Cardiac Biomarkers and Left Ventricular Hypertrophy in Asymptomatic Hemodialysis Patients

Reneta Yovcheva Koycheva; Vasil Cholakov; Jivko Andreev; Margarit Penev; Rosen Iliev; Krasimira Nancheva; Vanya Tsoneva

doi:10.3889/oamjms.2016.011

Authors

Reneta Yovcheva Koycheva Department of Nephrology, University Hospital "Prof. Dr. Stoyan Kirkovich", Stara Zagora
Vasil Cholakov Department of Nephrology, University Hospital "Prof. Dr. Stoyan Kirkovich", Stara Zagora
Jivko Andreev Department of Nephrology, University Hospital "Prof. Dr. Stoyan Kirkovich", Stara Zagora
Margarit Penev Department of Nephrology, University Hospital "Prof. Dr. Stoyan Kirkovich", Stara Zagora
Rosen Iliev Department of Nephrology, University Hospital "Prof. Dr. Stoyan Kirkovich", Stara Zagora
Krasimira Nancheva Department of Nephrology, University Hospital "Prof. Dr. Stoyan Kirkovich", Stara Zagora
Vanya Tsoneva Department of Nephrology, University Hospital "Prof. Dr. Stoyan Kirkovich", Stara Zagora

DOI:

https://doi.org/10.3889/oamjms.2016.011

Keywords:

hemodialysis, cardiac troponin T, natriuretic peptide, C-reactive protein, left ventricular hypertrophy

Abstract

BACKGROUND: Cardiac biomarkers are often elevated in dialysis patients showing the presence of left ventricular dysfunction. The aim of the study is to establish the plasma levels of high-sensitivity cardiac troponin T (hs TnT), precursor of B-natriuretic peptide (NT-proBNP) and high sensitivity C-reactive protein (hs CRP) and their relation to the presence of left ventricular hypertrophy (LVH) in patients undergoing hemodialysis without signs of acute coronary syndrome or heart failure.

MATERIAL AND METHODS: Were studied 48 patients - 26 men and 22 women. Pre and postdialysis levels of hs cTnT, NT-proBNP and hs CRP were measured at week interim procedure. Patients were divided in two groups according to the presence of echocardiographic evidence of LVH - gr A - 40 patients (with LVH), and gr B - 8 patients (without LVH).

RESULTS: In the whole group of patients was found elevated predialysis levels of all three biomarkers with significant increase (p < 0.05) after dialysis with low-flux dialyzers. Predialysis values of NT-proBNP show moderate positive correlation with hs cTnT (r = 0.47) and weaker with hs CRP (r = 0.163). Such dependence is observed in postdialysis values of these biomarkers. There is a strong positive correlation between the pre and postdialysis levels: for hs cTnT (r = 0.966), for NT-proBNP (r = 0.918) and for hs CRP (r = 0.859). It was found a significant difference in the mean values of hs cTnT in gr. A and gr. B (0.07 Â± 0.01 versus 0.03 Â± 0.01 ng /mL, p < 0.05) and NT-proBNP (15,605.8 Â± 2,072.5 versus 2,745.5 Â± 533.55 pg /mL, p < 0.05). Not find a significant difference in hs CRP in both groups.

CONCLUSIONS: The results indicate the relationship of the studied cardiac biomarkers with LVH in asymptomatic patients undergoing hemodialysis treatment.

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