Key result
Elevated 24-hour urinary marinobufagenin excretion was positively associated with left ventricular mass in the highest quartile (β = 0.15; P = 0.043), with the relationship evident only in women.
Why the study?
Does elevated marinobufagenin excretion associate with early structural cardiac changes in young healthy adults?
Cross-Sectional (n=711)
Does elevated marinobufagenin excretion associate with early structural cardiac changes in young healthy adults?
Effect estimate: β = 0.15
p-value: p=0.043
Elevated marinobufagenin excretion is independently associated with increased left ventricular mass in young healthy adults, particularly in women, suggesting a role in early structural cardiac changes.
Hypothesis-generating for sex-specific early remodeling in healthy youth; leaves open causal role and clinical relevance.
Background The endogenous steroidal inhibitor of sodium–potassium-dependent adenosine triphosphate and natriuretic hormone, marinobufagenin, plays a physiological role in ionic homeostasis. Animal models suggest that elevated marinobufagenin adversely associates with cardiac and renal, structural and functional alterations. It remains uncertain whether marinobufagenin relates to the early stages of target organ damage development, especially in young adults without cardiovascular disease. We therefore explored whether elevated 24-hour urinary marinobufagenin excretion was related to indices of subclinical target organ damage in young healthy adults. Design This cross-sectional study included 711 participants from the African-PREDICT study (black 51%, men 42%, 24.8 ± 3.02 years). Methods We assessed cardiac geometry and function by two-dimensional echocardiography and pulse wave Doppler imaging. 24-Hour urinary marinobufagenin and sodium excretion were measured, and the estimated glomerular filtration rate determined. Results Across marinobufagenin excretion quartiles, left ventricular mass ( P < 0.001), end diastolic volume ( P < 0.001), stroke volume ( P = 0.004) and sodium excretion ( P < 0.001) were higher within the fourth compared with the first quartile. Partial regression analyses indicated that left ventricular mass ( r = 0.08, P = 0.043), end diastolic volume ( r = 0.10, P = 0.010) and stroke volume ( r = 0.09, P = 0.022) were positively related to marinobufagenin excretion. In multivariate-adjusted regression analysis, left ventricular mass associated positively with marinobufagenin excretion only in the highest marinobufagenin excretion quartile (adjusted R2 = 0.20; β = 0.15; P = 0.043). This relationship between left ventricular mass and marinobufagenin excretion was evident in women (adjusted R2 = 0.06; β = 0.127; P = 0.015) but not in men (adjusted R2 = 0.06; β = 0.007; P = 0.92). Conclusions Left ventricular mass positively and independently associates with marinobufagenin excretion in young healthy adults with excessively high marinobufagenin excretion. Women may be more sensitive to the effects of marinobufagenin on early structural cardiac changes.
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Strauss‐Kruger et al. (2018) conducted a cross-sectional in young healthy adults without cardiovascular disease (n=711). 24-hour urinary marinobufagenin excretion vs. lower marinobufagenin excretion was evaluated on left ventricular mass (β = 0.15, p=0.043). Elevated 24-hour urinary marinobufagenin excretion was positively associated with left ventricular mass in the highest quartile (β = 0.15; P = 0.043), with the relationship evident only in women.
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