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Erschienen in: Zeitschrift für Gerontologie und Geriatrie 1/2018

20.05.2016 | Original Contribution

Association between cystatin C and heart failure with preserved ejection fraction in elderly Chinese patients

verfasst von: M.D. C. C. Xu, M.D. Ph.D. G. X. Fu, M.D. Q. Q. Liu, M.D. Y. Zhong

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 1/2018

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Abstract

Background

Approximately 50 % of patients with heart failure have a preserved ejection fraction (HFpEF). Cystatin C has been reported to be associated with cardiovascular events. This study was carried out to investigate whether cystatin C is associated with cardiac function and cardiac diastolic properties in elderly Chinese HFpEF patients.

Material and methods

A cross-sectional study of 381 elderly Chinese HFpEF patients (81 women, average age 82 ± 6 years) was conducted. Serum concentrations of cystatin C and the New York Heart Association (NYHA) classification were assessed and early (E) to late (A) transmitral flow velocity ratios (E/A ratio) were measured to assess cardiac diastolic properties.

Results

Cystatin C levels, N‑terminal pro brain natriuretic peptide (NT-proBNP) levels and age were significantly correlated to the NYHA class (r = 0.605 P < 0.001, r = 0.333 P < 0.001 and r = 0.254 P < 0.001, respectively). Cystatin C levels, age and body mass index (BMI) were negatively correlated to the E/A ratio (r = −0.224 P = 0.005, r = −0.258 P = 0.001 and r = −0.258 P = 0.003, respectively). The patients with cystatin C concentrations below 1.3 mg/l had a higher E/A ratio compared to those with cystatin C concentrations higher than 1.3 mg/l. Cystatin C was also significantly associated with both the NYHA classification and the E/A ratio even after adjustment for the creatinine clearance rate (CCr).

