on February 10, 2009
Published online before print February 10, 2009, doi: 10.1161/CIRCHEARTFAILURE.108.807271
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Original Article |
Association of Cystatin C with Left Ventricular Structure and Function: The Dallas Heart Study
1 UT Southwestern Medical Center;
2 Brigham and Women's Hospital
3 E-mail: david.markham{at}utsouthwestern.edu
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 magnetic resonance imaging. The associations of cystatin C with LV mass, LV end systolic and diastolic volumes (LVESV and LVEDV), concentricity (LV mass/LVEDV), LV wall thickness, and LVEF 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 LVESV, LVEDV, or LVEF. After adjustment with traditional covariates and estimated glomerular filtration rate (GFR) 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 GFR 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 LVH 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: concentricity • cystatin C • Dallas Heart Study • left ventricular hypertrophy • renal function
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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]
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