TY - JOUR
T1 - Relations of biomarkers representing distinct biological pathways to left ventricular geometry
AU - Velagaleti, Raghava S.
AU - Gona, Philimon
AU - Levy, Daniel
AU - Aragam, Jayashri
AU - Larson, Martin G.
AU - Tofler, Geoffrey H.
AU - Lieb, Wolfgang
AU - Wang, Thomas J.
AU - Benjamin, Emelia J.
AU - Vasan, Ramachandran S.
PY - 2008/11/25
Y1 - 2008/11/25
N2 - Background - Several biological pathways are activated concomitantly during left ventricular (LV) remodeling. However, the relative contribution of circulating biomarkers representing these distinct pathways to LV geometry is unclear. Methods and Results - We evaluated 2119 Framingham Offspring Study participants (mean age, 57 years; 57% women) who underwent measurements of biomarkers of inflammation (C-reactive protein), hemostasis (fibrinogen and plasminogen activator inhibitor-1), neurohormonal activation (B-type natriuretic peptide), and renin-angiotensin-aldosterone system (aldosterone and renin modeled as a ratio [ARR]) and echocardiography at a routine examination. LV geometry was defined on the basis of sex-specific distributions of LV mass (LVM) and relative wall thickness (RWT): normal (LVM and RWT <80th percentile), concentric remodeling (LVM <80th percentile but RWT ≥80th percentile), eccentric hypertrophy (LVM ≥80th percentile but RWT <80th percentile), and concentric hypertrophy (LVM and RWT ≥80th percentile). We related the biomarker panel to LV geometry using polytomous logistic regression adjusting for clinical covariates and used backwards elimination to identify a parsimonious set of biomarkers associated with LV geometry. Modeled individually, C-reactive protein, fibrinogen, plasminogen activator inhibitor-1, and ARR were related to LV geometry (P<0.01). In multivariable analyses, the biomarker panel was significantly related to altered LV geometry (P<0.0001). On backwards elimination, logARR alone was significantly and positively associated with eccentric (odds ratio per SD increment, 1.20; 95% confidence interval, 1.05 to 1.37) and concentric LV hypertrophy (odds ratio per SD increment, 1.29; 95% confidence interval, 1.06 to 1.58). Conclusions - Our cross-sectional observations on a large community-based sample identified ARR as a key correlate of concentric and eccentric LV hypertrophy, consistent with a major role for the renin-angiotensin-aldosterone system in LV remodeling.
AB - Background - Several biological pathways are activated concomitantly during left ventricular (LV) remodeling. However, the relative contribution of circulating biomarkers representing these distinct pathways to LV geometry is unclear. Methods and Results - We evaluated 2119 Framingham Offspring Study participants (mean age, 57 years; 57% women) who underwent measurements of biomarkers of inflammation (C-reactive protein), hemostasis (fibrinogen and plasminogen activator inhibitor-1), neurohormonal activation (B-type natriuretic peptide), and renin-angiotensin-aldosterone system (aldosterone and renin modeled as a ratio [ARR]) and echocardiography at a routine examination. LV geometry was defined on the basis of sex-specific distributions of LV mass (LVM) and relative wall thickness (RWT): normal (LVM and RWT <80th percentile), concentric remodeling (LVM <80th percentile but RWT ≥80th percentile), eccentric hypertrophy (LVM ≥80th percentile but RWT <80th percentile), and concentric hypertrophy (LVM and RWT ≥80th percentile). We related the biomarker panel to LV geometry using polytomous logistic regression adjusting for clinical covariates and used backwards elimination to identify a parsimonious set of biomarkers associated with LV geometry. Modeled individually, C-reactive protein, fibrinogen, plasminogen activator inhibitor-1, and ARR were related to LV geometry (P<0.01). In multivariable analyses, the biomarker panel was significantly related to altered LV geometry (P<0.0001). On backwards elimination, logARR alone was significantly and positively associated with eccentric (odds ratio per SD increment, 1.20; 95% confidence interval, 1.05 to 1.37) and concentric LV hypertrophy (odds ratio per SD increment, 1.29; 95% confidence interval, 1.06 to 1.58). Conclusions - Our cross-sectional observations on a large community-based sample identified ARR as a key correlate of concentric and eccentric LV hypertrophy, consistent with a major role for the renin-angiotensin-aldosterone system in LV remodeling.
KW - Aldosterone
KW - Biological markers
KW - Echocardiography
KW - Hypertrophy
KW - Remodeling
KW - Renin
UR - http://www.scopus.com/inward/record.url?scp=57749186656&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=57749186656&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.108.817411
DO - 10.1161/CIRCULATIONAHA.108.817411
M3 - Article
C2 - 19001021
AN - SCOPUS:57749186656
SN - 0009-7322
VL - 118
SP - 2252
EP - 2258
JO - Circulation
JF - Circulation
IS - 22
ER -