Conclusion

Both cystatin C and NT-proBNP were found to be correlated to the NYHA classification. Independent of renal function, higher serum concentrations of cystatin C were associated with a worse NYHA classification and abnormal cardiac diastolic properties in elderly Chinese HFpEF patients.
Literatur
1.
Zurück zum Zitat Zile MR, Gaasch WH, Anand IS, Haass M, Little WC, Miller AB, Lopez-Sendon J, Teerlink JR, White M, McMurray JJ, Komajda M, McKelvie R, Ptaszynska A, Hetzel SJ, Massie BM, Carson PE, I‑Preserve Investigators (2010) Mode of death in patients with heart failure and a preserved ejection fraction: Results from the Irbesartan in Heart Failure With Preserved Ejection Fraction Study (I-Preserve) trial. Circulation 121:1393–1405 CrossRefPubMed Zile MR, Gaasch WH, Anand IS, Haass M, Little WC, Miller AB, Lopez-Sendon J, Teerlink JR, White M, McMurray JJ, Komajda M, McKelvie R, Ptaszynska A, Hetzel SJ, Massie BM, Carson PE, I‑Preserve Investigators (2010) Mode of death in patients with heart failure and a preserved ejection fraction: Results from the Irbesartan in Heart Failure With Preserved Ejection Fraction Study (I-Preserve) trial. Circulation 121:1393–1405 CrossRefPubMed
2.
Zurück zum Zitat Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM (2006) Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med 355(3):251–259 CrossRefPubMed Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM (2006) Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med 355(3):251–259 CrossRefPubMed
3.
Zurück zum Zitat Yancy CW, Lopatin M, Stevenson LW, De Marco T, Fonarow GC (2006) ADHERE Scientific Advisory Committee and Investigators: Clinical presentation, management, and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function: A report from the Acute Decompensated Heart Failure National Registry (ADHERE) Database. J Am Coll Cardiol 47:76–84 CrossRefPubMed Yancy CW, Lopatin M, Stevenson LW, De Marco T, Fonarow GC (2006) ADHERE Scientific Advisory Committee and Investigators: Clinical presentation, management, and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function: A report from the Acute Decompensated Heart Failure National Registry (ADHERE) Database. J Am Coll Cardiol 47:76–84 CrossRefPubMed
4.
Zurück zum Zitat Mogensen UM, Ersbøll M, Andersen M, Andersson C, Hassager C, Torp-Pedersen C, Gustafsson F, Køber L (2011) Clinical characteristics and major comorbidities in heart failure patients more than 85 years of age compared with younger age groups. Eur J Heart Fail 13:1216–1223 CrossRefPubMed Mogensen UM, Ersbøll M, Andersen M, Andersson C, Hassager C, Torp-Pedersen C, Gustafsson F, Køber L (2011) Clinical characteristics and major comorbidities in heart failure patients more than 85 years of age compared with younger age groups. Eur J Heart Fail 13:1216–1223 CrossRefPubMed
5.
Zurück zum Zitat Andersson SE, Edvinsson ML, Björk J, Edvinsson L (2008) High NTproBNP is a strong predictor of outcome in elderly heart failure patients. Am J Geriatr Cardiol 17:13–20 CrossRefPubMed Andersson SE, Edvinsson ML, Björk J, Edvinsson L (2008) High NTproBNP is a strong predictor of outcome in elderly heart failure patients. Am J Geriatr Cardiol 17:13–20 CrossRefPubMed
6.
Zurück zum Zitat Lassus J, Harjola VP, Sund R, Siirilä-Waris K, Melin J, Peuhkurinen K, Pulkki K, Nieminen MS (2007) FINN-AKVA Study group: Prognostic value of Cystatin-C in acute heart failure in relation to other markers of renal function and NT-proBNP. Eur Heart J 28:1841–1847 CrossRefPubMed Lassus J, Harjola VP, Sund R, Siirilä-Waris K, Melin J, Peuhkurinen K, Pulkki K, Nieminen MS (2007) FINN-AKVA Study group: Prognostic value of Cystatin-C in acute heart failure in relation to other markers of renal function and NT-proBNP. Eur Heart J 28:1841–1847 CrossRefPubMed
7.
Zurück zum Zitat Deo R, Shlipak MG, Ix JH, Ali S, Schiller NB, Whooley MA (2009) Association of Cystatin C with Ischemia in Patients with Coronary Heart Disease. Clin Cardiol 32(11):E18–E22 CrossRefPubMedPubMedCentral Deo R, Shlipak MG, Ix JH, Ali S, Schiller NB, Whooley MA (2009) Association of Cystatin C with Ischemia in Patients with Coronary Heart Disease. Clin Cardiol 32(11):E18–E22 CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Galderisi M (2005) Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects. Cardiovasc Ultrasound 4:3–9 Galderisi M (2005) Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects. Cardiovasc Ultrasound 4:3–9
9.
