Biomarkers and echocardiography for evaluating the improvement of the ventricular diastolic function after surgical relief of hydronephrosis

Huei Ming Yeh, Ting Tse Lin, Chih Fan Yeh, Ho Shiang Huang, Sheng Nan Chang, Jou Wei Lin, Chia Ti Tsai, Ling Ping Lai, Yi You Huang, Chun Lin Chu

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

The pathophysiology of cardio-renal syndrome (CRS) is complex. Hydronephrosis caused by urolithiasis may cause cytokine release and lead to cardiac dysfunction. The aim of this study was to evaluate cardiac function changes observed in patients who received double J placement using feasible biomarkers and echocardiography. This was a prospective, single-center study. Eighty-seven patients who presented with acute unilateral hydronephrosis and received ureteroscope stone manipulation were enrolled. Echocardiography and cytokines were measured on the day of the operation and 24 hours after the procedure. Changes before and after surgery were assessed by the paired t-test and Wilcoxon test. Correlation analyses between echocardiographic diastolic indices and cytokine levels were performed using Pearson’s correlation coefficients. Patients with hydronephrosis showed a higher left atrium volume index (LAVI), decreased E’, and increased E/ E’ ratio, which indicated diastolic dysfunction. Patients with hydronephrosis also exhibited decreased global strain rates during isovolumetric relaxation (SRIVR) and E/ SRIVR, which confirmed the diastolic dysfunction. Significant reductions in LAVI, increases in SRIVR and decreases in E/ SRIVR were observed after the operation. Biomarkers, such as TGF-β and serum NT-proBNP, were significantly decreased after surgery. In addition, a significant correlation was observed between the post-surgical decrease in TGF-β1 and increase in SRIVR. Unilateral hydronephrosis causes cardiac diastolic dysfunction, and relieving hydronephrosis could improve diastolic function. Improvements in cardiac dysfunction can be evaluated by echocardiography and measuring cytokine levels. The results of this study will inform efforts to improve the early diagnosis of CRS and prevent further deterioration of cardiac function when treating patients with hydronephrosis.

Original languageEnglish
Article numbere0188597
JournalPloS one
Volume12
Issue number11
DOIs
Publication statusPublished - 2017 Nov

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Echocardiography
Ventricular Function
Hydronephrosis
echocardiography
Biomarkers
Strain rate
biomarkers
cytokines
Cytokines
Cardio-Renal Syndrome
cardiac output
Surgery
surgery
kidneys
Heart Atria
early diagnosis
Ureteroscopes
pathophysiology
Deterioration
Urolithiasis

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Yeh, Huei Ming ; Lin, Ting Tse ; Yeh, Chih Fan ; Huang, Ho Shiang ; Chang, Sheng Nan ; Lin, Jou Wei ; Tsai, Chia Ti ; Lai, Ling Ping ; Huang, Yi You ; Chu, Chun Lin. / Biomarkers and echocardiography for evaluating the improvement of the ventricular diastolic function after surgical relief of hydronephrosis. In: PloS one. 2017 ; Vol. 12, No. 11.
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abstract = "The pathophysiology of cardio-renal syndrome (CRS) is complex. Hydronephrosis caused by urolithiasis may cause cytokine release and lead to cardiac dysfunction. The aim of this study was to evaluate cardiac function changes observed in patients who received double J placement using feasible biomarkers and echocardiography. This was a prospective, single-center study. Eighty-seven patients who presented with acute unilateral hydronephrosis and received ureteroscope stone manipulation were enrolled. Echocardiography and cytokines were measured on the day of the operation and 24 hours after the procedure. Changes before and after surgery were assessed by the paired t-test and Wilcoxon test. Correlation analyses between echocardiographic diastolic indices and cytokine levels were performed using Pearson’s correlation coefficients. Patients with hydronephrosis showed a higher left atrium volume index (LAVI), decreased E’, and increased E/ E’ ratio, which indicated diastolic dysfunction. Patients with hydronephrosis also exhibited decreased global strain rates during isovolumetric relaxation (SRIVR) and E/ SRIVR, which confirmed the diastolic dysfunction. Significant reductions in LAVI, increases in SRIVR and decreases in E/ SRIVR were observed after the operation. Biomarkers, such as TGF-β and serum NT-proBNP, were significantly decreased after surgery. In addition, a significant correlation was observed between the post-surgical decrease in TGF-β1 and increase in SRIVR. Unilateral hydronephrosis causes cardiac diastolic dysfunction, and relieving hydronephrosis could improve diastolic function. Improvements in cardiac dysfunction can be evaluated by echocardiography and measuring cytokine levels. The results of this study will inform efforts to improve the early diagnosis of CRS and prevent further deterioration of cardiac function when treating patients with hydronephrosis.",
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Biomarkers and echocardiography for evaluating the improvement of the ventricular diastolic function after surgical relief of hydronephrosis. / Yeh, Huei Ming; Lin, Ting Tse; Yeh, Chih Fan; Huang, Ho Shiang; Chang, Sheng Nan; Lin, Jou Wei; Tsai, Chia Ti; Lai, Ling Ping; Huang, Yi You; Chu, Chun Lin.

In: PloS one, Vol. 12, No. 11, e0188597, 11.2017.

Research output: Contribution to journalArticle

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AU - Chang, Sheng Nan

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AU - Chu, Chun Lin

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