Association of cystatin C with changes of left ventricular structure and function in individuals with different cardiovascular risk

Abstract

Aim. This study aims to investigate the association of cystatin C with changes of left ventricular structure and function in individuals with different cardiovascular risk (CVR).Material and methods. 267 patients with low-moderate (group I, n=58), high (group II, n=80) and extremely high (group III, n=129) CVR were examined. The level of serum cystatin C, creatinine and blood lipid spectrum, filtration rate of the kidneys and echocardiography indicators were estimated.Results. Among all the study participants (n=267), 194 patients (72,6% of cases) had the increased level of serum cystatin C; 165 patients (61,7% of cases) showed the signs of the left ventricular hypertrophy (LVH). The increased level of serum cystatin C was observed in 51,7% of cases in group I; 75,0% — in group II and 80,6% — in group III. The values of glomerular filtration rate (GFR) calculated using the CKD-EPI and F. Hoek formula were the following: 100,2±17,0 ml/min/1,73 m2 and 84,8±15,5 ml/min/1,73 m2, p<0,05 in group I; 81,2±21,6 ml/min/1,73 m2 and 63,1±18,3 ml/min/1,73 m2, p<0,05 in group II; 63,0 (32,0;93,0) ml/min/1,73 m2 and 55,1 (22,1;70,7) ml/min/1,73 m2 — in group III. The LVH detection increased with the increase of the CVR degree (43,1% — in group I; 66,2% — in group II and 67,4% in group III). Relative wall thickness (RWT, units) increased significantly from the patients of group I (0,34±0,04 units) to the patients of group II (0,37±0,08 units) and III (0,38±0,06 units). Eccentric variant of LVH significantly prevailed in all the groups. On one side, it was found that the level of serum cystatin C was in direct correlation with left ventricular mass index (LVMI, r=0,268, p<0,05) and left ventricular RWT (r=0,190, p<0,05), and on the other side, the inverse relationship between LVMI and GFR for cystostatin C was observed (r=-0,324, p<0,05).Conclusion. The results of the study showed that the level of serum cystatin C and LVMI value significantly increase with the increase of the CVR degree. The high levels of serum cystatin C are closely associated with the increase of LVMI and the changes in the RWT value. In turn, the increase of LVMI negatively correlated with filtration rate of the kidneys in patients with different CVR. Concerning the structural changes in the left ventricle, eccentric HLV prevailed in all the three groups.