Zurück zum Zitat Bonow RO, Ganiats TG, Beam CT, Blake K, Casey DE Jr, Goodlin SJ, Grady KL, Hundley RF, Jessup M, Lynn TE, Masoudi FA, Nilasena D, Piña IL, Rockswold PD, Sadwin LB, Sikkema JD, Sincak CA, Spertus J, Torcson PJ, Torres E, Williams MV, Wong JB (2012) American College of Cardiology Foundation: ACCF/AHA/AMA-PCPI 2011 Performance Measures for Adults With Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association – Task Force on Performance Measures and the American Medical Association – Physician Consortium for Performance Improvement. Circulation 125:2382–2401 CrossRefPubMed Bonow RO, Ganiats TG, Beam CT, Blake K, Casey DE Jr, Goodlin SJ, Grady KL, Hundley RF, Jessup M, Lynn TE, Masoudi FA, Nilasena D, Piña IL, Rockswold PD, Sadwin LB, Sikkema JD, Sincak CA, Spertus J, Torcson PJ, Torres E, Williams MV, Wong JB (2012) American College of Cardiology Foundation: ACCF/AHA/AMA-PCPI 2011 Performance Measures for Adults With Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association – Task Force on Performance Measures and the American Medical Association – Physician Consortium for Performance Improvement. Circulation 125:2382–2401 CrossRefPubMed
10.
Zurück zum Zitat Dovjak P (2013) Diastolic heart failure: heart failure with preserved ejection fraction. Z Gerontol Geriatr 46:71–79 (quiz 80–81) CrossRefPubMed Dovjak P (2013) Diastolic heart failure: heart failure with preserved ejection fraction. Z Gerontol Geriatr 46:71–79 (quiz 80–81) CrossRefPubMed
11.
Zurück zum Zitat Raphael C, Briscoe C, Davies J, Whinnett IZ, Manisty C, Sutton R, Mayet J, Francis DP (2007) Limitations of the New York Heart Association functional classification system and self-reported walking distances in chronic heart failure. Heart 93(4):476–482 CrossRefPubMed Raphael C, Briscoe C, Davies J, Whinnett IZ, Manisty C, Sutton R, Mayet J, Francis DP (2007) Limitations of the New York Heart Association functional classification system and self-reported walking distances in chronic heart failure. Heart 93(4):476–482 CrossRefPubMed
12.
Zurück zum Zitat Baptista JP, Udy AA, Sousa E, Pimentel J, Wang L, Roberts JA, Lipman J (2011) A comparison of estimates of glomerular filtration in critically ill patients with augmented renal clearance. Crit Care 15(3):R139 CrossRefPubMedPubMedCentral Baptista JP, Udy AA, Sousa E, Pimentel J, Wang L, Roberts JA, Lipman J (2011) A comparison of estimates of glomerular filtration in critically ill patients with augmented renal clearance. Crit Care 15(3):R139 CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelisa A (2009) Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr 10:165–193 CrossRefPubMed Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelisa A (2009) Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr 10:165–193 CrossRefPubMed
14.
Zurück zum Zitat Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM (2006) Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med 355:251–259 CrossRefPubMed Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM (2006) Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med 355:251–259 CrossRefPubMed
15.
Zurück zum Zitat Collerton J, Kingston A, Yousaf F, Davies K, Kenny A, Neely D, Martin-Ruiz C, MacGowan G, Robinson L, Kirkwood TB, Keavney B (2014) Utility of NT-proBNP as a rule-out test for left ventricular dysfunction in very old people with limiting dyspnoea: the Newcastle 85+ Study. Cardiovasc Disord 26:14:128 CrossRef Collerton J, Kingston A, Yousaf F, Davies K, Kenny A, Neely D, Martin-Ruiz C, MacGowan G, Robinson L, Kirkwood TB, Keavney B (2014) Utility of NT-proBNP as a rule-out test for left ventricular dysfunction in very old people with limiting dyspnoea: the Newcastle 85+ Study. Cardiovasc Disord 26:14:128 CrossRef
16.
Zurück zum Zitat Lam CS, Donal E, Kraigher-Krainer E, Vasan RS (2011) Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur J Heart Fail 13(1):18–28 CrossRefPubMed Lam CS, Donal E, Kraigher-Krainer E, Vasan RS (2011) Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur J Heart Fail 13(1):18–28 CrossRefPubMed
17.
Zurück zum Zitat Sakata Y, Ohtani T, Takeda Y, Yamamoto K, Mano T (2013) Left ventricular stiffening as therapeutic target for heart failure with preserved ejection fraction. Circ J 77:886–892 CrossRefPubMed Sakata Y, Ohtani T, Takeda Y, Yamamoto K, Mano T (2013) Left ventricular stiffening as therapeutic target for heart failure with preserved ejection fraction. Circ J 77:886–892 CrossRefPubMed
18.
Zurück zum Zitat Khouri SJ, Maly GT, Suh DD, Walsh TE (2004) A practical approach to the echocardiographic evaluation of diastolic function. J Am Soc Echocardiogr 17(3):290–297 CrossRefPubMed Khouri SJ, Maly GT, Suh DD, Walsh TE (2004) A practical approach to the echocardiographic evaluation of diastolic function. J Am Soc Echocardiogr 17(3):290–297 CrossRefPubMed
19.
