Circulating osteoprotegerin as a cardiac biomarker for left ventricular diastolic dysfunction in patients with pre-dialysis chronic kidney disease: the KNOW-CKD study.

IF 3.8 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Clinical Research in Cardiology Pub Date : 2024-11-01 Epub Date: 2024-02-06 DOI:10.1007/s00392-024-02382-w
Sang Heon Suh, Tae Ryom Oh, Hong Sang Choi, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Kook-Hwan Oh, Ji Yong Jung, Young Youl Hyun, Soo Wan Kim
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Abstract

Background: Heart failure with preserved ejection fraction (HFpEF) is a major cause of mortality in patients with chronic kidney disease (CKD), and diagnosis is challenging. Moreover, no specific biomarker for HFpEF has been validated in patients with CKD. The present study aimed to investigate the association between serum osteoprotegerin (OPG) levels and the risk of left ventricular diastolic dysfunction (LVDD), a surrogate of HFpEF, in patients with pre-dialysis CKD.

Methods: A total of 2039 patients with CKD at stage 1 to pre-dialysis 5 were categorized into quartiles (Q1 to Q4) by serum OPG levels, and were cross-sectionally analyzed. The study outcome was LVDD, which was operationally defined as the ratio of early transmitral blood flow velocity to early diastolic velocity of the mitral annulus (E/e') > 14.

Results: In the analysis of baseline characteristics, higher serum OPG levels were clearly related to the risk factors of HFpEF. A scatter plot analysis revealed a moderate correlation between serum OPG levels and E/e' (R = 0.351, P < 0.001). Logistic regression analysis demonstrated that the risk of LVDD in Q3 (adjusted odds ratio 2.576, 95% confidence interval 1.279 to 5.188) and Q4 (adjusted odds ratio 3.536, 95% confidence interval 1.657 to 7.544) was significantly higher than that in Q1.

Conclusions: Elevated serum OPG levels are associated with the risk of LVDD in patients with pre-dialysis CKD. The measurement of serum OPG levels may help the diagnosis of LVDD, which is an important echocardiographic feature of HFpEF.

Abstract Image

循环骨蛋白gerin作为透析前慢性肾脏病患者左心室舒张功能障碍的心脏生物标志物:KNOW-CKD研究。
背景:射血分数保留型心力衰竭(HFpEF)是慢性肾脏病(CKD)患者死亡的主要原因,但诊断却很困难。此外,目前还没有针对 CKD 患者的 HFpEF 的特异性生物标志物得到验证。本研究旨在探讨透析前慢性肾脏病患者血清骨保护蛋白(OPG)水平与左心室舒张功能障碍(LVDD)风险之间的关系,而左心室舒张功能障碍是高频低氧血症的替代指标:根据血清OPG水平将2039名1期至透析前5期的CKD患者分为四等分(Q1至Q4),并进行横断面分析。研究结果为 LVDD,其操作定义为二尖瓣环早期透射血流速度与二尖瓣环早期舒张速度之比(E/e')> 14:在基线特征分析中,较高的血清 OPG 水平与 HFpEF 的风险因素明显相关。散点图分析显示,血清 OPG 水平与 E/e' 之间存在中度相关性(R = 0.351,P 结论:血清 OPG 水平升高与二尖瓣瓣环速度(E/e' > 14)之间存在中度相关性:血清 OPG 水平升高与透析前慢性肾脏病患者的低密度心血管病风险有关。血清 OPG 水平的测量有助于 LVDD 的诊断,而 LVDD 是 HFpEF 的一个重要超声心动图特征。
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来源期刊
Clinical Research in Cardiology
Clinical Research in Cardiology 医学-心血管系统
CiteScore
11.40
自引率
4.00%
发文量
140
审稿时长
4-8 weeks
期刊介绍: Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery. As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.
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