Utility of Cardiac Biomarkers in the Setting of Kidney Disease

Savoj, Javad; Becerra, Brian; Kim, Jin K.; Fusaro, Maria; Gallieni, Maurizio; Lombardo, Dawn; Lau, Wei Ling

doi:10.1159/000495946

Cited by 31 publications

(29 citation statements)

References 56 publications

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“…Recently, Gal-3 has been indicated to be involved in the following broad pathological processes: Inflammation [9], fibrosis, cell-to-cell [10,11] or cell-to-matrix [12] contacts, cell proliferation [13,14], and protection from apoptosis [15,16]. Furthermore, many studies have revealed that Gal-3 expression is detected in many disease conditions, such as heart disease [17][18][19][20][21][22][23], kidney disease [24][25][26][27], diabetes mellitus [24,25,28], viral infection [29][30][31][32], autoimmune disease [33][34][35][36], neurodegenerative disorders [37][38][39][40][41][42], and tumor formation [43][44][45][46][47][48][49][50][51][52].…”

Section: Clinical Significance and Applications Of Galectine-3 (Gal-3)mentioning

confidence: 99%

“…It is plausible that cardiovascular disease (CVD) and chronic kidney disease (CKD) are closely interrelated with each other, and patients with CKD have a strong risk of CVD [115,116]. It is well known that CKD is prevalent in patients with CVD and responsible for approximately half of all CKD-related deaths [26]. Thus, patients with end-stage CKD are at much higher risk of mortality due to CVD.…”

Section: Cardiovascular Disease and Chronic Kidney Diseasementioning

confidence: 99%

“…As mentioned earlier in Section 3, "Gal-3 and heart disease", Gal-3 is detected in cases of myofibroblast proliferation, fibrogenesis, tissue repair and myocardial remodeling, and is also associated with kidney fibrosis and increased risk of CKD. The wide tissue distribution of Gal-3 expression associated with fibrosis in both heart disease and kidney disease complicates the utility of Gal-3 as a cardiac biomarker in CKD patients [26].…”

Section: Cardiovascular Disease and Chronic Kidney Diseasementioning

confidence: 99%

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Galectin-3 as a Next-Generation Biomarker for Detecting Early Stage of Various Diseases

et al. 2020

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Galectin-3 is a β-galactoside-binding lectin which is important in numerous biological activities in various organs, including cell proliferation, apoptotic regulation, inflammation, fibrosis, and host defense. Galectin-3 is predominantly located in the cytoplasm and expressed on the cell surface, and then often secreted into biological fluids, like serum and urine. It is also released from injured cells and inflammatory cells under various pathological conditions. Many studies have revealed that galectin-3 plays an important role as a diagnostic or prognostic biomarker for certain types of heart disease, kidney disease, viral infection, autoimmune disease, neurodegenerative disorders, and tumor formation. In particular, it has been recognized that galectin-3 is extremely useful for detecting many of these diseases in their early stages. The purpose of this article is to review and summarize the recent literature focusing on the biomarker characteristics and long-term outcome predictions of galectin-3, in not only patients with various types of diseases, but associated animal models.

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Section: Clinical Significance and Applications Of Galectine-3 (Gal-3)mentioning

confidence: 99%

Section: Cardiovascular Disease and Chronic Kidney Diseasementioning

confidence: 99%

Section: Cardiovascular Disease and Chronic Kidney Diseasementioning

confidence: 99%

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Galectin-3 as a Next-Generation Biomarker for Detecting Early Stage of Various Diseases

et al. 2020

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“…Impairment of maximal exercise performance is well-established in CKD [1][2][3], but less is known about its determinants. Elevated troponin T has been shown to be associated with increased cardiovascular mortality in end stage kidney disease (ESKD) [4][5][6]. The Food and Drug Administration has approved the use of troponin T (TnT) for identifying high mortality risk in CKD patients [5].…”

Section: Introductionmentioning

confidence: 99%

“…The Food and Drug Administration has approved the use of troponin T (TnT) for identifying high mortality risk in CKD patients [5]. N-terminal pro-B-type natriuretic peptide (proBNP) elevation may occur in CKD independent of heart failure [4], but usually re ects underlying heart disease such as left ventricular hypertrophy or coronary atherosclerosis [7,8]. proBNP has been associated with cardiovascular events and cardiovascular mortality in CKD [9].…”

Section: Introductionmentioning

confidence: 99%

Maximal Stress Ergometry Performance is Associated with Troponin T and Abdominal Aortic Calcification Score in Severe Chronic Kidney Disease