Zurück zum Zitat Hayley BD, Burwash IG (2012) Heart failure with normal left ventricular ejection fraction: role of echocardiography. Curr Opin Cardiol 27:169–180 CrossRefPubMed Hayley BD, Burwash IG (2012) Heart failure with normal left ventricular ejection fraction: role of echocardiography. Curr Opin Cardiol 27:169–180 CrossRefPubMed
21.
Zurück zum Zitat Wu J, Yu SY, Wo D, Zaho MM, Zhang LJ, Li J (2015) Risks and predictors of mild diastolic dysfunction among middle-aged and aged women: a population-based cohort study. J Hum Hypertens 10:e2015.85 Wu J, Yu SY, Wo D, Zaho MM, Zhang LJ, Li J (2015) Risks and predictors of mild diastolic dysfunction among middle-aged and aged women: a population-based cohort study. J Hum Hypertens 10:e2015.85
22.
Zurück zum Zitat Akasheva DU, Plokhova EV, Tkacheva ON, Strazhesko ID, Dudinskaya EN, Kruglikova AS, Pykhtina VS, Brailova NV, Pokshubina IA, Sharashkina NV, Agaltsov MV, Skvortsov D, Boytsov SA (2015) Age-Related Left Ventricular Changes and Their Association with Leukocyte Telomere Length in Healthy People. PLoS ONE 10(8):e0135883 CrossRefPubMedPubMedCentral Akasheva DU, Plokhova EV, Tkacheva ON, Strazhesko ID, Dudinskaya EN, Kruglikova AS, Pykhtina VS, Brailova NV, Pokshubina IA, Sharashkina NV, Agaltsov MV, Skvortsov D, Boytsov SA (2015) Age-Related Left Ventricular Changes and Their Association with Leukocyte Telomere Length in Healthy People. PLoS ONE 10(8):e0135883 CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Sarnak MJKRS-BCOFLFJNSPBMNABSDSMG, Study CH (2005) Cystatin C concentration as a risk factor for heart failure in older adults. Ann Intern Med 142:497–505 CrossRefPubMed Sarnak MJKRS-BCOFLFJNSPBMNABSDSMG, Study CH (2005) Cystatin C concentration as a risk factor for heart failure in older adults. Ann Intern Med 142:497–505 CrossRefPubMed
24.
Zurück zum Zitat Galderisi M, Cicala S, Caso P, De Simone L, D’Errico A, Petrocelli A, de Divitiis O (2002) Coronary flow reserve and myocardial diastolic dysfunction in arterial hypertension. Am J Cardiol 90:860–864 CrossRefPubMed Galderisi M, Cicala S, Caso P, De Simone L, D’Errico A, Petrocelli A, de Divitiis O (2002) Coronary flow reserve and myocardial diastolic dysfunction in arterial hypertension. Am J Cardiol 90:860–864 CrossRefPubMed
25.
Zurück zum Zitat Gökkuşu CA, Ozden TA, Gül H, Yildiz A (2005) Relationship between plasma cystatin C and creatinine in chronic renal diseases and Tx-transplant patients. Clin Biochem 37:94–97 CrossRef Gökkuşu CA, Ozden TA, Gül H, Yildiz A (2005) Relationship between plasma cystatin C and creatinine in chronic renal diseases and Tx-transplant patients. Clin Biochem 37:94–97 CrossRef
26.
Zurück zum Zitat Doganer YC, Aydogan U, Aparci M, Nerkiz P, Barcin C, Cayci T, Sari O (2014) Comparison of cystatin-C and pentraxin-3 in coronary atherosclerosis. Coron Artery Dis 25(7):589–594 CrossRefPubMed Doganer YC, Aydogan U, Aparci M, Nerkiz P, Barcin C, Cayci T, Sari O (2014) Comparison of cystatin-C and pentraxin-3 in coronary atherosclerosis. Coron Artery Dis 25(7):589–594 CrossRefPubMed
27.
Zurück zum Zitat Tang WH, Dupont M, Hernandez AF, Voors AA, Hsu AP, Felker GM, Butler J, Metra M, Anker SD, Troughton RW, Gottlieb SS, McMurray JJ, Armstrong PW, Massie BM, Califf RM, O’Connor CM, Starling RC (2015) Comparative assessment of short-term adverse events in acute heart failure with cystatin C and other estimates of renal function: results from the ASCEND-HF trial. JACC Heart Fail 3(1):40–49 CrossRefPubMed Tang WH, Dupont M, Hernandez AF, Voors AA, Hsu AP, Felker GM, Butler J, Metra M, Anker SD, Troughton RW, Gottlieb SS, McMurray JJ, Armstrong PW, Massie BM, Califf RM, O’Connor CM, Starling RC (2015) Comparative assessment of short-term adverse events in acute heart failure with cystatin C and other estimates of renal function: results from the ASCEND-HF trial. JACC Heart Fail 3(1):40–49 CrossRefPubMed
28.
Zurück zum Zitat Sanders-van WS, van Empel V, Davarzani N, Maeder MT, Handschin R, Pfisterer ME, Brunner-La RHP (2015) investigators T‑C: Circulating biomarkers of distinct pathophysiological pathways in heart failure with preserved vs. reduced left ventricular ejection fraction. Eur J Heart Fail 17:1006–1014 CrossRef Sanders-van WS, van Empel V, Davarzani N, Maeder MT, Handschin R, Pfisterer ME, Brunner-La RHP (2015) investigators T‑C: Circulating biomarkers of distinct pathophysiological pathways in heart failure with preserved vs. reduced left ventricular ejection fraction. Eur J Heart Fail 17:1006–1014 CrossRef
Metadaten
Titel
Association between cystatin C and heart failure with preserved ejection fraction in elderly Chinese patients
verfasst von
M.D. C. C. Xu
M.D. Ph.D. G. X. Fu
M.D. Q. Q. Liu
M.D. Y. Zhong
Publikationsdatum
20.05.2016
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 1/2018
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-016-1058-5