Serum Cystatin C levels were significantly elevated in PAH patients compared to controls (1.00 vs 0.78 mg/L, P=0.001) and correlated with right ventricular pressure, function, and morphology.
Case-Control (n=24)
Does serum Cystatin C correlate with right ventricular morphology, function, and pressure in patients with pulmonary arterial hypertension?
Cystatin C is elevated in patients with pulmonary arterial hypertension and correlates significantly with right ventricular pressure, function, and morphology, suggesting its potential utility as a novel biomarker.
Absolute Event Rate: 1% vs 0.78%
p-value: p=0.001
BACKGROUND AND OBJECTIVE: Cystatin C (CysC), a novel marker of renal function, predicts left heart failure and cardiovascular mortality. The hypothesis that serum CysC levels correlate with right ventricular (RV) morphology, function and pressure in pulmonary arterial hypertension (PAH) was tested. METHODS: As part of a prospective study, 14 PAH subjects and 10 matched controls underwent same-day echocardiography, cardiac magnetic resonance imaging (CMR), and phlebotomy for CysC, brain natriuretic peptide (BNP), and N-terminal BNP (NT-ProBNP). RV ejection fraction (RVEF), end-diastolic volume, end-systolic volume and mass were calculated using CMR. RV systolic pressure (RVSP), strain and diastolic function (including tricuspid valve (TV) E velocity, A velocity, e' velocity, E/A ratio and E/e' ratio) were assessed using echocardiography. RESULTS: RVSP was significantly elevated in PAH subjects versus controls (57 ± 17 vs. 28 ± 8 mm Hg, P < 0.0001). CysC was abnormally elevated in the PAH cohort when compared with controls (1.00 ± 0.23 vs 0.78 ± 0.05 mg/L, P = 0.001). CysC positively correlated with RVSP (rho 0.61, P = 0.002), RV end-diastolic volume (rho 0.50, P = 0.01), RV end-systolic volume (rho 0.58, P = 0.003), mass index (rho 0.66, P = 0.0004), strain (rho 0.51, P = 0.01) and strain rate (rho 0.51, P = 0.01) and negatively correlated with RVEF (rho -0.58, P = 0.003) and TV e' (rho -0.75, P < 0.0001). The same correlations with BNP and NT-ProBNP were comparable with CysC. CONCLUSIONS: In a small cohort, CysC accurately correlates with RV pressure, function and morphology. CysC may represent a novel PAH biomarker.
Fenster et al. (Fri,) conducted a case-control in Pulmonary arterial hypertension (n=24). Cystatin C assessment vs. Matched controls was evaluated on Serum Cystatin C levels (mg/L) (p=0.001). Serum Cystatin C levels were significantly elevated in PAH patients compared to controls (1.00 vs 0.78 mg/L, P=0.001) and correlated with right ventricular pressure, function, and morphology.