Increased procollagen type i C-terminal peptide levels indicate diastolic dysfunction in end-stage renal disease patients undergoing maintenance dialysis therapy

Chi Ting Su, Yen Wen Liu, Jou Wei Lin, Shih I. Chen, Chun Shin Yang, Jyh Hong Chen, Kuan Yu Hung, Wei Chuan Tsai, Jenq Wen Huang

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Background: Cardiac dysfunction is common among patients with end-stage renal disease. The aim of this study was to explore the determinants of diastolic dysfunction in patients with end-stage renal disease on maintenance hemodialysis. Methods: Patients with asymptomatic end-stage renal disease undergoing hemodialysis underwent Doppler tissue imaging analysis and two-dimensional speckle-tracking echocardiography with strain analysis. Blood studies included albumin, cardiac troponin T, and procollagen type I C-terminal peptide (PICP). Results: All enrolled patients had left ventricular (LV) diastolic dysfunction and were stratified into two groups by a cutoff value of 13 for the ratio of early transmitral flow velocity to the average early diastolic annular velocity (E/e′). Seventy-two of the enrolled patients (87%) had grade 1 diastolic dysfunction, and 11 patients (13%) had higher grades of diastolic dysfunction. The study population did not include a representative sample of patients with the pseudonormal or restrictive filling patterns of diastolic dysfunction. There were no significant differences in gender, age, LV geometric change, ejection fraction, global systolic longitudinal strain and strain rate, and prevalence of comorbidities between groups. Patients with average E/e′ ≥ 13 had higher PICP, which was significantly correlated with cardiac troponin T, average E/e′, and systolic circumferential strain rate. By multivariate regression analysis, average E/e′ level was an independent factor of PICP level (P =.047). Conclusions: Hemodialysis patients with high average E/e′ ratios showed increased levels of LV filling pressure and higher severity levels of cardiac fibrosis, which occurred before the development of systolic dysfunction. PICP was a potential indicator of diastolic dysfunction and increased LV filling pressure.

Original languageEnglish
Pages (from-to)895-901
Number of pages7
JournalJournal of the American Society of Echocardiography
Volume25
Issue number8
DOIs
Publication statusPublished - 2012 Aug

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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