Lankinen¹,

Hakamäki²,

Metsärinne³

et al. 2020

Preprint

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Background Cardiac biomarkers Troponin T (TnT) and N-terminal pro-B-type natriuretic peptide (proBNP) and abdominal aortic calcification score (AAC) are associated with cardiovascular events and mortality in patients with chronic kidney disease (CKD). The effects of cardiac biomarkers and AAC on maximal exercise capacity in CKD are unknown and were studied. Methods 174 CKD 4-5 patients not on maintenance dialysis underwent maximal bicycle ergometry stress testing, lateral lumbar radiograph to study AAC, echocardiography and biochemical assessments. Results The subjects with proportional maximal ergometry workload (WMAX%) less than 50% of the expected values had higher TnT, proBNP, AAC, left ventricular end-diastolic diameter, left ventricular mass index, E/e’ and pulse pressure, and lower global longitudinal strain compared to the better performing patients. TnT (β= -0.09, p=0.02), AAC (β= -1.67, p<0.0001) and diabetes (β= -11.07, p<0.0001) remained significantly associated with WMAX% in the multivariable model. Maximal ergometry workload (in Watts) was similarly associated with TnT and AAC in addition to age, male gender, hemoglobin and diastolic blood pressure in a respective multivariate model. AAC and TnT showed fair predictive power for WMAX% less than 50% of the expected value with AUCs of 0.70 and 0.75, respectivelyConclusions TnT and AAC are independent determinants of maximal ergometry stress test workload in patients with advanced CKD.http://www.ClinicalTrials.gov NCT04223726

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Sacubitril/valsartan in patients with heart failure with reduced ejection fraction with end‐stage of renal disease

Lee

Kim

et al. 2020

ESC Heart Failure

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Aims Sacubitril/valsartan (SV) reduced heart failure hospitalization and cardiovascular mortality compared with enalapril in the Prospective Comparison of ARNI with ACE-I to Determine Impact on Global Mortality and Morbidity in Heart Failure trial. However, this trial excluded patients with end stage of renal disease (ESRD); thus, the efficacy and safety of SV in heart failure with reduced ejection fraction (HFrEF) with ESRD remains uncertain. Methods and resultsWe retrospectively analysed the clinical and laboratory data of 501 HFrEF patients who administered with SV from March 2017 to April 2019 in a single tertiary university hospital. A total of 23 HFrEF patients with ESRD on dialysis [58.3% non-ischaemic heart failure; left ventricular ejection fraction (LVEF): 29.7 ± 4.4%] were included in this study. At baseline and follow-up visit, we evaluated cardiovascular biomarkers such as high-sensitive troponin T (hsTnT), soluble ST2 (sST2), echocardiographic parameters, and clinical and adverse events. The mean dose of SV was 90 ± 43 mg/day at baseline and 123 ± 62 mg/day at last follow-up (follow-up duration: median 132 days). The level of hsTnT was significantly reduced from 236.2 ± 355.3 to 97.0 ± 14.0 pg/mL (P = 0.002), and the sST2 level was significantly reduced from 40.4 ± 44.0 to 19.6 ± 14.1 ng/mL (P = 0.005). LVEF was significantly improved from 29.7 ± 4.4% to 40.8 ± 10.4% (P = 0.002). During the follow-up, up-titration, down-titration, and maintenance of SV dosing were observed in 7 (30%), 5 (21.7%), and 11 patients (47.8%), respectively. SV down-titration group had adverse events including symptomatic hypotension (systolic blood pressure <100 mmHg) (n = 4) and dizziness (n = 1), but they did not discontinue SV therapy. Conclusions We found that SV could safely reduce the hsTnT and sST2 levels and improve LVEF in HFrEF patients with ESRD. As far as we know, this is the first study to show the efficacy and safety of SV in HFrEF with ESRD on dialysis. Larger prospective, long-term follow-up study should be warranted.

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Utility of Cardiac Biomarkers in the Setting of Kidney Disease

Cited by 31 publications

References 56 publications

Galectin-3 as a Next-Generation Biomarker for Detecting Early Stage of Various Diseases

Galectin-3 as a Next-Generation Biomarker for Detecting Early Stage of Various Diseases

Maximal Stress Ergometry Performance is Associated with Troponin T and Abdominal Aortic Calcification Score in Severe Chronic Kidney Disease

Sacubitril/valsartan in patients with heart failure with reduced ejection fraction with end‐stage of renal disease

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