Nosaka Kazumasa, Nakamura Kazufumi, Kusano Kengo, Toh Norihisa, Tada Takeshi, Miyoshi Toru, Doi Masayuki, Kohno Kunihisa, Morita Hiroshi, Ito Hiroshi
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Congest Heart Fail. 2013 Jul-Aug;19(4):E35-9. doi: 10.1111/chf.12039.
Diastolic dysfunction of the heart is correlated with cardiac mortality. Serum cystatin C (CysC) is an endogenous marker of kidney function. It is not clear whether serum CysC is associated with diastolic dysfunction in patients with varying cardiac conditions with concomitant diastolic abnormalities and preserved ejection fraction (EF). The authors measured serum CysC levels in patients with cardiac diseases and examined the relationships between serum CysC levels and diastolic function. Serum CysC was measured and echocardiography was performed in 124 consecutive patients with cardiac diseases. Transmitral flow (TMF) patterns surrogating diastolic function were categorized into two groups: a normal group and an abnormal group. Serum CysC and BNP showed a significant positive correlation. There were no significant differences in serum CysC among those cardiac diseases. Seventy-eight patients with cardiac disease and preserved EF (left ventricular EF ≥50%) and without renal dysfunction (estimated glomerular filtration rate ≥60 mL/minute/1.73 m(2) ) were examined. Multivariate linear regression analysis demonstrated that left atrium diameter and abnormal TMF patterns were independent determinants of serum CysC. Furthermore, patients with elevated serum CysC levels had poor prognosis. Serum CysC is associated with diastolic dysfunction in patients with various cardiac diseases and preserved EF. Serum CysC might be a biomarker of cardiac diastolic dysfunction in patients with preserved EF.
心脏舒张功能障碍与心脏死亡率相关。血清胱抑素C（CysC）是肾功能的内源性标志物。目前尚不清楚血清CysC是否与伴有舒张功能异常且射血分数（EF）保留的不同心脏疾病患者的舒张功能障碍有关。作者测量了心脏病患者的血清CysC水平，并研究了血清CysC水平与舒张功能之间的关系。对124例连续的心脏病患者测量了血清CysC水平并进行了超声心动图检查。代表舒张功能的二尖瓣血流（TMF）模式分为两组：正常组和异常组。血清CysC与脑钠肽（BNP）呈显著正相关。这些心脏病患者的血清CysC水平无显著差异。对78例EF保留（左心室EF≥50%）且无肾功能不全（估计肾小球滤过率≥60 mL/分钟/1.73 m²）的心脏病患者进行了检查。多变量线性回归分析表明，左心房直径和异常的TMF模式是血清CysC的独立决定因素。此外，血清CysC水平升高的患者预后较差。血清CysC与各种心脏病且EF保留的患者的舒张功能障碍有关。血清CysC可能是EF保留患者心脏舒张功能障碍的生物标志物。
