Document Detail


Endogenous ouabain and cardiomyopathy in dialysis patients.
MedLine Citation:
PMID:  18070001     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND METHODS: Endogenous ouabain (EO) is markedly raised in patients with chronic renal failure. As high EO induces myocardial cell hypertrophy in vitro and it is associated with left ventricular hypertrophy (LVH) in essential hypertensives and in patients with heart failure we investigated the relationship between plasma EO and LV mass and geometry in 156 end-stage renal disease (ESRD) patients. EO was measured by a specific radioimmunoassay and by mass spectrometry. RESULTS: On univariate analysis, plasma EO was directly related to LV mass (r = 0.26, P = 0.001) and LV end diastolic volume (r = 0.25, P = 0.002) and these relationships held true in multiple linear regression models including a series of potential confounders. Patients with eccentric LVH (n = 41, i.e. 26%) had the highest plasma levels of EO when compared to patients with other patterns of LV geometry (P = 0.001). Furthermore, plasma EO had diagnostic value for eccentric LVH because the area under the corresponding ROC curve (68%) was significantly greater (P = 0.002) than the threshold of diagnostic indifference. In this analysis, the sensitivity was 91% and the specificity was 36%. The positive predictive value was 33% but EO had a remarkably high negative predictive value (92%) for the exclusion of eccentric hypertrophy. CONCLUSIONS: In ESRD patients, plasma EO is independently associated with LV mass, LV volume and eccentric LVH. The results of this study are compatible with the hypothesis that EO is involved in alterations of LV mass in ESRD.
Authors:
P Stella; P Manunta; F Mallamaci; M Melandri; D Spotti; G Tripepi; J M Hamlyn; L S Malatino; G Bianchi; C Zoccali
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2007-12-07
Journal Detail:
Title:  Journal of internal medicine     Volume:  263     ISSN:  1365-2796     ISO Abbreviation:  J. Intern. Med.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-14     Completed Date:  2008-04-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904841     Medline TA:  J Intern Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  274-80     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Dialysis, and Hypertension, University 'Vita e Salute', San Raffaele Hospital, Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biological Markers / blood
Blood Pressure / physiology
Cohort Studies
Female
Humans
Hypertrophy, Left Ventricular / blood*,  etiology,  ultrasonography*
Kidney Failure, Chronic / blood*,  complications,  ultrasonography
Male
Middle Aged
Ouabain / blood*
Predictive Value of Tests
Renal Dialysis*
Ventricular Remodeling / physiology
Grant Support
ID/Acronym/Agency:
HL 075584/HL/NHLBI NIH HHS; HL 078870/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 630-60-4/Ouabain

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