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The shrunken pore syndrome is associated with declined right ventricular systolic function in a heart failure population – the HARVEST study

Christensson, Anders LU ; Grubb, Anders LU ; Molvin, John LU ; Holm, Hannes LU ; GRÄNSBO, KLAS LU ; Tasevska-Dinevska, Gordana LU ; Bachus, Erasmus LU ; Jujic, Amra LU and Magnusson, Martin LU (2016) In Scandinavian Journal of Clinical & Laboratory Investigation 76(7). p.568-574
Abstract

The close relationship between heart and kidney diseases was studied with respect to the ‘Shrunken pore syndrome’ that is characterized by a difference in renal filtration between cystatin C and creatinine. Patients were retrieved from the HeARt and brain failure inVESTigation trail (HARVEST) which is an ongoing study undertaken in individuals hospitalized for the diagnosis of heart failure. Ninety-five of 116 patients who underwent transthoracic echocardiograms (TTE) were eligible for this study. We used four different formulas for estimated glomerular filtration rate (eGFR); CKD-EPIcreatinine, CKD-EPIcystatin C, LMrev and CAPA. Presence of the syndrome was defined as eGFR cystatin C ≤ 60% of eGFR... (More)

The close relationship between heart and kidney diseases was studied with respect to the ‘Shrunken pore syndrome’ that is characterized by a difference in renal filtration between cystatin C and creatinine. Patients were retrieved from the HeARt and brain failure inVESTigation trail (HARVEST) which is an ongoing study undertaken in individuals hospitalized for the diagnosis of heart failure. Ninety-five of 116 patients who underwent transthoracic echocardiograms (TTE) were eligible for this study. We used four different formulas for estimated glomerular filtration rate (eGFR); CKD-EPIcreatinine, CKD-EPIcystatin C, LMrev and CAPA. Presence of the syndrome was defined as eGFR cystatin C ≤ 60% of eGFR creatinine and absence of the syndrome as eGFR cystatin C >90% and <110% of eGFR creatinine. In a linear regression model, adjusted for age and sex, and the ‘Shrunken pore syndrome’ defined by the equation pair CAPA and LMrev and the equation pair CKD-EPIcystatin C and CKD-EPIcreatinine, echocardiographic parameters were studied. The ‘Shrunken pore syndrome’ showed statistically significant associations with measurements of right ventricular (RV) systolic function; (TAPSE and RV S’) (according to the equation pair CKD-EPIcystatin C and CKD-EPIcreatinine). In conclusion, heart failure patients with the ‘Shrunken pore syndrome’ are at increased risk of having RV systolic dysfunction whilst heart failure patients without ‘Shrunken pore syndrome’ seem protected. These findings may indicate common pathophysiological events in the kidneys and the heart explaining the observed increased risk of mortality in subjects with the ‘Shrunken pore syndrome’.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardio-renal syndrome, creatinine, cystatin C, echocardiography, glomerular filtration rate
in
Scandinavian Journal of Clinical & Laboratory Investigation
volume
76
issue
7
pages
7 pages
publisher
Informa Healthcare
external identifiers
  • scopus:84987619247
  • wos:000385808700006
ISSN
0036-5513
DOI
10.1080/00365513.2016.1223338
language
English
LU publication?
yes
id
9a6de8bd-fb03-4f7d-bfbc-a8bef73fd5f7
date added to LUP
2016-10-21 11:22:59
date last changed
2017-09-16 00:01:00
@article{9a6de8bd-fb03-4f7d-bfbc-a8bef73fd5f7,
  abstract     = {<p>The close relationship between heart and kidney diseases was studied with respect to the ‘Shrunken pore syndrome’ that is characterized by a difference in renal filtration between cystatin C and creatinine. Patients were retrieved from the HeARt and brain failure inVESTigation trail (HARVEST) which is an ongoing study undertaken in individuals hospitalized for the diagnosis of heart failure. Ninety-five of 116 patients who underwent transthoracic echocardiograms (TTE) were eligible for this study. We used four different formulas for estimated glomerular filtration rate (eGFR); CKD-EPI<sub>creatinine</sub>, CKD-EPI<sub>cystatin C</sub>, LMrev and CAPA. Presence of the syndrome was defined as eGFR <sub>cystatin C</sub> ≤ 60% of eGFR <sub>creatinine</sub> and absence of the syndrome as eGFR <sub>cystatin C</sub> &gt;90% and &lt;110% of eGFR <sub>creatinine</sub>. In a linear regression model, adjusted for age and sex, and the ‘Shrunken pore syndrome’ defined by the equation pair CAPA and LMrev and the equation pair CKD-EPI<sub>cystatin C</sub> and CKD-EPI<sub>creatinine,</sub> echocardiographic parameters were studied. The ‘Shrunken pore syndrome’ showed statistically significant associations with measurements of right ventricular (RV) systolic function; (TAPSE and RV S’) (according to the equation pair CKD-EPI<sub>cystatin C</sub> and CKD-EPI<sub>creatinine</sub>). In conclusion, heart failure patients with the ‘Shrunken pore syndrome’ are at increased risk of having RV systolic dysfunction whilst heart failure patients without ‘Shrunken pore syndrome’ seem protected. These findings may indicate common pathophysiological events in the kidneys and the heart explaining the observed increased risk of mortality in subjects with the ‘Shrunken pore syndrome’.</p>},
  author       = {Christensson, Anders and Grubb, Anders and Molvin, John and Holm, Hannes and GRÄNSBO, KLAS and Tasevska-Dinevska, Gordana and Bachus, Erasmus and Jujic, Amra and Magnusson, Martin},
  issn         = {0036-5513},
  keyword      = {Cardio-renal syndrome,creatinine,cystatin C,echocardiography,glomerular filtration rate},
  language     = {eng},
  month        = {10},
  number       = {7},
  pages        = {568--574},
  publisher    = {Informa Healthcare},
  series       = {Scandinavian Journal of Clinical & Laboratory Investigation},
  title        = {The shrunken pore syndrome is associated with declined right ventricular systolic function in a heart failure population – the HARVEST study},
  url          = {http://dx.doi.org/10.1080/00365513.2016.1223338},
  volume       = {76},
  year         = {2016},
}