’s Hospital (S.A.M.), Boston, Mass.

Correspondence to David W. Markham, MD, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, HA9.133, Dallas, TX 75390-9047. E-mail David.Markham{at}utsouthwestern.edu

Received July 16, 2008; accepted December 3, 2008.

Background— 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.

Methods and Results— 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.

Conclusions— 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.

Key Words: cystatin C • concentricity • left ventricular hypertrophy • hypertension • renal function • Dallas Heart Study

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CLINICAL PERSPECTIVE

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

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				M. D. McMurray, J. E. Trivax, and P. A. McCullough Serum Cystatin C, Renal Filtration Function, and Left Ventricular Remodeling Circ Heart Fail, March 1, 2009; 2(2): 86 - 89. [Full Text] [PDF]