Association of Kidney Tubule Biomarkers With Cardiac Structure and Function in the Multiethnic Study of Atherosclerosis

• Published in: The American journal of cardiology 2023-06, Vol.196, p.11-18
• Main Authors: Wettersten, Nicholas, Katz, Ronit, Greenberg, Jason H., Gutierrez, Orlando M., Lima, Joao A.C., Sarnak, Mark J., Schrauben, Sarah, Deo, Rajat, Bonventre, Joseph, Vasan, Ramachandran S., Kimmel, Paul L., Shlipak, Michael, Ix, Joachim H.
• Format: Article
• Language: English
• Subjects: Abnormalities; Aged; Albuminuria - complications; Arteriosclerosis; Atherosclerosis; Atherosclerosis - complications; Biomarkers; Blood pressure; Body mass index; Cardiovascular disease; Cardiovascular Diseases; Chitinase; Creatinine; Diabetes; Diabetes mellitus; Epidermal growth factor receptors; Female; Glomerular Filtration Rate; Heart; Heart diseases; Humans; Inflammation; Kidney diseases; Kidney Tubules; Kidneys; Magnetic resonance imaging; Male; Middle Aged; Monocyte chemoattractant protein; Monocyte chemoattractant protein 1; Monocytes; Plasma; Proteins; Receptors; Receptors, Urokinase Plasminogen Activator; Renal Insufficiency, Chronic - complications; Risk factors; Statistical analysis; Stroke Volume; Structure-function relationships; Tumor necrosis factor-TNF; U-Plasminogen activator; Urine; Urokinase; Ventricle; Ventricular Function, Left
• ISSN: 0002-9149; 1879-1913; 1879-1913
• DOI: 10.1016/j.amjcard.2023.02.031

Markers of glomerular disease, estimated glomerular filtration rate (eGFR) and albuminuria, are associated with cardiac structural abnormalities and incident cardiovascular disease (CVD). We aimed to determine whether biomarkers of kidney tubule injury, function, and systemic inflammation are associated with cardiac structural abnormalities. Among 393 Multi-Ethnic Study of Atherosclerosis participants without diabetes, CVD, or chronic kidney disease, we assessed the association of 12 biomarkers of kidney tubule injury, function, and systemic inflammation with the left ventricular mass/volume ratio (LVmvr) and left ventricular ejection fraction (LVEF) on cardiac magnetic resonance imaging using linear regression. The average age was 60 ± 10 years; 48% were men; mean eGFR was 96±16 ml/min/1.73 m2; mean LVmvr was 0.93±0.18 g/ml, and mean LVEF was 62±6%. Each twofold greater concentration of plasma soluble urokinase plasminogen activator receptor was associated with a 0.04 g/ml (95% confidence interval [CI] 0.01 to 0.08 g/ml) higher LVmvr and 2.1% (95% CI 0.6 to 3.5%) lower LVEF, independent of risk factors for CVD, eGFR, and albuminuria. Each twofold greater plasma monocyte chemoattractant protein 1 was associated with higher LVmvr with a similar coefficient to that of plasma soluble urokinase plasminogen activator receptor. Each twofold greater concentration of plasma chitinase-3-like protein 1 and urine alpha-1-microglobulin was associated with a 1.1% (95% CI 0.4 to 1.7%) and 1.2% (95% CI 0.2 to 2.2%) lower LVEF, respectively. In conclusion, abnormal kidney tubule health may lead to cardiac dysfunction above and beyond eGFR and albuminuria.