Cardiac troponin T and malondialdehyde modified plasma lipids in haemodialysis patients.
Cardiac troponin T and malondialdehyde modified plasma lipids in haemodialysis patients.
复制标题
心肌肌钙蛋白 T 和丙二醛改变血液透析患者的血浆脂质。
DOI：
--
复制
发表时间：
2003
影响因子：
--
通讯作者：
D. Verbeelen
中科院分区：
文献类型：
--
作者：
B. Scott;A. Deman;P. Peeters;C. van den Branden;J. Stolear;G. Van Camp;D. Verbeelen
背景
BACKGROUND
In patients with end-stage renal disease (ESRD), treated with haemodialysis, a high overall mortality is observed. A previous study showed that cardiac troponin T (cTnT) is a strong independent predictor of outcome in this population. In this study we investigated possible causes of cTnT increase and its relationship with a marker of oxidative stress.
METHODS
In a group of 71 haemodialysis patients (36 male, 35 female, mean age 68.7+/-1.5 years) we determined cTnT and compared its presence with several biochemical parameters and with malondialdehyde (MDA), which is an indicator of oxidative stress. None of the patients suffered an acute coronary event during the observation period. Three measurements of cTnT and MDA were performed with a 2-week interval. Forty-nine patients underwent a transthoracic echocardiography.
RESULTS
Twenty-nine patients (or 40.8%) had a positive cTnT determination (defined as cTnT >/=0.10 ng/ml). cTnT positive patients had significantly higher levels of MDA (P=0.0125), C-reactive protein (CRP) (P=0.04) and pre-dialysis urea (P=0.04). Regression analysis showed that both pre-dialysis urea and MDA independently influenced cTnT. No correlation was found with age, dialysis adequacy, post-dialysis urea, total cholesterol, white blood cell count, fibrinogen or any of the echocardiographical parameters. Presence of heart failure, diabetes or use of medication could not discriminate between cTnT positive and cTnT negative patients. MDA levels correlated positively with time on haemodialysis (P=0.0021). Echocardiography showed left ventricular hypertrophy in 88% of the examined patients and impaired wall motion in 35%. Patients with clinical signs of heart failure had a lower ejection fraction and worse wall motion score index. No correlation existed between echocardiographic findings and cTnT or MDA. Survival was independently predicted by cTnT (P=0.0025), MDA (P=0.0007), CRP (P=0.006) and age (P=0.0143). Patients with both cTnT and CRP increase had a survival of <50% at 1 year, compared with 90% in patients with both cTnT and CRP within the normal range and 80% when either CRP or cTnT was increased (chi(2)=12.127; P=0.0023).
CONCLUSIONS
This study confirms that the presence of cTnT predicts prognosis in ESRD. The presence of cTnT is linked to oxidative stress, inflammation and uraemia. The absence of specific findings on EKG and echocardiography points towards subclinical myocardial damage caused by endothelial disturbances.
正常生理和尿毒症中一氧化氮的活性。
DOI：
--
发表时间：
1996
期刊：
Seminars in nephrology.
影响因子：
--
作者：
Blantz,RC;Lortie,M;Vallon,V;Gabbai,FB;Parmer,RJ;Thomson,S
通讯作者：
Thomson,S