Abstract 2385: Cystatin C is Associated with Left Ventricular Mass Independent of Traditional Markers of Renal Function in a Multiethnic Population-based Sample: The Dallas Heart Study
Introduction: Cystatin C, a novel marker of renal function, has been associated with left ventricular (LV) hypertrophy and dysfunction in patients with coronary disease. We tested the hypothesis that cystatin C is associated with LV mass in a healthy population-based sample.
Methods: Cystatin C was measured in 3221 participants in the Dallas Heart Study, a multiethnic population based study involving patients 30 to 65 years of age. Glomerular filtration rate (GFR) was estimated by the MDRD equation. All subjects underwent MRI analysis of LV structure and function. The association of cystatin C with LV mass, LV mass/body surface area (BSA), LV end diastolic volume (LVEDV), concentricity (LV mass/LVEDV), LV wall thickness, and LVEF were evaluated by univariable and multivariable analyses.
Results: Cystatin C levels ranged from 0.46 to 6.55 mg/l. In univariable analyses, increasing levels of cystatin C correlated with higher LV mass, LV mass/BSA, LVEDV, concentricity, and wall thickness (see table⇓, p < 0.001), but not with LVEF. After adjustment for age, gender, race, diabetes, history of hypertension, systolic blood pressure, lean mass, fat mass, BNP, and estimated GFR, cystatin C remained associated with LV mass (p < 0.001), concentricity (p = 0.02), and LV wall thickness (p < 0.001), but not with LVEDV (p=0.09). Similarly significant results were found with adjustment for creatinine.
Conclusions: Higher levels of cystatin C were associated with increased LV mass and a concentric LVH phenotype. These findings were independent of potential confounding variables including standard measurements of renal function, supporting the hypothesis that cystatin C is more than simply a measure of renal function and may be an independent predictor of preclinical structural heart abnormalities.