Association of Cystatin C With Poor Exercise Capacity and Heart Rate Recovery: Data From the Heart and Soul Study

McManus, David D.; Shlipak, Michael G.; Ix, Joachim H.; Ali, Sadia; Whooley, Mary A.

doi:10.1053/j.ajkd.2006.12.016

Cited by 20 publications

(12 citation statements)

References 31 publications

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“…Either of these mechanisms in isolation, or in concert, may account for these associations. Second, we have previously demonstrated that kidney dysfunction is associated with lower heart rate recovery after exercise testing, and heart rate recovery is an established marker of cardiovascular autonomic function 15. Since autonomic signaling in the left atrium and pulmonary veins is thought to be a key factor in the initiation and maintenance of AF, kidney dysfunction may lead to AF through its association with altered autonomic tone 16.…”

Section: Discussionmentioning

confidence: 99%

Relation of Kidney Function and Albuminuria With Atrial Fibrillation (from the Heart and Soul Study)

McManus

Corteville

Shlipak

et al. 2009

The American Journal of Cardiology

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Atrial fibrillation (AF) is common in end-stage renal disease (ESRD), but the relationship between more modest decrements in kidney function or albuminuria with AF is uncertain. Among 956 outpatients with coronary heart disease (CHD), we assessed kidney function by 3 methods (cystatin C-based [eGFR cys ] and creatinine-based [eGFR Cr ] estimated glomerular filtration rate, and urinary albumin-to-creatinine ratio [ACR]) and prevalent AF by surface electrocardiogram. Multivariable logistic regression evaluated the associations of each measure of kidney function with AF. The mean eGFR cys was 71 ± 23 ml/min/1.73m 2 and median ACR was 10 mg/g (interquartile range 6 -19 mg/ g). Forty subjects (4%) had prevalent AF. Compared to participants with eGFR cys in the highest tertile (eGFR cys > 79), those with eGFR cys in the lowest tertile (eGFR cys < 62) had more than 3-fold greater odds of AF (OR 3.43; 95% CI 1.18 -9.97) after multivariate adjustment for traditional CVD risk factors. This association remained significant with further adjustment for ACR (OR 3.37; 95% 1.02 -11.14). Results were similar for eGFR Cr , but did not reach statistical significance (OR 1.59; 95% CI 0.57 -4.40). Participants with ACR in the highest tertile (ACR > 15 mg/g) had more than 4-fold greater odds of AF compared to participants in the lowest ACR tertile (ACR < 7 mg/g); an association that remained significant after adjustment for eGFR cys (OR 4.36; 95% CI 1.45 -13.05) or eGFR Cr (OR 4.61; 95% CI 1.56 -13.66). In conclusion, among outpatients with CHD, lower eGFR cys and higher ACR are each associated with prevalent AF, independent of one another.

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Section: Discussionmentioning

confidence: 99%

Relation of Kidney Function and Albuminuria With Atrial Fibrillation (from the Heart and Soul Study)

McManus

Corteville

Shlipak

et al. 2009

The American Journal of Cardiology

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“…Furthermore, the proportion of participants with poor exercise capacity was 45% among those with cystatin C concentration in the highest quartile (>1.3 mg/L) compared with 12% among those in the lowest quartile (<0.92mg/L, adjusted OR 3.2; 95%CI 1.6 to 6.5, p=0.001). 13 Leikis and colleagues also demonstrated 14 that as renal function declined over 2 years, there was a corresponding decrease in exercise performance even when hemoglobin was maintained.…”

Section: Physical Functioning and Frailty In Ckdmentioning

confidence: 98%

Consequences of CKD on Functioning

Kittiskulnam

Sheshadri

Johansen

2016

Seminars in Nephrology

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CKD is highly prevalent in the U.S. and throughout the world,1 with approximately 13% of adults affected.2 In addition, according to recent estimates, almost half of patients with CKD stage 3-5 are 70 years of age or older.2 In the United States, the number of prevalent ESRD cases continues to rise in patients aged over 65. In light of the demographic characteristics of patients with CKD and ESRD, there has been considerable focus on associations between CKD and cardiovascular outcomes.3 Until recently, less attention had been paid to other consequences of CKD in general and among older individuals with CKD in particular, but there is now solid evidence linking CKD with impairments of physical function, cognitive function, and emotional function and quality of life. This review will summarize available literature on these topics, focusing specifically on physical functioning and frailty; cognitive function; emotional health, including depression and anxiety; and health-related quality of life.

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“…These relationships between cardiovascular disease and increased CysC concentrations have been described both in cohorts or sub-groups of patients selected on the basis of a past history of cardiovascular disease (216,217,219,221,225,226) and in patients without cardiovascular history (220, 222-224, 228, 229). Some also consider that increased CysC values may be associated with morphological cardiac abnormalities, such as left ventricular hypertrophy or left ventricular dysfunction on echocardiography (228), functional abnormalities, such as heart failure (230), or poor exercise tolerance (231). In all of these studies, the association between cardiovascular disease and CysC appeared to be stronger than with creatinine or GFR estimation algorithms based on creatinine.…”

Section: Future Perspectives For Cysc Applications Cysc As a Cardiovamentioning

confidence: 99%

Cystatin C: current position and future prospects

Séronie-Vivien

Delanaye

Piéroni³

et al. 2008

Clinical Chemistry and Laboratory Medicine

164

145

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Cystatin C is a low-molecular-weight protein which has been proposed as a marker of renal function that could replace creatinine. Indeed, the concentration of cystatin C is mainly determined by glomerular filtration and is particularly of interest in clinical settings where the relationship between creatinine production and muscle mass impairs the clinical performance of creatinine. Since the last decade, numerous studies have evaluated its potential use in measuring renal function in various populations. More recently, other potential developments for its clinical use have emerged. This review summarises current knowledge about the physiology of cystatin C and about its use as a renal marker, either alone or in equations developed to estimate the glomerular filtration rate. This paper also reviews recent data about the other applications of cystatin C, particularly in cardiology, oncology and clinical pharmacology. Clin Chem Lab Med 2008;46:1664-86.

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Association of Cystatin C With Poor Exercise Capacity and Heart Rate Recovery: Data From the Heart and Soul Study

Cited by 20 publications

References 31 publications

Relation of Kidney Function and Albuminuria With Atrial Fibrillation (from the Heart and Soul Study)

Relation of Kidney Function and Albuminuria With Atrial Fibrillation (from the Heart and Soul Study)

Consequences of CKD on Functioning

Cystatin C: current position and future prospects

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